Cipronex

Leaflet attached to the packaging: information for the user

Cipronex, 2 mg/ml, solution for infusion

Ciprofloxacin

You should carefully read the contents of the leaflet before using the medicine, as it contains important information for the patient.

• You should keep this leaflet, so that you can read it again if you need to.
• If you have any further questions, ask your doctor or nurse.
• This medicine has been prescribed specifically for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
• If you experience any side effects, including those not listed in this leaflet, please tell your doctor or nurse. See section 4.

Table of contents of the leaflet

• 1. What is Cipronex and what is it used for
• 2. Important information before taking Cipronex
• 3. How to take Cipronex
• 4. Possible side effects
• 5. How to store Cipronex
• 6. Contents of the packaging and other information

1. What is Cipronex and what is it used for

Cipronex is an antibiotic belonging to the fluoroquinolone group. The active substance is ciprofloxacin.
Ciprofloxacin works by killing the bacteria that cause infections. It only works on certain strains of bacteria.
Adults

• Lower respiratory tract infections caused by Gram-negative bacteria
• exacerbations of chronic obstructive pulmonary disease; In exacerbation of chronic obstructive pulmonary disease, Cipronex should only be used when the use of other commonly recommended antibacterial agents for the treatment of these infections is considered inappropriate.
• pulmonary infections in patients with cystic fibrosis or bronchiectasis;
• community-acquired pneumonia.
• Chronic suppurative otitis media.
• Exacerbation of chronic sinusitis, especially caused by Gram-negative bacteria.
• Uncomplicated acute urinary tract infection. In uncomplicated acute urinary tract infection, Cipronex should only be used when the use of other commonly recommended antibacterial agents for the treatment of this infection is considered inappropriate.
• Acute pyelonephritis.
• Complicated urinary tract infections.
• Bacterial prostatitis.
• Epididymo-orchitis, including cases caused by susceptible strains of Neisseria gonorrhoeae.
• Pelvic inflammatory disease, including cases caused by susceptible strains of Neisseria gonorrhoeae. If it is suspected or confirmed that the above-mentioned genital infections are caused by Neisseria gonorrhoeae, it is particularly important to obtain local data on the prevalence of resistance to ciprofloxacin and to confirm susceptibility based on laboratory tests.
• Gastrointestinal infections (e.g. traveler's diarrhea).
• Intra-abdominal infections.
• Skin and soft tissue infections caused by Gram-negative bacteria.
• Malignant otitis externa.
• Bone and joint infections.
• Pulmonary tuberculosis (prevention of infections after contact with bacteria and treatment).

Ciprofloxacin can be used to treat patients with neutropenia and fever, which is likely to be caused by a bacterial infection.
Children and adolescents

• Pulmonary infections caused by Pseudomonas aeruginosain patients with cystic fibrosis.
• Complicated urinary tract infections and acute pyelonephritis.
• Pulmonary tuberculosis (prevention of infections after contact with bacteria and treatment).

Ciprofloxacin can also be used to treat severe infections in children and adolescents, if the doctor considers it necessary.
Treatment should only be recommended by doctors who have experience in treating cystic fibrosis and/or severe infections in children and adolescents.
Official guidelines on the proper use of antibacterial agents should be taken into account.

2. Important information before taking Cipronex

When not to take Cipronex:

• if the patient is allergic to ciprofloxacin, to other quinolone drugs or to any of the other ingredients of this medicine (listed in section 6);
• if the patient is taking tizanidine at the same time (see section 2 - "Cipronex and other medicines").

Warnings and precautions

Before startingCipronex, you should discuss this with your doctor:

• if the patient has a dilatation of a large blood vessel (aortic or large peripheral artery aneurysm);
• if the patient has had a dissection of the aorta (tear in the aortic wall);
• if the patient has a heart valve problem;
• if the patient has a family history of aortic aneurysm or aortic dissection or congenital heart valve problems, or other risk factors or predisposing conditions (e.g. Marfan syndrome or vascular form of Ehlers-Danlos syndrome, Turner syndrome, Sjögren's syndrome [autoimmune inflammatory disease] or vascular diseases such as Takayasu arteritis, giant cell arteritis, Behcet's disease, hypertension or confirmed atherosclerosis, rheumatoid arthritis [joint disease] or endocarditis [heart infection]);
• if the patient has kidney problems, as the dose of the medicine may need to be changed;
• if the patient has epilepsy or other neurological disorders;
• if the patient has had tendon problems during treatment with such antibiotics as Cipronex;
• if the patient has diabetes - see below - subsection "While taking this medicine" and section 4;
• if the patient has myasthenia gravis (a type of muscle weakness);
• if the patient has had an irregular heartbeat (arrhythmia);
• if the patient has a congenital or family history of prolonged QT interval (visible in the ECG - a test of heart electrical activity);
• if the patient has an electrolyte imbalance in the blood (especially low potassium and magnesium levels in the blood);
• if the patient has a very slow heart rate (called bradycardia);
• if the patient has poor heart function (heart failure);
• if the patient has had a heart attack;
• if the patient is a woman or an elderly person;
• if the patient is taking other medicines that may affect the ECG (see section - "Cipronex and other medicines"). You should not take antibacterial medicines containing fluoroquinolones or quinolones (e.g. pefloxacin, moxifloxacin), including Cipronex, if you have had any severe side effects while taking a quinolone or fluoroquinolone in the past. In such a situation, you should inform your doctor as soon as possible.

While taking this medicine

If while taking Cipronexany of the following symptoms occur, you should immediately inform your doctor. The doctor will decide whether to stop taking Cipronex.

• Severe, sudden allergic reaction(anaphylactic reaction or shock, angioedema). Although rare, a severe allergic reaction can occur even after the first dose, with symptoms such as: chest tightness, dizziness, nausea, fainting or dizziness when standing up. If this happens, you should stop taking Cipronex and contact your doctor immediately.
• While taking this medicine, it is rare for joint and muscle pain and inflammation of the tendons and tendon ruptureto occur. The risk is increased in elderly people (over 60 years), after organ transplantation, in cases of kidney problems or treatment with corticosteroids. Tendon inflammation and rupture can occur within the first 48 hours of treatment, and even up to several months after stopping treatment with Cipronex. After the first symptoms of pain or tendon inflammation appear (e.g. in the ankle, wrist, elbow, shoulder or knee), you should stop taking Cipronex, contact your doctor and rest the affected area. You should avoid excessive exertion, as this may increase the risk of tendon rupture.
• If the patient has epilepsyor other neurological disorders, such as: cerebral ischemia or stroke, side effects from the central nervous system may occur. If this happens, you should stop taking Cipronex and contact your doctor immediately.
• After the first dose of Cipronex, psychotic reactionsmay occur. If the patient has depressionor psychosis, the symptoms of these diseases may worsen while taking Cipronex. If this happens, you should stop taking Cipronex and contact your doctor immediately.
• The patient may rarely experience symptoms of nerve damage(neuropathy), such as pain, burning, tingling, numbness and/or weakness, especially in the feet and legs and hands and arms. In such a case, you should stop taking Cipronex and immediately inform your doctor to prevent the development of potentially irreversible disease.
• Quinolone antibiotics may cause an increase in blood sugar levels above normal (hyperglycemia) or a decrease in blood sugar levels below normal, which can lead to loss of consciousness (hypoglycemic coma) (see section 4). This is important for patients with diabetes. Patients with diabetes are advised to carefully monitor their blood sugar levels.
• While taking antibiotics, including Cipronex, or even for several weeks after the end of treatment, diarrheamay occur. If it is severe or persistent, or if the patient notices blood or mucus in the stool, you should immediately stop taking Cipronex, as it can be life-threatening. You should not take medicines that slow down or stop bowel movements and contact your doctor.
• If the patient is giving a blood or urine sample for analysis, they should inform their doctor or laboratory staff that they are taking Cipronex.
• Cipronex may cause liver damage. If the patient notices the following symptoms: loss of appetite, jaundice (yellowing of the skin), dark urine, itching of the skin or stomach upset, they should stop taking Cipronex and contact their doctor immediately.
• Cipronex may decrease the number of white blood cells, which can lead to a decrease in resistance to infections. If the patient notices symptoms such as: fever and severe deterioration of general condition or fever with local signs of infection, such as: sore throat, larynx, mouth and problems with the urinary system, they should contact their doctor immediately. A blood test will be ordered to check if there has been a decrease in the number of white blood cells (agranulocytosis). Remember to inform your doctor that you are taking this medicine.
• If the patient or their family has a deficiency of glucose-6-phosphate dehydrogenase (G6PD), they should inform their doctor, as ciprofloxacin may cause a risk of anemia.
• While taking Cipronex, the skin becomes more sensitive to sunlight and ultraviolet radiation (UV). You should avoid exposure to strong sunlight or artificial UV radiation (e.g. in a solarium).
• If the patient's vision has deteriorated or they are experiencing other eye problems, they should immediately consult an ophthalmologist.
• In case of sudden severe abdominal, back or chest pain, which may be a sign of an aneurysm and aortic dissection, the patient should immediately go to the emergency room. The risk of these changes may be higher in patients treated with systemic corticosteroids.
• In case of sudden shortness of breath, especially when lying down, or swelling of the ankles, feet or abdomen, or palpitations (feeling of rapid or irregular heartbeat), the patient should immediately contact their doctor.
• Long-term, disabling and potentially irreversible severe side effects: Fluoroquinolone and quinolone antibacterial agents, including Cipronex, have been associated with very rare but severe side effects. Some of them have been long-term (lasting for months or years), disabling or potentially irreversible. These include: tendon pain, muscle and joint pain in the upper and lower limbs, walking difficulties, abnormal sensations, such as tingling, burning, itching, numbness or burning, sensory disturbances, including vision, taste and smell and hearing disorders, depression, memory disorders, severe fatigue and severe sleep disorders. If any of these side effects occur after taking Cipronex, the patient should immediately contact their doctor before continuing treatment. The patient and doctor will decide whether to continue treatment, also considering antibiotics from another group.

