What is Ciprowon TZ?
Ciprowon TZ is used to treat bacterial infections in many different parts of the body. Ciprowon TZ oral liquid and tablets are also used to treat anthrax infection after inhalational exposure. Ciprowon TZ may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.
Ciprowon TZ extended-release tablets are only used to treat urinary tract infections, including acute uncomplicated pyelonephritis.
Proquin® XR tablets are only used to treat uncomplicated or simple urinary tract infections (acute cystitis).
Ciprowon TZ belongs to the class of drugs known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, Ciprowon TZ will not work for colds, flu, or other virus infections.
Ciprowon TZ is available only with your doctor's prescription.
Ciprowon TZ indications
Ciprowon TZ Tablets, USP are indicated for the treatment of infections caused by susceptible isolates of the designated microorganisms in the conditions and patient populations listed below.
Urinary Tract Infections
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of urinary tract infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Proteus mirabilis, Providencia rettgeri, Morganella morganii, Citrobacter koseri, Citrobacter freundii, Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus epidermidis, Staphylococcus saprophyticus, or Enterococcus faecalis.
Acute Uncomplicated Cystitis
Ciprowon TZ Tablets, USP are indicated in adult female patients for treatment of acute uncomplicated cystitis caused by Escherichia coli or Staphylococcus saprophyticus.
Chronic Bacterial Prostatitis
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of chronic bacterial prostatitis caused by Escherichia coli or Proteus mirabilis.
Lower Respiratory Tract Infections
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of lower respiratory tract infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Pseudomonas aeruginosa, Haemophilus influenzae, Haemophilus parainfluenzae, or Streptococcus pneumoniae. Also, Ciprowon TZ Tablets, USP are indicated for the treatment of acute exacerbations of chronic bronchitis caused by Moraxella catarrhalis.
Acute Sinusitis
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of acute sinusitis caused by Haemophilus influenzae, Streptococcus pneumoniae, or Moraxella catarrhalis.
Skin and Skin Structure Infections
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of skin and skin structure infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Proteus vulgaris, Providencia stuartii, Morganella morganii, Citrobacter freundii, Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus aureus, methicillin-susceptible Staphylococcus epidermidis, or Streptococcus pyogenes.
Bone and Joint Infections
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of bone and joint infections caused by Enterobacter cloacae, Serratia marcescens, or Pseudomonas aeruginosa.
Complicated Intra-Abdominal Infections
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of complicated intra-abdominal infections (used in combination with metronidazole) caused by Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, or Bacteroides fragilis.
Infectious Diarrhea
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of infectious diarrhea caused by Escherichia coli (enterotoxigenic isolates), Campylobacter jejuni, Shigella boydii†, Shigella dysenteriae, Shigella flexneri or Shigella sonnei† when antibacterial therapy is indicated.
†Although treatment of infections due to this organism in this organ system demonstrated a clinically significant outcome, efficacy was studied in fewer than 10 patients.
Typhoid Fever (Enteric Fever)
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of typhoid fever (enteric fever) caused by Salmonella typhi. The efficacy of Ciprowon TZ in the eradication of the chronic typhoid carrier state has not been demonstrated.
Uncomplicated Cervical and Urethral Gonorrhea
Ciprowon TZ Tablets, USP are indicated in adult patients for treatment of uncomplicated cervical and urethral gonorrhea due to Neisseria gonorrhoeae.
Complicated Urinary Tract Infections and Pyelonephritis
Ciprowon TZ Tablets, USP are indicated in pediatric patients one to 17 years of age for treatment of complicated urinary tract infections (cUTI) and pyelonephritis due to Escherichia coli.
Inhalational Anthrax (post-exposure)
Ciprowon TZ Tablets, USP are indicated in adults and pediatric patients from birth to 17 years of age for inhalational anthrax (post-exposure) to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.
Ciprowon TZ serum concentrations achieved in humans served as a surrogate endpoint reasonably likely to predict clinical benefit and provided the initial basis for approval of this indication.1 Supportive clinical information for Ciprowon TZ for anthrax post-exposure prophylaxis was obtained during the anthrax bioterror attacks of October 2001.
Plague
Ciprowon TZ Tablets, USP are indicated for treatment of plague, including pneumonic and septicemic plague, due to Yersinia pestis (Y. pestis) and prophylaxis for plague in adults and pediatric patients from birth to 17 years of age. Efficacy studies of Ciprowon TZ could not be conducted in humans with plague for feasibility reasons. Therefore this indication is based on an efficacy study conducted in animals only.
