Among the usual adverse effects of ciprofloxacin are gastrointestinal disturbances, CNS toxicity and hypersensitivity reactions.
Nausea, vomiting, diarrhea, abdominal pain and dyspepsia are experienced as common gastrointestinal disturbances. Reports of pseudomembranous colitis are seldom received. Headache, anorexia, flatulence, bilirubinemia, dizziness and restlessness are the most common CNS effects. Other CNS toxicity associated with the use of ciprofloxacin are tremor, drowsiness, insomnia, agitation, confusion, unpleasant dreams, visual disturbances and other sensory disturbances, hallucinations, depression and convulsions, eosinophilic meningitis, acute psychoses, peripheral neuropathy, dysesthesia, catatonia, hemisparesis and tinnitus.
Patients taking ciprofloxacin may also experience hypersensitivity reactions eg, rash, pruritus, photosensitivity, vasculitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, laryngeal edema and anaphylaxis (may be fatal). Reversible arthralgia and joint erosions were seen in animals. A case of tendon damage was also reported.
Reports of transient elevation of serum creatinine, blood urea nitrogen and liver enzyme values, acute renal failure secondary to interstitial nephritis, crystalluria, jaundice, moniliasis, asthenia, hepatitis, eosinophilia, leukopenia, thrombocytopenia, pancytopenia, hemolytic anemia or agranulocytosis, myalgia and gynecomastia were received. Tachycardia, edema syncope, hot flushes and sweating are among the cardiovascular effects of the use of ciprofloxacin.
Pseudomembranous colitis and superinfection with Candida, C. difficile
and S. pneumoniae
associated with the use of ciprofloxacin were reported. The risk of methicillin-resistant S. aureus
and vancomycin-resistant enterococci colonization are high in patients taking ciprofloxacin.