INTRODUCTION
PERKOCIP 250 TABLET contains ciprofloxacin, which belongs to the group of medicines called fluoroquinolone antibiotics. It is used in adults in the treatment of bacterial infections of the respiratory tract, ear and sinus, urinary tract, genital tract, gastrointestinal tract, skin and soft tissue, bone and joint as well as anthrax inhalation exposure infections. The medicine is also used in the management of fever in neutropenia-associated infections.
PERKOCIP 250 TABLET on prolonged use can cause an overgrowth of other non-susceptible organisms. The medicine may produce a psychiatric reaction when taken for the first time. Caution should be taken in elderly patients while taking PERKOCIP 250 TABLET as it can result in prolonged QT intervals.
Before taking PERKOCIP 250 TABLET, inform your doctor if you are having kidney problems, neurological conditions, or heart diseases such as a tear in the aortic wall of the heart, bulge, or large blood vessels, leaking in the heart valves and congenital heart disease or myasthenia gravis.
PERKOCIP 250 TABLET is generally not recommended during pregnancy and breastfeeding. The most common side effect of taking PERKOCIP 250 TABLET is nausea and diarrhoea. Consult a doctor immediately if any of the symptoms worsen.
USES OF PERKOCIP 250 TABLET
PERKOCIP 250 TABLET is used in adults to treat bacterial infections of the following:
- respiratory tract infections
- recurring ear and sinusitis infections
- urinary tract infections
- genital tract infections
- gastrointestinal tract infections
- intraabdominal infections
- skin and soft tissue infections
- bone and joint infections
- anthrax inhalation exposure
- management for fever in neutropenia-associated infection
HOW PERKOCIP 250 TABLET WORKS
PERKOCIP 250 TABLET contains Ciprofloxacin which is an antibacterial agent that acts by preventing bacterial replication by targeting the essential enzyme inside the bacteria. This leads to the restriction of growth of the disease-causing bacteria inside the infected person and thereby helps to control the infection and treat its symptoms caused by it.
DIRECTIONS FOR USE
Take PERKOCIP 250 TABLET as advised by your physician. Try to take the medicine after meals. Swallow PERKOCIP 250 TABLET with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.
SIDE EFFECTS OF PERKOCIP 250 TABLET
COMMON
- nausea
- diarrhoea
UNCOMMON
- fungal superinfections (serious fungal infections)
- loss of appetite
- taste disorders
- vomiting
- stomach pain
- wind (flatulence)
- indigestion and heartburn
- hyperactivity, agitation
- headache, dizziness, sleeping problems
- allergic reaction such as itching, hives, rash
- poor kidney function
- joint pain in adults
- pains in muscles and bones
- feeling unwell (asthenia)
- fever
- fluid retention
- high concentration of eosinophils (type of white blood cell)
- increased amounts of certain substances in the blood (transaminases, bilirubin or alkaline phosphatase levels)
RARE
- muscle pain, inflammation of the joints, increased muscle tone and cramping
- inflammation of the bowel (colitis) linked to antibiotic use
- changes to the blood count (leukopenia, leucocytosis, neutropenia, anaemia pancytopenia), bone-marrow depression
- allergic reaction such as swelling (oedema) rapid swelling of the skin and mucous membranes (angioedema)
- increased blood sugar (hyperglycaemia), decreased blood sugar (hypoglycaemia)
- anxiety reaction, strange dreams, depression
- decreased skin sensitivity, tremors, migraine, altered sense of smell (olfactory disorders)
- tinnitus (ringing noise in the ear), impaired hearing
- fainting, inflammation of the blood vessel (vasculitis)
- shortness of breath including asthmatic symptoms
- pancreatitis, hepatitis (inflammation of liver and pancreas), death of liver cells (liver necrosis)
- sensitivity to light, pin-point bleeding under the skin (petechiae)
- blood or crystals in the urine, urinary tract inflammation
- excessive sweating
- increased levels of the enzyme amylase
- pain and swelling in the joints, and inflammation or rupture of tendons
- nerve damage (neuropathy) such as pain, burning, tingling, numbness, and weakness especially in the feet and legs or hands and arms
Stop taking PERKOCIP 250 TABLET and consult your doctor immediately if you experience any of the following side effects:
- sensory disorders including impairment of vision, taste and smell, and hearing, depression, memory impairment, severe fatigue, and severe sleep disorders.
