Septic arthritis : It is also known as joint infection or infectious arthritis. In this, there is inflammation of joints due to the invasion of a joint by an infectious agent. Osteomyelitis : It is an infection of bone which is caused by staphylococcus bacteria which can be found in the nose or skin in healthy individuals.
Meningitis : It is inflammation of meninges in which the membranes covering the brain and spinal cord get inflamed. It occurs due to infection which can be caused by bacteria or viruses. Dysentery : It is inflammation of the intestine, particularly colon which is caused by bacteria Shigella. However, some may experience side effects such as nausea, vomiting, stomach pain, dizziness, headache, dryness in the mouth, metallic taste and heartburn. If you take it in more than the recommended dose, it might cause unpleasant side effects.
If you think your symptoms are not improving, please consult your doctor. Your symptoms might get improved with time but it is advised to complete the full course of treatment. However, if it is time to take the next dose, skip the missed dose and continue with the next dose. While we strive to provide complete, accurate, and expert-reviewed content on our 'Platform', we make no warranties or representations and disclaim all responsibility and liability for the completeness, accuracy, or reliability of the aforementioned content.
Reliance on any information and subsequent action or inaction is solely at the user's risk, and we do not assume any responsibility for the same. The content on the Platform should not be considered or used as a substitute for professional and qualified medical advice. Upload Special offers. Interruption of breastfeeding is recommended during tinidazole therapy and for 3 days following the last dose.
Although effective in clinical trials, ciprofloxacin is not a drug of first choice in the paediatric population due to an increased incidence of adverse reactions compared with controls. Quinolones, including ciprofloxacin, cause arthropathy arthralgia, arthritis , in juvenile animals.
Geriatric patients are at increased risk for developing severe tendon disorders including tendon rupture when being treated with a fluoroquinolone such as ciprofloxacin. This risk is further increased in patients receiving concomitant corticosteroid therapy. Tendinitis or tendon rupture can involve the Achillestendon, hand, shoulder, or other tendon sites and can occur during or after completion of therapy; cases occurring up to several months after fluoroquinolone treatment have been reported.
Caution should be used when prescribing ciprofloxacin to elderly patients especially those on corticosteroids. Patients should be informed of this potential adverse reaction and advised to discontinue ciprofloxacin and contact their healthcare provider if any symptoms of tendinitis or tendon rupture occur.
No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals on any drug therapy cannot be ruled out.
Ciprofloxacin is known to be substantially excreted by the kidneys, and the risk of adverse reactions may be greater in patients with impaired renal function. However, since some older individuals experience reduced renal function by virtue of their advanced age, care should be taken in dose selection for elderly patients, and renal function monitoring may be useful in these patients. In general, elderly patients may be more susceptible to drug-associated effects on the QT interval.
Therefore, precaution should be taken when using ciprofloxacin with concomitant drugs that can result in prolongation of the QT interval e. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Ciprofloxacin is eliminated primarily by renal excretion; however, the drug is also metabolised and partially cleared through the biliary system of the liver and through the intestine.
These alternative pathways of drug elimination appear to compensate for the reduced renal excretion in patients with renal impairment.
Nonetheless, some modification of dosage is recommended, particularly for patients with severe renal dysfunction. Patients Undergoing Haemodialysis: If tinidazole is administered on the same day as and prior to haemodialysis, it is recommended that an additional dose of tinidazole equivalent to one-half of the recommended dose be administered after the end of the haemodialysis.
In preliminary studies in patients with stable chronic liver cirrhosis, no significant changes in ciprofloxacin pharmacokinetics have been observed.
The pharmacokinetics of ciprofloxacin in patients with acute hepatic insufficiency has not been studied. There are no data on tinidazole pharmacokinetics in patients with impaired hepatic function.
Reduced elimination of metronidazole, a chemically-related nitroimidazole, has been reported in this population. Usual recommended doses of tinidazole should be administered cautiously in patients with hepatic dysfunction.
Due to its neurological effects, ciprofloxacin may affect reaction time. Thus, the ability to drive or to operate machinery may be impaired. Drugs of similar chemical structure, including tinidazole, have been associated with various neurological disturbances such as dizziness, vertigo, ataxia, peripheral neuropathy paraesthesia, sensory disturbances, hypoesthesia and rarely convulsions. If any abnormal neurological signs develop during tinidazole therapy, the drug should be discontinued.