Limitation of Use
Use in Pediatric Patients
Although effective in clinical trials, Ciprowon TZ is not a drug of first choice in the pediatric population due to an increased incidence of adverse events compared to controls, including events related to joints and/or surrounding tissues. Ciprowon TZ Tablets, USP, like other fluoroquinolones, is associated with arthropathy and histopathological changes in weight-bearing joints of juvenile animals.
Lower Respiratory Tract Infections
Ciprowon TZ Tablets, USP are not a drug of first choice in the treatment of presumed or confirmed pneumonia secondary to Streptococcus pneumoniae.
Usage
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ciprowon TZ Tablets, USP and other antibacterial drugs, Ciprowon TZ Tablets, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
If anaerobic organisms are suspected of contributing to the infection, appropriate therapy should be administered. Appropriate culture and susceptibility tests should be performed before treatment in order to isolate and identify organisms causing infection and to determine their susceptibility to Ciprowon TZ. Therapy with Ciprowon TZ Tablets, USP may be initiated before results of these tests are known; once results become available appropriate therapy should be continued. As with other drugs, some isolates of Pseudomonas aeruginosa may develop resistance fairly rapidly during treatment with Ciprowon TZ. Culture and susceptibility testing performed periodically during therapy will provide information not only on the therapeutic effect of the antimicrobial agent but also on the possible emergence of bacterial resistance.
How should I use Ciprowon TZ?
Use Ciprowon TZ tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Ciprowon TZ tablets comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Ciprowon TZ tablets refilled.
- Take Ciprowon TZ tablets by mouth with or without food. The preferred dosing time is 2 hours after a meal.
- Swallow Ciprowon TZ tablets whole with a full glass of water. Do not break, crush, or chew before swallowing. If you cannot swallow Ciprowon TZ tablets whole, tell your doctor.
- Drinking extra fluids while you are taking Ciprowon TZ tablets is recommended. Check with your doctor for instructions.
- If you also take any products containing magnesium, aluminum, calcium, iron, or zinc (eg, antacids, quinapril, vitamins/minerals); didanosine; sucralfate; or bismuth subsalicylate, do not take them within 6 hours before or 2 hours after taking Ciprowon TZ tablets. Check with your doctor if you have questions.
- If you also take sevelamer, do not take it within 4 hours before or after taking Ciprowon TZ tablets. Check with your doctor if you have questions.
- Ciprowon TZ tablets works best if it is taken at the same time each day.
- To clear up your infection completely, take Ciprowon TZ tablets for the full course of treatment. Keep taking it even if you feel better in a few days.
- Avoid taking Ciprowon TZ tablets with milk or milk products (eg, calcium-enriched juice, yogurt) by themselves. However, taking Ciprowon TZ tablets as part of a full meal that contains milk or milk products is permitted.
- Do not miss any doses. If you miss a dose of Ciprowon TZ tablets, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Ciprowon TZ tablets.
Uses of Ciprowon TZ in details
Use: Labeled Indications
Children and Adolescents: Treatment of complicated urinary tract infections and pyelonephritis due to E. coli. Note: Although effective, Ciprowon TZ is not the drug of first choice in children.
Infants, Children, Adolescents, and Adults: Prophylaxis to reduce incidence or progression of disease following inhalation exposure to Bacillus anthracis; prophylaxis and treatment of plague (Yersinia pestis).
Adults: Treatment of the following infections when caused by susceptible bacteria: Urinary tract infections; acute uncomplicated cystitis in females, chronic bacterial prostatitis, bone and joint infections, complicated intra-abdominal infections (in combination with metronidazole), infectious diarrhea, typhoid fever (Salmonella typhi), hospital-acquired (nosocomial) pneumonia.
Limitations of use: Because fluoroquinolones have been associated with disabling and potentially irreversible serious adverse reactions (eg, tendinitis and tendon rupture, peripheral neuropathy, CNS effects), reserve Ciprowon TZ for use in patients who have no alternative treatment options for acute uncomplicated cystitis.
Off Label Uses
Anthrax
Based on the Centers for Disease Control and Prevention (CDC) expert panel meetings on prevention and treatment of anthrax, Ciprowon TZ is an effective and recommended agent for treatment of cutaneous or systemic anthrax.