- severe allergic reaction with symptoms such as tightness in the chest, feeling dizziness, feeling sick, fainting, and experience dizziness while standing
- impairment of eyesight, taste, smell, hearing
- pain and swelling of tendons (Ex. in your ankle, wrist, elbow, shoulder or knee), difficulty in walking
- cerebral ischemia (less blood flow to the brain) or stroke, seizure (fits)
- mental disturbances (psychiatric reactions such as depression and potentially leading to suicidal thoughts, suicidal attempts, or completed suicide), memory impairment and sleep disturbances
- nerve damage (neuropathy) in the feet and legs or hands and arms causing symptoms such as pain, burning, tingling, numbness or weakness
- increase in blood sugar levels (hyperglycaemia), or lowered blood sugar levels below normal levels, in severe cases can lead to loss of consciousness or coma
- sudden shortness of breath, especially while lying down flat, rapid irregular heartbeat and swelling of your ankles, feet or abdomen
- presence of crystals in the urine with discomfort when passing urine (crystalluria)
- false Tuberculosis test (Mycobacterium)
- sensitive skin to sunlight or ultraviolet (UV) light
- liver damage leading to symptoms such as loss of appetite, yellowing of the skin, urine dark in colour, itching or pain in the stomach,
- infection with symptoms such as fever and serious deterioration of your general condition, or fever with local infection symptoms such as sore throat/pharynx/mouth or urinary problems
HOW TO MANAGE SIDE EFFECTS
Nausea and vomiting:
Take this medicine with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food.
Diarrhoea:
Drink lots of fluids, such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for treating diarrhoea. Consult your doctor if the symptom did not improve.
Skin rash:
Avoid hot showers because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if the symptom did not improve.
WARNING & PRECAUTIONS
PREGNANCY
PERKOCIP 250 TABLET is not recommended for pregnant and planning to get pregnant women. Consult your doctor before taking PERKOCIP 250 TABLET.
BREASTFEEDING
PERKOCIP 250 TABLET is generally not recommended for use in breastfeeding women as it may pass through breast milk and could be harmful to the baby. Consult your doctor before taking PERKOCIP 250 TABLET.
DRIVING AND USING MACHINES
Do not drive or use heavy machinery after taking PERKOCIP 250 TABLET as the medicine could cause dizziness and can potentially reduce your attention. Consult your doctor before taking PERKOCIP 250 TABLET.
ALCOHOL
Avoid consumption of alcohol while taking PERKOCIP 250 TABLET because it can make you feel dizzier. Consult your doctor before taking PERKOCIP 250 TABLET.
KIDNEY
PERKOCIP 250 TABLET should be taken with caution in patients with severe kidney problems. Consult your doctor before taking PERKOCIP 250 TABLET.
LIVER
PERKOCIP 250 TABLET should be taken with caution in patients with severe liver damage. Consult your doctor before taking PERKOCIP 250 TABLET.
ALLERGY
Do not take PERKOCIP 250 TABLET if you are allergic to ciprofloxacin or any other quinolone antibiotics.
HEART DISEASE
PERKOCIP 250 TABLET should be used with caution in patients suffering from heart problems such as prolonged QT interval (seen on ECG, electrical recording of the heart), have very slow heart rhythm (bradycardia), weak heart (heart failure), history of heart attack, leaking of heart valves, tearing in the aortic wall, bulging of a large blood vessel, if you have taken any medicine that cause abnormal ECG changes, and congenital heart valve disease. Consult your doctor before taking PERKOCIP 250 TABLET.
OTHERS
Before taking PERKOCIP 250 TABLET, inform your doctor if you
- suffer from epilepsy or other neurological conditions
- have tendon problems during previous treatment with antibiotics
- have a history of diabetes
- have a disease that causes muscle weakness (myasthenia gravis)
- have a deficiency in glucose-6-phosphate dehydrogenase (G6PD
- have a history of connective tissue disorder such as
- Marfan syndrome or Ehlers-Danlos syndrome
- Turner syndrome (chromosomal defect)
- Sjogren’s syndrome (an inflammatory autoimmune disease)
- vascular disorders such as Takayasu arteritis giant cell arteritis
- Behcet’s disease (blood vessel inflammation throughout your body)
- rheumatoid arthritis (a disease of the joints)
- endocarditis (an infection of the heart)
Use in geriatrics:
PERKOCIP 250 TABLET should be used with caution in elderly patients (above 60 years of age) especially in those with impaired kidney function. Consult your doctor before taking PERKOCIP 250 TABLET.