The following serious and otherwise important adverse drug reactions are discussed in greater detail in other sections of the labelling:. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
During clinical investigations with oral and parenteral ciprofloxacin, 49, patients received courses of the drug. The most frequently reported adverse reactions, from clinical trials of all formulations, all dosages, all drug-therapy durations, and for all indications of ciprofloxacin therapy were nausea 2.
In randomised, double-blind, controlled clinical trials comparing ciprofloxacin tablets with cefuroxime axetil — mg BID and with clarithromycin mg BID in patients with respiratory tract infections, ciprofloxacin demonstrated a CNS adverse reaction profile comparable with the control drugs. The duration of therapy was 10—21 days mean duration of treatment was 11 days, with a range of 1—88 days.
A total of ciprofloxacin- and comparator-treated patients were enrolled. An Independent Paediatric Safety Committee IPSC reviewed all cases of musculoskeletal adverse reactions, including abnormal gait or abnormal joint exam baseline or treatment-emergent. Within 6 weeks of treatment initiation, the rates of musculoskeletal adverse reactions were 9. All musculoskeletal adverse reactions occurring by 6 weeks resolved clinical resolution of signs and symptoms , usually within 30 days of end of treatment.
Radiological evaluations were not routinely used to confirm resolution of the adverse reactions. Ciprofloxacin-treated patients were more likely to report more than one adverse reaction and on more than one occasion compared with control patients. The rate of musculoskeletal adverse reactions was consistently higher in the ciprofloxacin group compared with the control group across all age subgroups.
At the end of 1 year, the rate of these adverse reactions reported at any time during that period was Serious adverse reactions were seen in 7. Short-term safety data for ciprofloxacin was also collected in a randomised, double-blind, clinical trial for the treatment of acute pulmonary exacerbations in cystic fibrosis patients aged 5—17 years. Periodic musculoskeletal assessments were conducted by treatment-blinded examiners.
Patients were followed for an average of 23 days after completing treatment range, 0—93 days. Other adverse reactions were similar in nature and frequency between treatment arms. The efficacy of ciprofloxacin for the treatment of acute pulmonary exacerbations in paediatric cystic fibrosis patients has not been established. In addition to the adverse reactions reported in paediatric patients in clinical trials, it should be expected that adverse reactions reported in adults during clinical trials or postmarketing experience may also occur in paediatric patients.
The following adverse reactions have been reported from worldwide marketing experience with fluoroquinolones, including ciprofloxacin.
Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Haematologic: eosinophilia, leucopaenia, decreased blood platelets, elevated blood platelets, pancytopaenia.
Renal: elevations of serum creatinine, BUN, crystalluria, cylindruria, and haematuria have been reported. Other changes occurring were as follows: elevation of serum gammaglutamyl transferase, elevation of serum amylase, reduction in blood glucose, elevated uric acid, decrease in haemoglobin, anaemia, bleeding diathesis, increase in blood monocytes, and leucocytosis.
The drug may cause low blood sugar and mental health-related side effects. Low blood sugar levels, also called hypoglycaemia, can lead to coma. The mental health side effects more prominent and more consistent across the systemic fluoroquinolone drug class are as mentioned below;. Among 3, patients treated with a single 2 g dose of tinidazole, in both controlled and uncontrolled trichomoniasis and giardiasis clinical studies, adverse reactions were reported by For multi-day dosing in controlled and uncontrolled amoebiasis studies, adverse reactions were reported by Central Nervous System: Two serious adverse reactions reported included convulsions and transient peripheral neuropathy, including numbness and paraesthesia.
Other CNS reports included vertigo, ataxia, giddiness, insomnia, drowsiness. Hypersensitivity: urticaria, pruritus, rash, flushing, sweating, dryness of mouth, fever, burning sensation, thirst, salivation, angio-oedema. Other: Candid a overgrowth, increased vaginal discharge, oral candidiasis, hepatic abnormalities, including raised transaminase level, arthralgias, myalgias, and arthritis.
