TYFLOX is indicated for the treatment of single infection or mixed infections caused by two or more susceptible organisms. TYFLOX can also be used for infections caused by organisms resistant to other antibiotics including aminoglycosides, penicillins and cephalosporins. The extensive tissue penetration of Ciprofloxacin combined with its enhanced antibacterial activity (including antipseudomonal activity), enables TYFLOX to be used alone (depending on sensitivity results) or in combination with an aminoglycoside or with beta-Iactam antibiotics. For instance, when severe neutropenia is present or with an antibiotic active against anaerobes where the presence of Bacteroides fragilis is suspected. TYFLOX is indicated for the treatment of the following infections caused by sensitive bacteria: Severe systemic infections: Septicaemia, bacteremia, peritonitis, infections in immunosuppressed patients with hematological or solid tumors and in patients in intensive care with specific problems such as infected burns. Respiratory tract infections: Lobar and bronchopneumonia, acute and chronic bronchitis, acute exacerbation of cystic fibrosis, bronchiectasis, empyema. Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis, epididymitis. Skin and soft tissue infections: Infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas, infected burns. Gastro-intestinal infections: Enteric fever, infective diarrhoea. Infections of the biliary tract: Cholangitis, cholecystitis, empyema of the gall bladder. Intra-abdominal infections: Peritonitis, intra-abdominal abscesses. Bone and joint infections: Osteomyelitis, septic arthritis. Pelvic infections: Salpingitis, endometritis, pelvic inflammatory diseases. Eye, ear, nose and throat infections: Otitis media, sinusitis, mastoiditis, tonsillitis. Gonorrhoea: Urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organisms or organisms moderately sensitive to penicillins.

In vitro studies have shown that the antibacterial action of Ciprofloxacin results from the inhibition of bacterial DNA gyrase. This mode of action differs from that of penicillins, cephalosporins, aminoglycosides and tetracyclines. Therefore, organisms resistant to these antibiotics are generally sensitive to Ciprofloxacin.

Concurrent administration of Ciprofloxacin with theophylline may lead to elevated plasma concentrations of theophylline and prolongation of its elimination half-life. This may result in increased risk of theophylline-related adverse reactions. If concomitant use cannot be avoided plasma levels of theophylline should be monitored and dosage adjustments made as appropriate.
Antacids containing Magnesium hydroxide or Aluminium hydroxide may interfere with the absorption of Ciprofloxacin resulting in serum and urine levels lower than desired. So, concurrent administration of these agents with Ciprofloxacin should be avoided. Probenecid interferes with renal tubular secretion of Ciprofloxacin and produces an increase in the level of Ciprofloxacin in the serum. This should be considered if patients are receiving both drugs concomitantly.
As with other broad spectrum antibiotics, prolonged use of Ciprofloxacin may result In overgrowth of non susceptible organisms. Repeated evaluation of the patient's condition and microbial susceptibility testing is essential. If superinfection occurs during therapy, appropriate measures should be taken.

Ciprofloxacin is contraindicated in patients who have shown hypersensitivity to Ciprofloxacin or other quinolones. Ciprofloxacin is also contraindicated in children and growing adolescents except where the benefits of treatment exceed the risks.
Use in pregnancy and lactation: Reproduction studies performed in mice, rats and rabbits using parenteral and oral administration did not reveal any evidence of teratogenicity, impairment of fertility or impairment of pre/post-natal development. However as with other quinolones, Ciprofloxacin has been shown to cause arthropathy in immature animals and therefore, its use during pregnancy is not recommended. Studies in rats have indicated that Ciprofloxacin is secreted in milk, thus administration to nursing mothers is  not recommended.

Gastrointestinal disturbances: Nausea, diarrhoea, vomiting, dyspepsia, abdominal pain. Disturbance of the central nervous system: Dizziness, headache, tiredness, confusion, convulsions.

Ciprofloxacin should be used with caution in patients with a history of convulsive disorders. Crystalluria related to the use of Ciprofloxacin has been observed only rarely. Patients receiving Ciprofloxacin should be well hydrated and excessive alkalinity of the urine should be avoided.

No information on overdose is available. In case of overdose routine measures such as gastric lavage should be performed as soon as possible after ingestion of Ciprofloxacin tablets. Serum levels of Ciprofloxacin are reduced by dialysis.