Interaction charts on this desk are for reading, not for writing a prescription or filling a bottle. Open the orbit disclaimer
Orbit · Orbit · Anti-infective
Last reviewed · 13 min read · Updated
Orbit card
| Onset | Hours; tendon injury can be hours or delayed months |
|---|---|
| Duration | Course length is labeled; 500 mg x 14 is the cash row |
| Food | Dairy and cations need a mapped gap |
| Alcohol | Not an antidote; CNS and tendon rules still apply |
Fluoroquinolone pairing chart. Not UTI triage by inbox.
Concomitant tizanidine is contraindicated on Cipro labels. The kinetic study used ciprofloxacin 500 mg twice daily for three days with a 4 mg tizanidine dose. Hypotension and sedation were potentiated. That is not a 'watchful' pair.
Theophylline exposure can rise. If both stay, levels and CNS watch belong to the clinician. QT-active stacks (Class IA/III, some macrolides, some antipsychotics) add another avoid-or-justify row.
Fourteen 500 mg tablets are the cash lock: $31.14 / $15.24 on the GoodRx caption. Dairy and antacid gaps still apply. Caelum does not dispense.
Generic ciprofloxacin 500 mg x 14, GoodRx tablet table.
Generic ciprofloxacin 500 mg, fourteen tablets, the Caelum Cipro orbit, 21 August 2026. GoodRx lists 500 mg x 14 at $31.14 / $15.24. Dairy and antacid gaps still apply. Tendon boxed text still applies. Caelum does not dispense.
Tizanidine is contraindicated with Cipro 500. Seven-fold Cmax in the labeled study. Hold or switch before the first tablet.
Tendon pain, nerve tingling, or a new CNS change stops the course. Months-later rupture still counts. Steroids and age over 60 raise the odds.
Dairy and cations need a mapped gap. Water is the swallow. QT-active stacks are avoid-or-justify.
Reserve language still asks for other options in some uncomplicated sinus, bronchitis, and cystitis cases.
Do not stack leftover Zithromax 500. Write the spasm bottle on the bag. 112 for collapse or sudden back pain with aorta history.
Ciprofloxacin inhibits CYP1A2. Tizanidine depends on that path. Seven-fold Cmax is how a muscle-relaxant afternoon becomes a faint at the sink.
Open the tizanidine orbit when spasm therapy is already on the chart. Hold or switch belongs to the prescriber, not to a hope that 500 mg is 'only an antibiotic.'
Other CYP1A2 substrates (some of theophylline story, some antidepressants) need a list read. Recite the spasm bottle even if it was last filled in winter.
| Pair | Label posture |
|---|---|
| Tizanidine | Contraindicated - Cmax ~7x, AUC ~10x with 500 mg BID x 3 d |
| Theophylline | Avoid or monitor levels; CNS risk rises |
| QT-prolonging drugs | Avoid / justify - interval can lengthen |
| Warfarin | INR can move - call the clinic |
| Oral sulfonylureas | Hypoglycemia reports - glucose watch |
The kinetic study used tizanidine 4 mg with ciprofloxacin 500 mg twice daily for three days. Cmax rose about 7-fold and AUC about 10-fold. Hypotension and sedation were potentiated.
That is why the pair is contraindicated, not 'use caution.' Hold or switch belongs to the prescriber before the first 500 mg.
Evening Zanaflex for spasm plus a night-time Cipro 500 is the exact study design people recreate at home.
Open the tizanidine orbit when spasm therapy is already on the chart. Do not hope 500 mg is 'only an antibiotic.'
If both were already swallowed, sit, hydrate per the clinic, and seek care for faint or extreme sleepiness. Do not take the next 500 mg to 'finish.'
Fluoroquinolone class language includes aortic-aneurysm caution. Vascular history belongs in the same sentence as the first 500 mg.
CNS effects include seizure, confusion, and suicidal-thinking language. Those are discontinue-and-avoid-future-quinolone events when they appear.
US labels ask clinicians to reserve Cipro for some uncomplicated sinus, bronchitis, and cystitis cases when other options exist. Fastest is not the pairing question.
Myasthenia is an avoid. New or sharper weakness on day two of 500 mg is a stop, not a 'push through the infection' plan.
Tendon injury can be bilateral and can arrive months later. Document the 500 mg dates for the next sports-medicine visit.
The first sentence is tizanidine. Contraindicated. Seven-fold Cmax in the labeled study with 500 mg twice daily for three days. Hold or switch before the first tablet.
The second sentence is theophylline if that bottle exists. Levels and CNS watch, or avoid.