Cipronex and other medicines

You should tell your doctor about all the medicines you are taking now or have taken recently, and about the medicines you plan to take.
Do not take Cipronex at the same time as tizanidine, as it may cause side effects such as low blood pressure and drowsiness (see section 2 - "When not to take Cipronex").
The following medicines will interact with Cipronex in the human body.
Taking Cipronex at the same time as these medicines may affect their therapeutic effect.
This may also increase the likelihood of side effects.
If you are taking other medicines that may affect your heart rhythm, medicines belonging to the group of anti-arrhythmic agents (e.g. quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide), tricyclic antidepressants, some antibacterial agents (belonging to the macrolide group) or some antipsychotic agents, you must tell your doctor.

You should inform your doctor if you are taking any of the following medicines:

• warfarin or other oral anticoagulant (e.g. acenocoumarol, phenprocoumon, fluindione);
• probenecid (used in gout);
• methotrexate (used in certain types of cancer, psoriasis, rheumatoid arthritis);
• theophylline (used in respiratory disorders);
• tizanidine (used to reduce excessive muscle tension in multiple sclerosis);
• clozapine (an antipsychotic agent);
• ropinirole (used in Parkinson's disease);
• phenytoin (used in epilepsy);
• metoclopramide (used to prevent nausea and vomiting);
• omeprazole (used to treat heartburn and stomach ulcers);
• cyclosporin (used after organ transplantation);
• glibenclamide (used in diabetes);

Cipronex may increasethe levels of the following medicines in the blood:

• pentoxifylline (used in circulatory disorders);
• caffeine;
• duloxetine (used in depression, diabetic neuropathy, urinary incontinence);
• lidocaine (used in anesthesiology, pain relief, arrhythmias);
• sildenafil (used in erectile dysfunction);
• agomelatine;
• zolpidem.

Taking Cipronex with food and drink

Food and drink do not affect the use of Cipronex.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.
It is recommended to avoid taking Cipronex during pregnancy.
Breastfeeding women should not take Cipronex, as ciprofloxacin passes into breast milk and may harm the baby.

Driving and using machines

Cipronex may cause drowsiness. Some neurological side effects may occur. Before driving or operating machinery, you should check how you react to Cipronex.
In case of doubt, consult your doctor.