Bite wound infection (animal and human bites)
Based on the Infectious Diseases Society of America (IDSA) guidelines for the diagnosis and management of skin and soft tissue infections (SSTIs), Ciprowon TZ, in combination with an appropriate agent for anaerobes, is an effective and recommended alternative option for prophylaxis and treatment of human or animal bite wounds, particularly in patients who are hypersensitive to beta-lactams.
Cat scratch disease, lymphadenitis (nondisseminated)
Data from a limited number of patients suggest that Ciprowon TZ may be beneficial for the treatment of cat scratch disease ).
Tularemia
Data from retrospective studies and case reports/series demonstrate varied results with the use of Ciprowon TZ in the management of tularemia. Guidelines created by the Infectious Diseases Society of America, Working Group on Civilian Biodefense, and the European Commission's Task Force on Biological and Chemical Agent Threats (BICHAT) recommend Ciprowon TZ as an alternative in the management of mild tularemia infection. In scenarios of mass casualty management and postexposure prophylaxis, the Working Group on Civilian Biodefense considers oral Ciprowon TZ and doxycycline as drugs of choice.
Ciprowon TZ description
Ciprowon TZ: Each 250- and 500-mg tablet contains Ciprofloxacin HCl 250 mg and 500 mg, respectively.
Each 50-, 100- and 200-mL vial of infusion solution contains Ciprofloxacin lactate 100 mg, 200 mg and 400 mg, respectively.
Ciprowon TZ tablet also contains microcrystalline cellulose, maize starch, crospovidone, anhydrous colloidal silica, magnesium stearate, hypromellose, macrogol 4000 and titanium dioxide (E171) while the infusion solution also contains lactic acid, sodium chloride, concentrated hydrochloric acid and water for injections.
Ciprowon TZ XR: Each 500 mg tablet contains Ciprofloxacin HCl monohydrate 334.8 mg and Ciprowon TZ hydrous 253 mg, corresponding to Ciprowon TZ 500 mg. Each 1 g tablet contains Ciprofloxacin HCl monohydrate 669.4 mg and Ciprowon TZ hydrate 506 mg, corresponding to Ciprowon TZ 1000 mg.
Ciprowon TZ XR also contains the following excipients: Crospovidone, magnesium stearate, anhydrous colloidal silica, succinic acid, hypromellose, macrogol 3350, titanium dioxide and purified water in bulk.
Ciprowon TZ dosage
Ciprowon TZ (Ciprowon TZ hcl) 500 mg tablets should be administered orally once daily for 3 days with a main meal of the day, preferably the evening meal.
Ciprowon TZ (Ciprowon TZ hcl) tablets should be taken whole and never split, crushed, or chewed.
Ciprowon TZ (Ciprowon TZ hcl) should be administered at least 4 hours before or 2 hours after antacids containing magnesium or aluminum, sucralfate, VIDEX® (didanosine) chewable/buffered tablets or pediatric powder, metal cations such as iron, and multivitamin preparations containing zinc.
Concomitant administration of Ciprowon TZ with milk products or calcium-fortified juices alone should be avoided since decreased absorption is possible.
Adequate hydration of patients receiving Ciprowon TZ (Ciprowon TZ hcl) should be maintained to prevent the formation of highly concentrated urine. Crystalluria and cylindruria has been reported with quinolones.
How supplied
Dosage Forms And Strengths
Extended release tablets: 500 mg* of Ciprowon TZ
*present as 582 mg of Ciprowon TZ hydrochloride monohydrate
Storage And Handling
Ciprowon TZ (Ciprowon TZ hcl) is available as blue film-coated tablets containing 500 mg Ciprowon TZ. The tablet is debossed with “500” on one side and “DMI” on the other side.
| Package | Strength | NDC Code |
| Bottles of 30: | 500 mg | 13913-001-30 |
| Blister Packs of 3: | 500 mg | 13913-001-03 |
Store Ciprowon TZ (Ciprowon TZ hcl) at 25°C (77 °F); excursions permitted to 15-30 °C (59-86 °F).
Revised February 2011. Depomed, Inc. 1360 O'Brien Drive, Menlo Park, CA 94025-1436. 1-866-458-6389
Ciprowon TZ interactions
See also:
What other drugs will affect Ciprowon TZ?
Ciprowon TZ may interfere with the clearance of drugs metabolized by the liver eg, theophylline and caffeine on account of the ability of Ciprowon TZ to inhibit hepatic metabolism. In 1 study, seizures had developed after concomitant use of Ciprowon TZ with theophylline.