The third sentence is QT-active drugs. Class IA and III agents are avoid-or-justify. Recite amiodarone before Achilles.
The fourth sentence is tendon risk modifiers: age over 60, corticosteroids, transplant. Pain, swelling, or a snap stops the course. Months later still counts.
The fifth sentence is neuropathy and CNS boxed text. Pins and needles on day two are not hydration. Confusion is a stop.
The sixth sentence is the cation and dairy gap. Water is the default swallow.
The seventh sentence is reserve language for some uncomplicated sinus, bronchitis, and cystitis cases when other options exist.
The eighth sentence is aorta caution and 112 for sudden severe chest or back pain.
Write the July 500 mg dates for October sports medicine. Do not stack leftover Zithromax 500 for coverage.
Leftover 500s from a Mexico week are not a harbour UTI plan. Indication, kidneys, and tizanidine still apply.
Strenuous activity plus a quinolone plus age over 60 is how Achilles stories start on vacation. Rest is part of the stop rule.
Sunburn is not the Doryx card. Fluoroquinolones have their own photosensitivity notes in some labels. Stop language still centers on tendon and nerve.
Do not stack leftover azithromycin 500 with leftover Cipro 500 because both boxes said 'antibiotic.' QT plus tendon is a worse pair, not a stronger course.
Write 112 on the bag for collapse. [email protected] is not that number.
Ciprofloxacin can move warfarin. A 500 mg fortnight is long enough for an INR call, not a wait-until-routine.
Oral sulfonylureas have hypoglycemia reports with cipro. Glucose watch belongs on the bag if diabetes tablets share the morning.
Caffeine clearance can fall. Jitter after a double espresso is a CYP1A2 footnote, not Achilles language. Still reciting tizanidine first.
Methotrexate and some immunosuppressants appear on interaction tables. Oncology needs the start date.
Clozapine and other CYP1A2 substrates can rise. Psychiatry bottles hide in coat pockets. Ask twice.
The cash lock remains generic ciprofloxacin 500 mg x 14 at $31.14 / $15.24. A 250 mg row is another NDC. Tizanidine remains contraindicated at either strength.
Ingrid peer-passes charts at Laugavegur 28. She does not clear harbour leftovers. [email protected] is for sources. 112 is for collapse.
Quinolone allergy. Tizanidine on the list. Known myasthenia. A tendon event on a prior fluoroquinolone. Those are hard noes unless a specialist document says otherwise.
Pregnancy and children: systemic quinolones are restricted territory. This orbit will not invent a home exception for a travel UTI.
Aortic-aneurysm caution language exists on the class. Vascular history belongs in the same sentence as the first 500 mg.
Renal impairment changes interval or dose. The 500 mg lock is a strength, not a CKD licence. eGFR belongs on the chart before a fourteen-count repeat.
A 250 mg row is another NDC. This desk will not invent a 250 coupon to match a drawer leftover. QT and tizanidine rules do not relax at 250.
Antacids, iron, and dairy still need the leaflet gap even when the dose was trimmed. Binding does not care that kidneys are slow.
Transplant patients on steroids sit in the high-tendon-risk cluster. Say that aloud before a weekend football plan.
Date-stamp the first tendon twinge. Hours or days from the first 500 mg still count. Months later still count.
Evening tizanidine for a sore back plus night-time Cipro 500 is the study design: 4 mg next to 500 mg twice daily. Contraindicated. Do not recreate it because both bottles were already in the coat.
A steroid burst for harbour asthma plus weekend football plus age over 60 is the tendon cluster. Pain is a stop. Months later still counts.
Yogurt at the hostel plus an antacid plus the 500 mg tablet is a binding fail that looks like a weak quinolone. Water first. Gap the cations.
Leftover azithromycin 500 plus leftover Cipro 500 is QT plus tendon without a diagnosis. Not coverage.
Theophylline from an old COPD row plus a new 500 mg fortnight is a level-and-CNS watch, or an avoid.
Aorta history plus sudden back pain is 112, not a finish-the-fourteen plan.
Uncomplicated cystitis with other options still sitting on the guideline page is reserve language, not fastest.
Write the spasm bottle name on the 500 mg bag before the first harbour night.
Tendinitis and rupture can start within hours or days, or months after the last 500 mg. Achilles is famous. Shoulder, hand, and biceps are on the same list. Age over 60, corticosteroids, and transplant status raise the odds.
Pain, swelling, or a snap: stop ciprofloxacin, rest the limb, and contact care. The tendon trace is that stop. Do not stretch through it on a Reykjavik harbour walk.
