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Convulsions have been reported in patients receiving Ciprofloxacin. Convulsions, increased intracranial pressure, and toxic psychosis have been reported in patients receiving Ciprofloxacin and other drugs of this class. Quinolones may also cause central nervous system (CNS) stimulation which may lead to tremors, restlessness, lightheadedness, confusion and hallucinations. As with all quinolones, Ciprofloxacin should be used with caution in patients with known or suspected CNS disorders, such as severe cerebral arteriosclerosis, epilepsy, and other factors that predispose to seizures.
Crystalluria related to Ciprofloxacin has been reported only rarely in humans because human urine is usually acidic. Alkalinity of the urine should be avoided in patients receiving Ciprofloxacin. Patients should be well hydrated to prevent the formation of highly concentrated urine. Alteration of the dosage regimen is necessary for patients with impairment of renal function.
Use in pregnancy: Pregnancy Category C: Reproduction studies have been performed in rats and mice at doses up to 16 times the usual daily human dose and have revealed no evidence of impaired fertility or harm to the fetus due to Ciprofloxacin. In rabbits, Ciprofloxacin produced gastrointestinal disturbances resulting in maternal weight loss and an increased incidence of abortion. No teratogenicity was observed. After intravenous administration of doses up to 20 mg/kg, no maternal toxicity was produced, and no embryotoxicity or teratogenicity was observed.
Use in lactation: Ciprofloxacin is excreted in human milk. Because of the potential for serious adverse reactions in infants nursing from mothers taking Ciprofloxacin, a decision should be made either to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Use in children: Safety and effectivity in children and adolescents less than 18 years of age have not been established. Ciprofloxacin causes arthropathy in juvenile animals.