Ciprowon TZ is not recommended to be administered orally within 4 hrs of taking magnesium, aluminum or iron and zinc salts-containing antacids to prevent the reduction of absorption of Ciprowon TZ as well as other fluoroquinolones. Sucralfate, which releases aluminum ions in the stomach, may reduce absorption of Ciprowon TZ and other quinolones.
The possibility of interfering with the absorption of fluoroquinolones may be present in dairy products having high calcium content.
Although histamine H2 antagonist affect the pharmacokinetics of Ciprowon TZ, clinical effect is found insignificant.
Naproxen and chloroquine were found to cause adverse neurological effect with the addition of Ciprowon TZ. Effect was reduced when the antirheumatic drugs were discontinued.
In surgical infection prophylaxis, concomitant administration of Ciprowon TZ with opioid analgesics is not recommended as the peak serum concentration of Ciprowon TZ is reduced significantly.
Cytotoxic chemotherapy was reported to reduce the absorption of Ciprowon TZ. Enhanced nephrotoxicity was developed after concomitant use of the Ciprowon TZ with cyclosporine.
Plasma concentration of midazolam increases when administered with Ciprowon TZ.
Probenecid was found to reduce the urinary excretion of Ciprowon TZ without increasing plasma concentration of the latter.
Interference with Laboratory Results: In elderly patients treated with Ciprowon TZ for urinary tract infections, a false-positive reaction for urinary glucose (pseudoglycosuria) has been reported.
Ciprowon TZ side effects
See also:
What are the possible side effects of Ciprowon TZ?
Among the usual adverse effects of Ciprowon TZ are gastrointestinal disturbances, CNS toxicity and hypersensitivity reactions.
Nausea, vomiting, diarrhea, abdominal pain and dyspepsia are experienced as common gastrointestinal disturbances. Reports of pseudomembranous colitis are seldom received. Headache, anorexia, flatulence, bilirubinemia, dizziness and restlessness are the most common CNS effects. Other CNS toxicity associated with the use of Ciprowon TZ are tremor, drowsiness, insomnia, agitation, confusion, unpleasant dreams, visual disturbances and other sensory disturbances, hallucinations, depression and convulsions, eosinophilic meningitis, acute psychoses, peripheral neuropathy, dysesthesia, catatonia, hemisparesis and tinnitus.
Patients taking Ciprowon TZ may also experience hypersensitivity reactions eg, rash, pruritus, photosensitivity, vasculitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, laryngeal edema and anaphylaxis (may be fatal). Reversible arthralgia and joint erosions were seen in animals. A case of tendon damage was also reported.
Reports of transient elevation of serum creatinine, blood urea nitrogen and liver enzyme values, acute renal failure secondary to interstitial nephritis, crystalluria, jaundice, moniliasis, asthenia, hepatitis, eosinophilia, leukopenia, thrombocytopenia, pancytopenia, hemolytic anemia or agranulocytosis, myalgia and gynecomastia were received. Tachycardia, edema syncope, hot flushes and sweating are among the cardiovascular effects of the use of Ciprowon TZ.
Pseudomembranous colitis and superinfection with Candida, C. difficile and S. pneumoniae associated with the use of Ciprowon TZ were reported. The risk of methicillin-resistant S. aureus and vancomycin-resistant enterococci colonization are high in patients taking Ciprowon TZ.
Ciprowon TZ contraindications
See also:
What is the most important information I should know about Ciprowon TZ?
You should not use this medication if you are taking tizanidine (Zanaflex), if you have a history of myasthenia gravis, or if you are allergic to Ciprowon TZ or similar antibiotics such as gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and others.
Before taking Ciprowon TZ, tell your doctor if you have a heart rhythm disorder, kidney or liver disease, joint problems, diabetes, muscle weakness or trouble breathing, a condition called pseudotumor cerebri, a history of seizures, a history of head injury or brain tumor, low levels of potassium in your blood, a personal or family history of Long QT syndrome, or if you have ever had an allergic reaction to an antibiotic.
Do not take Ciprowon TZ with dairy products such as milk or yogurt, or with calcium-fortified juice.
Avoid taking antacids, vitamin or mineral supplements, sucralfate (Carafate), or didanosine (Videx) powder or chewable tablets within 6 hours before or 2 hours after you take Ciprowon TZ.