Cipronex contains sodium

The medicine contains 177 mg of sodium (the main component of common salt) in each 50 ml container.
This corresponds to 8.9% of the maximum recommended daily intake of sodium in the diet for adults.
The medicine contains 354 mg of sodium (the main component of common salt) in each 100 ml container.
This corresponds to 17.7% of the maximum recommended daily intake of sodium in the diet for adults.
The medicine contains 708 mg of sodium (the main component of common salt) in each 200 ml container.
This corresponds to 35.4% of the maximum recommended daily intake of sodium in the diet for adults.
If you are taking 110 ml of Cipronex or more per day for a long time (daily for more than a month), especially if you are controlling your sodium intake, you should contact your doctor or pharmacist.
The medicine can be mixed with the following solutions for intravenous infusion: physiological sodium chloride solution, Ringer's solution, lactated Ringer's solution, 5% and 10% glucose solution, 10% fructose solution. The sodium content from the diluent should be taken into account when calculating the total sodium content in the prepared dilution of the product. To obtain accurate information about the sodium content in the solution used to dilute the medicine, you should consult the product characteristics of the diluent used.

3. How to take Cipronex

This medicine should always be taken according to the doctor's instructions. The doctor will explain exactly what dose of Cipronex to take, how often and for how long. This will depend on the type of infection and its severity.
If the patient has kidney problems, they should inform their doctor, as the dose of the medicine may need to be changed.
Treatment usually lasts from 5 to 21 days, but in severe infections it may be longer.
The doctor will administer each dose intravenously, in a slow intravenous infusion. The duration of the infusion in children is 60 minutes. In adult patients, the duration of the infusion of ciprofloxacin 400 mg/200 ml is 60 minutes, and 200 mg/100 ml - 30 minutes. Thanks to the slow infusion, the occurrence of sudden side effects can be avoided.
Remember to drink plenty of fluids while taking Cipronex.
A detailed description of how to take and prepare the medicine for administration is given at the end of the leaflet, in the section "Information intended only for healthcare professionals".

Stopping Cipronex

It is important not to stop treatment, even if you feel better after a few days of taking the medicine. If you stop taking the medicine too early, the infection may not be fully treated and the symptoms of the infection may return or worsen. Resistance to the antibiotic may also develop.
If you have any further questions about taking this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.
The most serious side effectsobserved during treatment with this medicine are listed below.

If you notice any of the following symptoms, you should stop taking Cipronex and contact your doctor immediately, as you may need to take a different antibiotic.

Rare side effects(occurring in no more than 1 in 1000 patients):

• seizures (see section 2. Warnings and precautions);
• depression (potentially leading to suicidal thoughts, suicide attempts or suicide) (see section 2. Warnings and precautions);
• allergic reaction, swelling (edema) or rapid swelling of the skin and mucous membranes (angioedema) (see section 2. Warnings and precautions).

Very rare side effects(occurring in less than 1 in 10,000 patients):

• severe, sudden allergic reaction with symptoms such as chest tightness, dizziness, nausea or fainting, or dizziness when standing up (anaphylactic reaction/anaphylactic shock) (see section 2. Warnings and precautions);
• muscle weakness;
• tendon inflammation, which can lead to tendon rupture, especially the large tendon at the back of the ankle (Achilles tendon) (see section 2. Warnings and precautions);
• life-threatening skin rash, usually in the form of blisters or ulcers in the mouth, throat, nose, eyes and mucous membranes of the genitals, with subsequent spread of blisters or skin peeling (e.g. blistering polymorphic erythema - Stevens-Johnson syndrome or toxic epidermal necrolysis - Lyell's syndrome);
• death of liver cells (liver necrosis), very rarely leading to life-threatening liver failure, with symptoms such as: loss of appetite, diarrhea, fever, skin rash, itching, abdominal swelling, abdominal pain, nausea and vomiting (see section 2. Warnings and precautions);
• mental disorders (psychotic reactions potentially leading to suicidal thoughts, suicide attempts or suicide) (see section 2. Warnings and precautions).

Frequency not known(frequency cannot be estimated from the available data):

• heart disorders, such as: very rapid heartbeat, life-threatening irregular heartbeat, heart rhythm disorders (called "prolonged QT interval", visible in the ECG - a test of heart electrical activity);
• allergic reaction, which causes a rash, fever, inflammation of internal organs, blood disorders and systemic diseases (drug reaction with eosinophilia and systemic symptoms, abbreviated as DRESS, acute generalized exanthematous pustulosis, abbreviated as AGEP);
• disorders related to the nervous system, such as: pain, burning, tingling, numbness and/or weakness of the limbs (neuropathy);
• loss of consciousness due to a significant decrease in blood sugar levels (hypoglycemic coma). See section 2.