INTERACTIONS
A. Drug-Drug interactions:
Before taking PERKOCIP 250 TABLET, inform your doctor if you are taking any of the following medicine:
- vitamin K antagonists (Ex. warfarin, acenocoumarin, phenprocoumon or fluindione)
- other oral anti-coagulants Ex. dabigatran, rivaroxaban, apixaban, edoxaban and betrixaban (medicine to thin the blood)
- probenecid (medicine used to treat gout)
- methotrexate (medicines used for certain types of cancer, psoriasis, rheumatoid arthritis)
- theophylline (medicine used to treat breathing problems)
- tizanidine (medicine used to treat muscle spasticity in multiple sclerosis)
- olanzapine, clozapine, risperidone (medicine used for anti-psychosis)
- ropinirole (medicine used to treat Parkinson’s disease)
- phenytoin (medicine used to treat epilepsy)
- cyclosporin (medicine used to treat skin conditions, rheumatoid arthritis, and organ transplantation)
- other medicines that are used to treat alteration in heart rhythm (medicines that belong to the group of antiarrhythmics such as quinidine, hydroquinone, disopyramide, amiodarone, sotalol, dofetilide, ibutilide)
- tricyclic antidepressants (medicine that are used to treat depression such as doxepin and amoxapine)
- some antimicrobials (that belong to the group of macrolides such as azithromycin, clarithromycin)
- zolpidem (medicine to treat sleep disorders)
- pentoxifylline (medicine to treat circulatory disorders)
- caffeine (medicine used to stimulate the central nervous system)
- duloxetine (medicine used to treat depression, diabetic nerve damage or incontinence)
- lidocaine (medicines used to treat heart conditions or anaesthetic use)
- sildenafil (medicine used to treat erectile dysfunction)
- agomelatine (medicine used to treat major depressive disorder)
- meprazole, sucralfate (medicine used to treat indigestion and heartburn)
- iron, zinc (medicine used as mineral supplements)
- a polymeric phosphate binder (Ex. sevelamer or lanthanum carbonate)
- medicines or supplements containing calcium, magnesium, aluminium or iron
B. Drug-Food interaction:
Avoid eating or drinking any dairy products (such as milk or yoghurt) or drinks with added calcium while taking PERKOCIP 250 TABLET, as they may affect the absorption of the medicine.
Overdosage:
If you or anyone else accidentally took more of PERKOCIP 250 TABLET, consult your doctor immediately or visit the nearby hospital.
SYNOPSIS
| Drug | : | Ciprofloxacin |
| Pharmacological Category | : | Fluoroquinolone antibiotics |
| Therapeutic Indication | : | Treat specific kinds of bacterial infections |
| Dosage Forms | : | Tablets, Injections, Infusions, Drops, Dry Syrup, Eye ointment, Eye drops, Ointment, Ear drops |
MORE INFORMATION
- Keep out of reach from children
- Store at room temperature
FAQs ABOUT PERKOCIP 250 TABLET
What is PERKOCIP 250 TABLET used for?
PERKOCIP 250 TABLET is used in adults in the treatment of bacterial infections of the respiratory tract, ear and sinus, urinary tract, genital tract, gastrointestinal tract, skin and soft tissue, bone and joint, as well as anthrax inhalation exposure infections. PERKOCIP 250 TABLET is also used in the management of fever in patients with neutropenia-associated infection. Use of PERKOCIP 250 TABLET in children and adolescents is to treat lung and bronchial infections with cystic fibrosis and complicated urinary tract infections, including infections that cause pyelonephritis (a kidney infection that needs immediate medical attention). Consult your doctor before taking PERKOCIP 250 TABLET.Is PERKOCIP 250 TABLET safe to take?
PERKOCIP 250 TABLET is a relatively safe drug. However, the complications are more comparable to other drugs and hence should only be strictly taken if prescribed by a doctor for your present condition in the appropriate dose, frequency, and duration as advised.
Can I skip the dose of PERKOCIP 250 TABLET?
No. You should complete the full course of PERKOCIP 250 TABLET as prescribed by your doctor. It is important that PERKOCIP 250 TABLET be taken at the right dose and for the right duration given. Otherwise, the symptoms can prevail and sometimes worsen.
Can the use of PERKOCIP 250 TABLET cause diarrhoea?
Yes, the use of PERKOCIP 250 TABLET can cause diarrhoea. It is an antibiotic that eliminates harmful bacteria. However, it also attacks the helpful bacteria in your stomach or intestine and causes diarrhoea. Consult your doctor if you are experiencing severe diarrhoea after taking PERKOCIP 250 TABLET.
