Ciprofloxacin + Tinidazole

Indications

Ciprofloxacin + Tinidazole is used for: Gynaecological infections, Intra-abdominal infections, Respiratory tract infections, Prophylaxis of surgical infections

Adult Dose

Oral Gynaecological infections, Intra-abdominal infections, Respiratory tract infections, Prophylaxis of surgical infections Adult: As tablet containing ciprofloxacin (mg)/tinidazole (mg): 500/600, 250/300. Usually 1 tablet bid for 5-10 days depending on severity and response.

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity, patients with a history of blood dyscrasias.

Precautions

Renal impairment, history of seizures; ensure adequate hydration & urinary output; avoid alcohol ingestion. Not recommended for use in lactation and pregnancy. Not recommended for children. Patients with CNS disorders. Inadequate water intake during treatment may cause crystalluria.

Pregnancy-Lactation

Interactions

Antacids, sucralfate, calcium, Fe & Zn prep reduce absorption of ciprofloxacin. Concurrent use with ciclosporin may lead to transient increases in serum creatinine levels. Increases plasma levels and elimination half-life of theophylline; potentiates oral anticoagulant effects; disulfiram-like effect with alcohol. May affect metabolism of caffeine resulting in reduced clearance of caffeine.

Adverse Effects

Side effects of Ciprofloxacin + Tinidazole : Nausea, headache, vomiting, fatigue, abdominal pain, depression, dyspepsia, constipation, dry mouth, sometimes diarrhea, metallic taste, urticaria, erythema & rashes; rarely convulsions & hematological changes. Potentially Fatal: Severe hypersensitivity reaction (rarely).

Mechanism of Action

Ciprofloxacin is bactericidal against enteropathogens like Shigella, Salmonella, E coli, C jejuni, Vibrio cholerae etc.It acts by inhibition of DNA synthesis. Tinidazole is a potent anaerobicide. It is also effective against Entameba & Giardia. It acts by damaging DNA strands. This combination has the advantage of being effective against both bacteria & protozoa. Entameba requires normal faecal flora for its survival; ciprofloxacin kills the pathogenic intestinal bacteria & alters intestinal flora, & tinidazole directly eradicates Entameba. This combination can also be used in other systemic infections caused by susceptible organisms.