Ciprowon TZ may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. Stop taking Ciprowon TZ and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.
Active ingredient matches for Ciprowon TZ:
| Unit description / dosage (Manufacturer) | Price, USD |
| Ciprowon TZ 500+600 Tablet | $ 0.08 |
List of Ciprowon TZ substitutes (brand and generic names): | |
| Ciprowon | |
| Ciprowon 250 mg Tablet (Aan Pharma Pvt Ltd) | $ 0.04 |
| Ciprox (Bangladesh, Bulgaria, Germany, Iraq, Peru, Yemen) | |
| CIPROX Infusion / 200mg / 100ml units (Avex) | $ 0.20 |
| Ciprox 200mg INF / 100ml (Avex) | $ 0.20 |
| 200 mg x 100ml (Avex) | $ 0.20 |
| Ciprox 250 mg x 10 x 10's (Avex) | |
| Ciprox 500 mg x 10 x 10's (Avex) | |
| Injectable; Infusion; Ciprofloxacin Lactate 2 mg / ml (Avex) | |
| Tablets, Film-Coated; Oral; Ciprofloxacin Hydrochloride 250 mg (Avex) | |
| Tablets, Film-Coated; Oral; Ciprofloxacin Hydrochloride 500 mg (Avex) | |
| CIPROX 200MG INFUSION 1 bottle / 100 ML infusion each (Avex) | $ 0.17 |
| Ciprox film-coated tab 250 mg 10 x 10's (Avex) | |
| Ciprox film-coated tab 500 mg 10 x 10's (Avex) | |
| CIPROX infusion 200 mg x 100ml (Avex) | $ 0.22 |
| Ciprox 200mg Infusion (Avex) | $ 0.00 |
| Ciprox 0.2% (Oman) | |
| Ciprox-DS (Bangladesh) | |
| Ciprox-XR (Bangladesh) | |
| Ciproxacil-T (Ecuador) | |
| Ciproxacol (Peru) | |
| Ciproxain (India) | |
| Ciproxain 250mg TAB / 10 (Sain) | $ 0.42 |
| Ciproxain 500mg TAB / 10 (Sain) | $ 0.84 |
| CIPROXAIN tab 250 mg x 10's (Sain) | $ 0.42 |
| CIPROXAIN tab 500 mg x 10's (Sain) | $ 0.84 |
| Ciproxan (Japan, Peru, Thailand) | |
| Tablet; Oral; Ciprofloxacin 500 mg (Bayer) | |
| Ciproxan 250 mg x 10 x 10's (Bayer) | |
| Tablets; Oral; Ciprofloxacin 500 mg (Bayer) | |
| Ciproxan I.V. | |
| Injectable; Injection; Ciprofloxacin | |
| Ciproxel (Philippines) | |
| Ciproxel 500 mg x 10's | |
| Ciproxel 500 mg x 100's | $ 71.11 |
| Ciproxen (Bahrain, Bangladesh, Oman) | |
| Ciproxen 250mg (Oman) | |
| Ciproxen 500mg (Oman) | |
| Ciproxen 750mg (Oman) | |
| Ciproxene 250 | |
| Ciproxene 500 | |
| Ciproxene 750 | |
| Ciproxil XL (Egypt) | |
| Ciproxim (Bangladesh) | |
| Ciproxin (Australia, Austria, Estonia, Finland, Greece, Hong Kong, Iceland, Indonesia, Ireland, Israel, Italy, Kenya, Malta, Netherlands, New Zealand, Nigeria, Norway, Romania, Sweden, Switzerland, Taiwan, Tanzania, Turkey, Uganda, United Kingdom) | |
| Injectable; Injection; Ciprofloxacin 2 mg / ml (Trio Remedies Pvt.Ltd) | |
| Suspension; Oral; Ciprofloxacin 250 mg / 5 ml (Trio Remedies Pvt.Ltd) | |
| Suspension; Oral; Ciprofloxacin 500 mg / 5 ml (Trio Remedies Pvt.Ltd) | |
| Tablet, Film-Coated; Oral; Ciprofloxacin Hydrochloride 250 mg (Trio Remedies Pvt.Ltd) | |
See 7236 substitutes for Ciprowon TZ | |
References
- DailyMed. "CIPROFLOXACIN; DEXAMETHASONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "ciprofloxacin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "ciprofloxacin". http://www.drugbank.ca/drugs/DB00537 (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