Rare reported adverse reactions include bronchospasm, dyspnoea, coma, confusion, depression, furry tongue, pharyngitis, and reversible thrombocytopaenia. In pooled paediatric studies, adverse reactions reported in paediatric patients taking tinidazole were similar in nature and frequency to adult findings, including nausea, vomiting, diarrhoea, taste change, anorexia, and abdominal pain. The following adverse reactions have been identified and reported during post-approval use of tinidazole.
Because the reports of these reactions are voluntary and the population is of uncertain size, it is not always possible to reliably estimate the frequency of the reaction or establish a causal relationship to drug exposure. Severe acute hypersensitivity reactions have been reported on initial or subsequent exposure to tinidazole. Hypersensitivity reactions may include urticaria, pruritus, angio-oedema, Stevens-Johnson syndrome and erythema multiforme. If you experience any side effects, talk to your doctor or pharmacist or write to drugsafety cipla.
By reporting side-effects, you can help provide more information on the safety of this product. In the event of acute overdosage, reversible renal toxicity has been reported in some cases. Empty the stomach by inducing vomiting or by gastric lavage. Observe the patient carefully and give supportive treatment, including monitoring of renal function, urinary pH and acidify, if required, to prevent crystalluria and administration of magnesium, aluminium- or calcium-containing antacids, which can reduce the absorption of ciprofloxacin.
Adequate hydration must be maintained. There are no reported overdoses with tinidazole in humans. There is no specific antidote for the treatment of overdosage with tinidazole; therefore, treatment should be symptomatic and supportive. Gastric lavage may be helpful. As a fluoroquinolone antibacterial agent, the bactericidal action of ciprofloxacin results from the inhibition of both type II topoisomerase DNA-gyrase and topoisomerase IV, required for bacterial DNA replication, transcription, repair and recombination.
The mode of action of tinidazole against anaerobic bacteria and protozoa involves penetration of the drug into the cell of the micro-organism and subsequent damage of DNA strands or inhibition of their synthesis. The bactericidal action of ciprofloxacin results from inhibition of the enzymes, topoisomerase II DNA gyrase and topoisomerase IV, which are required for bacterial DNA replication, transcription, repair and recombination.
The mechanism of action of fluoroquinolones, including ciprofloxacin, is different from that of penicillins, cephalosporins, aminoglycosides, macrolides and tetracyclines; therefore, microorganisms resistant to these classes of drugs may be susceptible to ciprofloxacin. There is no known cross-resistance between ciprofloxacin and other classes of antimicrobials.
In vitro resistance to ciprofloxacin develops slowly by multiple-step mutations. Ciprofloxacin has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections:. The following in vitro data are available, but their clinical significance is unknown. However, the efficacy of ciprofloxacin in treating clinical infections due to these bacteria has not been established in adequate and well-controlled clinical trials. Acinetobacter iwoffi.
Vibrio parahaemolyticus. Legionella pneumophila. Tinidazole is an antiprotozoal, antibacterial agent. The nitro-group of tinidazole is reduced by cell extracts of Trichomonas. The free nitro-radical generated as a result of this reduction may be responsible for the antiprotozoal activity. Chemically reduced tinidazole was shown to release nitrites and cause damage to purified bacterial DNA in vitro.
The mechanism by which tinidazole exhibits activity against Giardia and Entamoeba species is not known. Culture and sensitivity testing of bacteria are not routinely performed to establish the diagnosis of bacterial vaginosis; standard methodology for the susceptibility testing of potential bacterial pathogens, i.
Gardnerella vaginalis, Mobiluncus spp. Tinidazole is active in vitro against most strains of the following organisms that have been reported to be associated with bacterial vaginosis:. Tinidazole demonstrates activity both in vitro and in clinical infections against the following protozoa: Trichomonas vaginalis; Giardia duodenalis also termed G.
For protozoal parasites, standardised susceptibility tests do not exist for use in clinical microbiology laboratories. The development of resistance to tinidazole by G. The clinical significance of such an effect is not known. Ciprofloxacin given as an oral tablet is rapidly and well absorbed from the gastrointestinal tract after oral administration.
Ciprofloxacin maximum serum concentrations and area under the curve AUC are shown in the chart for the —1, mg dose range. Maximum serum concentrations are attained 1—2 hours after oral dosing. Mean concentrations 12 hours after dosing with , or mg are 0.