Patients taking fluoroquinolones have reported cases of dilation and weakening of the aortic wall or aortic dissection, which can lead to rupture and result in death, as well as cases of heart valve problems. See also section 2.
Administration of quinolone and fluoroquinolone antibiotics, in some cases regardless of pre-existing risk factors, has very rarely caused long-term (lasting for months or years) or permanent drug side effects, such as: tendon inflammation, tendon rupture, joint pain, limb pain, walking difficulties, abnormal sensations, such as tingling, burning, itching, numbness or burning, neuropathy, fatigue, memory disorders and mental health disorders (which may include sleep disorders, anxiety, panic attacks, depression and suicidal thoughts), as well as hearing, vision, taste and smell disorders.
Other side effectsthat have been observed during treatment with Cipronex are listed below, according to their frequency of occurrence.
Common side effects(occurring in no more than 1 in 10 patients):

• nausea (nausea), diarrhea;
• local reaction at the injection site and infusion;
• joint pain and arthritis in children.

Uncommon side effects(occurring in no more than 1 in 100 patients):

• joint pain in adults;
• fungal superinfections;
• high levels of eosinophilia (a type of white blood cell);
• decreased appetite;
• excessive activity or agitation;
• headache, dizziness, sleep disorders or taste disturbances;
• vomiting, stomach pain, digestive disorders, such as indigestion (indigestion, heartburn) or gas (flatulence);
• increased levels of certain substances in the blood [transaminases and/or bilirubin];
• skin rash, itching or hives;
• kidney problems;
• muscle and bone pain, general weakness or fever;
• increased activity of the enzyme called alkaline phosphatase in the blood.

Rare side effects(occurring in no more than 1 in 1000 patients):

• muscle pain, arthritis, increased muscle tension or cramps;
• antibiotic-associated colitis (very rarely can be fatal) (see section 2. Warnings and precautions);
• changes in blood cell count (leukopenia, leukocytosis, neutropenia, anemia), increased or decreased platelet count;
• increased blood sugar levels (hyperglycemia);
• confusion, disorientation, anxiety reactions, unusual dreams or hallucinations;
• tingling sensation, excessive sensitivity to stimuli, decreased skin sensitivity, tremors or dizziness;
• vision disturbances, including double vision (see section 2. Warnings and precautions);
• ringing in the ears, hearing loss, hearing disorders;
• rapid heartbeat (tachycardia);
• vasodilation, low blood pressure or fainting;
• shortness of breath, including asthma symptoms;
• liver function disorders, jaundice (with bile stasis) or hepatitis;
• sensitivity to light (see section 2. Warnings and precautions);
• kidney failure, blood or crystals in the urine, urinary tract infection;
• fluid retention or excessive sweating;
• increased activity of the enzyme called amylase.

Very rare side effects(occurring in less than 1 in 10,000 patients):

• a specific type of decreased red blood cell count (hemolytic anemia); a dangerous decrease in the number of white blood cells (agranulocytosis) (see section 2. Warnings and precautions); a decrease in the number of red and white blood cells and platelets (aplastic anemia), which can be fatal, as well as bone marrow failure, which can also be fatal;
• allergic reaction similar to post-rheumatic disease (see section 2. Warnings and precautions);
• migraine, coordination disorders, unstable gait (gait disturbances), smell disorders, increased intracranial pressure and pseudo-brain tumor;
• disturbed color vision;
• inflammation of the blood vessel walls (vasculitis);
• pancreatitis;
• small, dark spots visible under the skin (purpura); various rashes or skin eruptions;
• exacerbation of myasthenia symptoms (see section 2. Warnings and precautions).

Frequency not known(frequency cannot be estimated from the available data):

• a disease related to the disturbance of water excretion from the body and decreased sodium levels in the blood (SIADH, English syndrome of inappropriate secretion of antidiuretic hormone);
• a feeling of excessive excitement (mania) or excessive optimism combined with increased activity (hypomania);
• effect on blood coagulation (in patients treated with vitamin K antagonists).