Peripheral neuropathy and CNS effects (seizure, confusion, suicidal thinking in labeled language) are discontinue-and-avoid-future-quinolone territory when they appear. Myasthenia can worsen. Known myasthenia is an avoid.
Tizanidine 4 mg with ciprofloxacin 500 mg twice daily for three days raised tizanidine Cmax about 7-fold. That sentence is why the pair is contraindicated, not monitored.
Theophylline levels and CNS watch belong to the clinician if both drugs must stay. Nausea and tremor are same-day calls.
Class IA and III agents plus Cipro 500 are avoid-or-justify QT rows. Recite amiodarone before you recite Achilles.
Tendon injury can start within hours or months later, can be bilateral, and is likelier over 60, on steroids, or after transplant. Pain is a stop.
Peripheral neuropathy and serious CNS effects are discontinue-and-avoid-future-quinolone territory. Pins and needles on day two are not 'hydration.'
Dairy and cations need the leaflet gap. Yogurt breakfasts are the travel fail. Water is the default swallow.
Reserve language asks clinicians not to use Cipro first for some uncomplicated sinus, bronchitis, or cystitis cases when other options exist.
Aortic-aneurysm caution is class language. Sudden severe chest or back pain is 112.
Do not stack leftover azithromycin 500 with leftover Cipro 500. QT plus tendon is a worse pair, not coverage.
Write the first tendon twinge date. Sports medicine in October still needs the July 500 mg dates.
Calcium, iron, magnesium, aluminum, zinc, and sucralfate bind quinolones. Many leaflets use a window such as two hours before or six hours after the cation product. Use the leaflet in your box, not a memory from another brand.
Yogurt with the 500 mg tablet is a common travel fail. Water is the default swallow. Caffeine can feel sharper because ciprofloxacin slows its clearance in some people - a jitter story, not a tendon story.
Reserve language on US labels asks clinicians not to use Cipro first for some uncomplicated sinus, bronchitis, or cystitis cases when other options exist. That is stewardship, not a forum debate.
| Absorption | Oral absorption good when cations are absent. |
|---|---|
| Distribution | Wide tissue distribution, including urine and prostate for some labeled uses. |
| Metabolism | CYP1A2 inhibitor; renal and hepatic clearance both matter. |
| Excretion | Adjust when eGFR falls - the 500 mg lock is a strength, not a CKD licence. |
If tizanidine was not named, the tendon lecture was the second sentence, not the first.
Keep the fluoroquinolone orbit trace beside this page when the indication itself is the debate. Confirm every stop or switch with a clinician. [email protected] for sources.
Checked against the current label and reviewed by Dr. Ingrid Bergsson. See Lift, Chart, Peer-pass, Publish.
Cipro 500 mg thread. Dr. Ingrid Bergsson's desk tone. Not UTI chat triage. Tendon rupture, severe neuropathy, or collapse: urgent care or 112.
Einar J., Reykjavik I use tizanidine 4 mg at night. Clinic wrote Cipro 500 for two weeks. Start tonight?
Do not start. Concomitant tizanidine is contraindicated. A labeled study gave tizanidine 4 mg with ciprofloxacin 500 mg twice daily for three days and saw about a 7-fold Cmax and 10-fold AUC rise, with more hypotension and sedation. Call the prescriber before the first 500 mg. Open the tizanidine orbit with this page. Caelum cannot clear the pair by email.
Sports physio, Egilsstadir Achilles pain in October. Quinolone in July. Still relevant?
Yes. Boxed text includes delayed rupture months after the last dose. Rest the tendon and tell the clinician the July 500 mg dates and any steroid burst. Future fluoroquinolones are often avoided. This is not a stretch-through-it harbour plan. 112 if you collapse.
Iris HH., Borgarnes Clozapine plus Cipro 500 for prostatitis. Extra warning?
Ciprofloxacin can raise some CYP1A2 substrates, including clozapine in interaction tables. Psychiatry needs the start date and may want levels. This is not a home hold of clozapine. Recite tizanidine too if a spasm bottle exists. QT language still applies. Call before the first 500 mg if that desk was not in the room.
Valur S., Egilsstadir Uncomplicated cystitis. Friend said Cipro 500 is fastest.
US labels ask clinicians to reserve fluoroquinolones for some uncomplicated sinus, bronchitis, and cystitis cases when other options exist. Fastest is not the pairing question. The fluoroquinolone orbit trace is about that reserve language. Ask for an indicated alternative if one fits.
Asa L., Akureyri I take theophylline. Extra warning?