The serum elimination half-life in subjects with normal renal function is approximately 4 hours. Serum concentrations increase proportionately with doses up to 1, mg. A mg oral dose given every 12 hours has been shown to produce an AUC equivalent to that produced by an intravenous IV infusion of mg ciprofloxacin given over 60 minutes every 12 hours. A mg oral dose given every 12 hours has been shown to produce an AUC at the steady state equivalent to that produced by an IV infusion of mg given over 60 minutes every 8 hours.
A mg oral dose results in a C max similar to that observed with a mg IV dose. A mg oral dose given every 12 hours produces an AUC equivalent to that produced by an infusion of mg ciprofloxacin given every 12 hours. When ciprofloxacin tablet is given concomitantly with food, there is a delay in the absorption of the drug, resulting in peak concentrations that occur closer to 2 hours after dosing rather than 1 hour, whereas there is no delay observed when ciprofloxacin suspension is given with food.
The overall absorption of ciprofloxacin tablet or ciprofloxacin suspension, however, is not substantially affected. The pharmacokinetics of ciprofloxacin given as the suspension is also not affected by food. Avoid concomitant administration of ciprofloxacin with dairy products like milk or yoghurt or calcium-fortified juices alone since decreased absorption is possible; however, ciprofloxacin may be taken with a meal that contains these products.
After oral administration, ciprofloxacin is widely distributed throughout the body. Tissue concentrations often exceed serum concentrations in both men and women, particularly in genital tissue, including the prostate. Ciprofloxacin is present in active form in the saliva , nasal and bronchial secretions, mucosa of the sinuses, sputum , skin blister fluid, lymph , peritoneal fluid, bile, and prostatic secretions.
Ciprofloxacin has also been detected in the lungs, skin, fat, muscle , cartilage and bone. Low levels of the drug have been detected in the aqueous and vitreous humours of the eye.
The metabolites have antimicrobial activity, but are less active than unchanged ciprofloxacin. The urinary excretion of ciprofloxacin is virtually complete within 24 hours after dosing. Thus, active tubular secretion would seem to play a significant role in its elimination.
Although bile concentrations of ciprofloxacin are several-fold higher than serum concentrations after oral dosing, only a small amount of the dose administered is recovered from the bile as unchanged drug. These times may not be reflective of what you may experience or how you should use this medicine. Please consult with your doctor to check how long do you need to use Ciplox TZ Tablet.
Click here and view survey results to find out what other patients report as time for effectiveness for Ciplox TZ Tablet. Please follow your doctor's advice on how often you need to Ciplox TZ Tablet. Click here and view survey results to find out what other patients report as frequency of using Ciplox TZ Tablet.
However, this may not be reflective of how you should use this medicine. Please follow your doctor's advice on how you should use this medicine. Click here and view survey results to find out what other patients report as timing of using Ciplox TZ Tablet.
If you experience drowsiness , dizziness, hypotension or a headache as side-effects when using Ciplox TZ Tablet medicine then it may not be safe to drive a vehicle or operate heavy machinery. One should not drive a vehicle if using the medicine makes you drowsy, dizzy or lowers your blood-pressure extensively. Pharmacists also advise patients not to drink alcohol with medicines as alcohol intensifies drowsiness side-effects. Please check for these effects on your body when using Ciplox TZ Tablet.
Always consult with your doctor for recommendations specific to your body and health conditions. Most medicines don't come with a potential for addiction or abuse. Usually, the government's categorizes medicines that can be addictive as controlled substances. Please consult the product package to make sure that the medicine does not belong to such special categorizations of medicines. Lastly, do not self-medicate and increase your body's dependence to medicines without the advice of a doctor.
Can i stop using this product immediately or do I have to slowly wean off the use? Some medicines need to be tapered or cannot be stopped immediately because of rebound effects. Please consult with your doctor for recommendations specific to your body, health and other medications that you may be using.
If it is close to the time of your next dose, skip the missed dose and resume your dosing schedule. Drug Name : Ciprofloxacin and Tinidazole Ciprofloxacin and Tinidazole generic contains antibacterial and antidiarrheal agents, prescribed for susceptible infections. Medindia currently has information on generic drugs and , brands that have their prices listed. New drugs with their prices are listed as and when they get approved by the drug controller.
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