CIPRO TRUST 500MG TABLETS (Each film coated tablet contains aprofloxaan USP 500mg

Indications

• Bacterial infections
• Respiratory tract infections
• Urinary tract infections
• Skin infections
• Gastrointestinal infections

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines in children.

Adults: Refer to the specific BNF for recommended dosing based on the type and severity of infection.

Mechanism of action

Aprofloxacin exerts its antibacterial effects by inhibiting bacterial DNA synthesis. It binds to the DNA gyrase and topoisomerase IV enzymes, interrupting DNA replication and transcription processes. This leads to the inability of bacteria to multiply and ultimately results in cell death.

Pharmacodynamics

Aprofloxacin exhibits concentration-dependent killing, meaning that the efficacy of the drug increases with higher concentrations. It has a post-antibiotic effect, where bacterial growth is inhibited even after drug concentrations fall below the minimum inhibitory concentration (MIC). Resistance mechanisms may include mutations in the target enzymes and efflux pump overexpression.

Pharmacokinetics

Aprofloxacin is well absorbed following oral administration, with bioavailability typically exceeding 80%. It is widely distributed throughout the body, including penetration into tissues and fluids. The drug is metabolized in the liver, and its elimination half-life ranges from 5 to 10 hours. Aprofloxacin is primarily excreted via the kidneys, with a significant portion of the dose being eliminated unchanged in the urine.

Contra-indications

• Hypersensitivity to aprofloxacin or any of its components
• History of tendon disorders related to fluoroquinolone use
• Concurrent use of tizanidine
• Severe hepatic impairment

Adverse effects

• Nausea
• Diarrhea
• Headache
• Dizziness
• Tendon rupture
• QT interval prolongation
• Rash
• Photosensitivity
• Liver enzyme elevations

Interactions

• Antacids containing magnesium or aluminum may reduce absorption
• Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of CNS stimulation
• Warfarin may have increased anticoagulant effects when used concurrently
• Corticosteroids may increase the risk of tendon damage
• Drugs that prolong the QT interval should be used with caution

Precautions

• Use with caution in patients with a history of seizures
• Assess for risk factors for tendon rupture, especially in older adults
• Monitor for signs of liver toxicity
• Caution in patients with myasthenia gravis due to potential exacerbation of symptoms

Pregnancy

Aprofloxacin is classified as a category C drug. Animal studies have shown adverse effects on the fetus, but there are no adequate studies in pregnant women. The drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Aprofloxacin is excreted in human milk. Caution should be exercised when administering to a breastfeeding woman, as it may affect the nursing infant.

Storage

Store at room temperature, away from moisture and light. Keep all medications out of the reach of children.

Formulations

• Tablets
• Injectable solution