Ciprofloxacin can raise theophylline. Labels prefer avoid, or levels and CNS watch if both must stay. Nausea, tremor, or a racing mind is a same-day call. Do not add a 500 mg fortnight on top of a quiet theophylline row without that plan.
Petra G., Vestmannaeyjar Steroid burst for asthma plus Cipro 500. Extra tendon risk?
Yes. Corticosteroids raise fluoroquinolone tendon risk, especially over 60. Know the stop symptoms on day one. Do not add weekend football. If both drugs are necessary, the chart should say so out loud, not hide the steroid as 'just a burst.'
Spasm clinic, Akranes Patient needs tizanidine tonight and Cipro 500 was just written. What now?
Do not give both. Call the prescriber who wrote the 500 mg fortnight before the first tablet. The labeled kinetic study is the reason this is a contraindication, not a monitor. Open the tizanidine orbit. If both were already swallowed, sit, and seek care for faint or extreme sedation. Do not take the next 500 mg to finish.
Linda JJ., Grindavik Glyburide plus Cipro 500. Extra glucose checks?
Hypoglycemia reports exist with sulfonylureas plus ciprofloxacin. Check glucose more often the first days. Recite both names. Do not add a second 500 mg because a reading looked high after a steroid burst - that is a different stack. Call if you cannot stay awake.
Johanna C., Isafjordur Why 500 mg x 14 on the cash band when my last script was 250?
Caelum locks generic ciprofloxacin 500 mg x 14 at $31.14 / $15.24. A 250 mg row is another NDC. Strength follows the indication and kidney function. This desk will not invent a 250 coupon to match a drawer leftover. QT and tizanidine rules do not relax at 250.
Nils LL., Stykkisholmur Can I take leftover azithromycin 500 with leftover Cipro 500 for 'coverage'?
No. That stack adds QT language to tendon and tizanidine rules without a diagnosis. Two leftover boxes are not a regimen. See the azithromycin orbit for macrolide pairs and this orbit for the quinolone stop. Caelum does not invent combo coverage.
Yrsa 2C, Bolungarvik Tendon snap three months after the last 500 mg. Still the Cipro?
Boxed text says rupture can occur months after the last dose. Tell sports medicine the July dates. Rest the tendon. Future quinolones are often avoided. This is not a reason to stretch through a harbour match. 112 if you collapse. Bring the steroid history if a burst sat on the same summer.
Helga P., Kopavogur Achilles ache on day four. Walk it off?
No. Stop ciprofloxacin, rest the tendon, and contact care the same day. Rupture can need surgery. Risk is higher over 60, on steroids, or after transplant, but the boxed text applies at all ages. The tendon trace is that stop. Do not stretch through a harbour walk because the 500 mg course is 'almost done.'
Ragnar F., Akranes On amiodarone. Cipro 500 for prostatitis - automatic?
Not automatic. Ciprofloxacin can prolong QT. Class III agents are named in the avoid-or-justify language. The infection may still need a quinolone. That decision is cardiology plus the prescriber, not a forum vote. Recite both names before day one.
Marta KK., Saudarkrokur Caffeine jitters after one 500 mg. Tendon starting?
Caffeine clearance can fall. Jitter is not Achilles language. Tendon language is pain, swelling, or a snap. Stop for that. You can cut coffee without stopping a needed 500 mg map. If anxiety or suicidal thinking appears, that is CNS boxed text - stop and call.
Tomas R., Hafnarfjordur Yogurt breakfast then Cipro 500 - fine?
Dairy and cations bind quinolones. Many leaflets separate the 500 mg tablet by hours from milk, yogurt, antacids, and iron. Use the gap on your box. Water is the default swallow. A mapped clock beats a guess from another brand.
Jakob II., Husavik Known aortic aneurysm. Clinic still wrote Cipro 500.
Class caution language includes aortic aneurysm. That does not automatically forbid every quinolone, and it does not make leftover 500s a harbour plan. Ask the prescriber to say the vascular history out loud and why another class will not do. Sudden severe chest or back pain is emergency care. 112.
Niels B., Selfoss Pins and needles in both feet on day two. Keep going?
Peripheral neuropathy is in the boxed cluster. Stop and call. Future quinolones are often avoided after that signal. Do not wait for the fourteen-count to empty. If weakness climbs or you cannot walk, seek urgent care. 112 if you collapse.
Desk note, Laugavegur 28 What must the next clinician hear?
Tizanidine or other spasm tablets, theophylline, QT drugs, steroid bursts, prior tendon events, and the exact 500 mg days taken. Confirm stops with the prescriber. [email protected] for sources. Ingrid peer-passes charts. She does not clear contraindications by mail.