Reporting side effects

If you experience any side effects, including those not listed in this leaflet, please tell your doctor or pharmacist, or nurse. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products, Medical Devices and Biocidal Products
Al. Jerozolimskie 181C
02-222 Warsaw
Phone: + 48 22 49 21 301
Fax: + 48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Cipronex

Medicines should be kept out of the sight and reach of children.
Store in the original packaging.
Do not store above 25°C.
Do not store in the refrigerator or freeze.
Protect from moisture and chemically active gases or strong odors.
The solution is sensitive to light, so the container should be removed from the packaging immediately before use. If the medicine is exposed to daylight for more than 3 days, its full effectiveness cannot be guaranteed. Unused solution should be discarded.
Do not use this medicine after the expiry date stated on the container or carton.
The expiry date refers to the last day of the month.
The inscription on the packaging after the abbreviation EXP means the expiry date, and after the abbreviation Lot means the batch number.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging and other information

What Cipronex contains

• The active substance of the medicine is ciprofloxacin. 1 container of 50 ml contains 100 mg of ciprofloxacin (in the form of monohydrate hydrochloride ciprofloxacin). 1 container of 100 ml contains 200 mg of ciprofloxacin (in the form of monohydrate hydrochloride ciprofloxacin). 1 container of 200 ml contains 400 mg of ciprofloxacin (in the form of monohydrate hydrochloride ciprofloxacin).
• The other ingredients are: sodium lactate, sodium chloride, hydrochloric acid, water for injections.

What Cipronex looks like and what the packaging contains

Cipronex is a clear solution for infusion with a slightly yellowish-greenish color, in a polyethylene container with an Insocap type adapter, placed in a cardboard box.
The packaging contains:
1 container of 50 ml;
1 or 40 containers of 100 ml;
1 or 20 containers of 200 ml.

Marketing authorization holder and manufacturer

Polpharma S.A. Pharmaceutical Works
ul. Pelplińska 19, 83-200 Starogard Gdański
phone: + 48 22 364 61 01

Date of last revision of the leaflet: ---------------------------------------------------------------------------------------------------------------------------

Advice - medical education

Antibiotics are used to treat bacterial infections. They do not work in viral infections.
Antibiotics should only be used in diseases where the doctor has prescribed them. Despite the action of antibiotics, some bacteria may survive or multiply. This phenomenon is called resistance: sometimes treatment with an antibiotic becomes ineffective.
Incorrect use of antibiotics increases resistance. You can even cause bacteria to become resistant and prolong treatment or reduce the effectiveness of the antibiotic, if you do not follow the doctor's instructions regarding:

• dose size;
• frequency of administration;
• duration of treatment.

Consequently, to maintain the effectiveness of this medicine:

• 1 – You should only use an antibiotic when prescribed by a doctor.
• 2 – You should strictly follow the doctor's instructions.
• 3 – You should not take an antibiotic again without the doctor's recommendation, even if the current disease is similar to the disease for which the antibiotic was prescribed.
• 4 – You should never give an antibiotic to another person, as it may be inappropriate for their disease.
• 5 – After the end of treatment, you should return the unused medicine to the pharmacy, so that it can be properly disposed of.

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Information intended only for healthcare professionals

Detailed information about this medicine, including information intended only for healthcare professionals, is available in the Product Characteristics on the website:
www.urpl.gov.pl.
Cipronex should be administered as an intravenous infusion.
Low temperature can cause the formation of precipitates, which dissolve at room temperature. The medicine should be warmed to room temperature before administration.
The container, after checking its integrity and breaking the protective foil, should be connected to the apparatus with a two-channel needle. The duration of the infusion in children is 60 minutes. In adult patients, the duration of the infusion of ciprofloxacin 400 mg/200 ml is 60 minutes, and 200 mg/100 ml - 30 minutes. Slow infusion into a large vein will minimize the patient's discomfort and reduce the risk of vein irritation. The infusion solution can be administered directly or after mixing with other compatible infusion solutions.

• The infusion solution should always be administered separately, unless compatibility with other medicines (solutions) has been confirmed. Visible signs of pharmaceutical incompatibility are, for example, precipitation, clouding and color change.

Pharmaceutical incompatibilities occur in the case of all infusion solutions (medicines) that are physically or chemically unstable at the pH value of these solutions (e.g. penicillin solutions, heparin solutions), especially in combination with solutions whose reaction has been adjusted to alkaline (pH of ciprofloxacin solutions: 3.5-4.6).
After initial intravenous administration, treatment can also be continued orally.