Can PERKOCIP 250 TABLET increase the risk of muscle damage?
Yes, the use of PERKOCIP 250 TABLET is known to increase the risk of muscle damage, commonly in the ankle (Achilles tendon). Muscle damage can happen in people of all ages who take PERKOCIP 250 TABLET. Inform your doctor if you feel any kind of muscle pain while using this medicine.
What will happen if I accidentally take more of PERKOCIP 250 TABLET?
If you have accidentally overdosed on PERKOCIP 250 TABLET, you may suffer from reversible kidney toxicity. In such cases, adequate hydration should be maintained. Hence, drink plenty of fluids, to avoid further complications. And consult a doctor immediately and visit the nearby hospital.
Can PERKOCIP 250 TABLET be given to breastfeeding mothers?
PERKOCIP 250 TABLET tablet is not recommended for breastfeeding mothers, as the medicine could harm the child. Consult your doctor if you are breastfeeding before you start taking this medication for infections.
Can I take PERKOCIP 250 TABLET for my cough and flu?
No, PERKOCIP 250 TABLET is an antibacterial medicine that acts only against specific kinds of bacterial infections and not against viral infections causing cough and flu. You should not self-medicate PERKOCIP 250 TABLET without prior consultation with a doctor. Self-prescription is dangerous and can lower the efficacy and therapeutic outcome of PERKOCIP 250 TABLET leading to antibiotic resistance
REFERENCES
1. KD Tripathi. Fluoroquinolones antibiotics. Essentials of Medical Pharmacology. Seventh Edition,2013. Page - 709.
2. George A. Jacoby, Mechanisms of Resistance to Quinolones, Clinical Infectious Diseases. [Accessed on 10th June 2022] https://academic.oup.com/cid/article/41/Supplement_2/S120/307501
3. Liam S. Redgrave, Sam B. Sutton, et.al. Fluoroquinolone resistance: mechanisms, impact on bacteria, and role in evolutionary success. Cell press. [Accessed on 10th June 2022] https://www.cell.com/trends/microbiology/pdf/S0966-842X(14)00089-4.pdf
4. Aldred KJ, Kerns RJ, Osheroff N. Mechanism of quinolone action and resistance. National Library of Medicine (PMC). 2014. [Accessed on 10th June 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985860/
5. V Mirone, Ferdinando Fusco, D Taglialatela. Efficacy and Safety of Ciprofloxacin XR 1000 mg Once Daily Versus Ciprofloxacin 500 mg Twice Daily in the Treatment of Complicated Urinary Tract infections. ResearchGate https://www.researchgate.net/publication/_
6. Dr. Reddy’s Laboratories (UK) Ltd. Electronic Medicines Compendium (EMC). [Revised in November 2020] [Accessed on 10th June 2022] https://www.medicines.org.uk/emc/files/pil.3483.pdf
7. Bayer HealthCare Pharmaceuticals Inc. [Revised in March 2020] [Accessed on 11th October 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/019537s090,020780s047lbl.pdf
8. Bayer Inc. [Revised in June 2021] [Accessed on 10th June 2022] https://www.bayer.com/sites/defa8. ult/files/2020-11/cipro-pm-en.pdf
9. Dr. Reddy’s Laboratories (UK) Ltd. Electronic Medicines Compendium (EMC). [Revised in November 2020] [Accessed on 10th June 2022] https://www.medicines.org.uk/emc/files/pil.3484.pdf
10. APL Swift Services (Malta) Limited. Electronic Medicines Compendium (EMC). [Revised in February 2022] [Accessed on 10th June 2022] https://www.medicines.org.uk/emc/files/pil.7258.pdf
11. Dr Reddy’s Laboratories (UK) Ltd. Electronic Medicines Compendium (EMC). [Revised in November 2020] [Accessed on 10th June 2022] https://www.medicines.org.uk/emc/files/pil.3483.pdf
12. M/S Golden Cross Pharma Pvt. Ltd. [Revised in July 2020] [Accessed on 10th June 2022] https://www.ciplamed.com/content/ciplox-tablets
13. Torrent Pharmaceuticals Ltd. [Revised in September 2016] [Accessed on 10th June 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/453.pdf
14. Bayer (Pty) Ltd. [Revised in September 2020] [Accessed on 10th June 2022] https://www.bayer.com/sites/default/files/CIPROBAY_ORAL_EN_PIL.pdf
USEFUL DIAGNOSTIC TESTS
- Complete Blood Count
- Peripheral Smear Examination
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