Ofloxacin (Ocuflox) vs. Ciprofloxacin (Cipro): Antibiotic Comparison

Ofloxacin vs. ciprofloxacin: What’s the difference?

• Ofloxacin and ciprofloxacin are fluoroquinolone antibiotics used to treat bacterial infections such as pneumonia, bronchitis, staph infections, STDs (gonorrhea, chlamydia), urinary tract infections (UTIs), and prostate infections caused by E. coli.
• A brand name for ofloxacin is Ocuflox. The Floxin brand of ofloxacin has been discontinued.
• A brand name for ciprofloxacin is Cipro.
• Side effects of ofloxacin and ciprofloxacin that are similar include nausea, vomiting, diarrhea, headache, and allergic reactions (such as hives and anaphylaxis).
• Side effects of ofloxacin that are different from ciprofloxacin include insomnia, dizziness, itching, vaginitis, anxiety, euphoria, hallucinations, low or high blood sugar levels (especially in people with diabetes), and skin sensitivity to sunlight (photosensitivity),
• Side effects of ciprofloxacin that are different from ofloxacin include abdominal pain, rash, and restlessness
• Ofloxacin, ciprofloxacin, and other fluoroquinolones have been associated with tendinitis and tendon rupture, particularly the Achilles tendon.

What is ofloxacin? What is ciprofloxacin?

Ofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections such as pneumonia, bronchitis, staph infections, STDs (gonorrhea, chlamydia), urinary tract infections (UTIs), and prostate infections caused by E. coli. Other fluoroquinolone antibiotics include levofloxacin (Levaquin), ciprofloxacin (Cipro), norfloxacin (Noroxin), moxifloxacin (Avelox), and trovafloxacin (Trovan). Ofloxacin stops the multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA).

Ciprofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections. It stops the multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA). Other fluoroquinolones include levofloxacin (Levaquin), norfloxacin (Noroxin), moxifloxacin (Avelox), and trovafloxacin (Trovan).

Bowel regularity means a bowel movement every day.
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What are the side effects of ofloxacin and ciprofloxacin?

Ofloxacin

The most common side effects of ofloxacin include:

• nausea,
• vomiting,
• diarrhea,
• insomnia,
• headache,
• dizziness,
• itching, and
• vaginitis in women.

Allergic reactions have been described, such as hives and anaphylaxis (shock).

Other important side effects include symptoms of nervous system stimulation, such as:

• anxiety,
• euphoria, and
• hallucinations.

Ofloxacin may cause low or high blood sugar levels especially in people with diabetes who are taking insulin or oral hypoglycemic drugs.

Patients taking ofloxacin can develop skin sensitivity (photsensitivity) to direct sunlight and should avoid exposure to sunlight or use sun protection and sunscreens.

Ofloxacin as well as other antibiotics in the fluoroquinolone class of antibiotics, has been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon. Some physicians recommend that patients discontinue vigorous exercise while they are taking fluoroquinolone antibiotics.

Ofloxacin should be used with caution in patients with central nervous system diseases such as seizures because rare seizures have been reported in patients receiving this medication.

Ofloxacin should be avoided in children and adolescents under 18 years of age, as safe use in these patients have not been established.

Many antibiotics, including ofloxacin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon (Clostridium difficile, pseudomembranous colitis). Pseudomembranous colitis can cause fever, abdominal pain, diarrhea, and sometimes even shock.

Ofloxacin should not be used in patients with myasthenia gravis because it can increase muscle weakness.

Ciprofloxacin

Cipro and Cipro XR as well as other antibiotics in the fluoroquinolone class of antibiotics has been associated with tendonitis and even tendon rupture, particularly the Achilles tendon. Some doctors and other medical professionals recommend that their patients discontinue vigorous exercise while they are taking fluoroquinolone antibiotics.

Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.

The most common side effects of Cipro, Cipro XR are:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Rash
• Headache
• Restlessness

Anaphylaxis, or shock, is a rare allergic reaction to this drug. This allergic reaction is a medical emergency and you are experiencing these symptoms seek medical immediately.

Symptoms of shock include:

• Cardiovascular collapse
• Facial or throat swelling
• Shortness of breath
• Hives
• Itching

Possible serious side effects of Cipro, Cipro XR include:

• Peripheral neuropathy
• Central nervous system effects (CNS), for example, toxic psychosis, nervousness, agitation, insomnia, anxiety, nightmares, paranoia, dizziness, tremors, depression, and hallucinations.
• Hyperglycemia
• Clostridiumdifficile-associated diarrhea (CDAD)
• Abnormal heart beats
• Liver dysfunction
• Stroke
• Convulsions
• Toxic epidermal necrolysis
• Stevens-Johnson syndrome
• Vasculitis
• Allergic pneumonitis
• Interstitial nephritis
• Acute kidney failure
• Hepatitis
• Jaundice
• Liver failure
• Anemia
• Leukopenia
• Cardiac arrest
• Respiratory failure

Other serious side effects and adverse events of Cipro, Cipro XR include:

Cipro, Cipro XR should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Cipro, Cipro XR.

Cipro, Cipro XR should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.

Many antibiotics, including Cipro, Cipro XR, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting Cipro, Cipro XR (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

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What is the dosage of ofloxacin vs. ciprofloxacin?

Ofloxacin

• The usual dose for patients with normal renal function is 200 to 400 mg every 12 hours.
• Dosages require adjustment in patients with severely abnormal liver or kidney function.
• Oflaxacin is availabile as tablets: 200, 300, and 400mg.
• Ofloxacin should be stored in a closed container at 15 C – 30 C (59 F – 86 F).

Ciprofloxacin

• For most infections the recommended oral dose for adults is 250-750 mg (immediate release tablets) every 12 hours or 500-1000 mg (extended release tablets) every 24 hours.
• The usual intravenous dose is 200-400 mg every 8-12 hours.

Preparations

• Tablets: 250, 500, and 750 mg.
• Tablets extended release (XR): 500 and 1000 mg.
• Microcapsules for suspension: 250 mg/5 ml, 500 mg/5 ml.
• Injection or Injection concentrate: 200 mg/100 ml, 200 mg/20 mg, 400 mg/200 ml, 400 mg/40 ml.

What drugs interact with ofloxacin and ciprofloxacin?

Ofloxacin

Ofloxacin reduces the elimination of theophylline, elevating blood levels of theophylline. (Theophylline is used to open airways in the treatment of asthma.) If concurrent use of ofloxacin and theophylline cannot be avoided, frequent blood tests to monitor theophylline blood levels should be performed. Ofloxacin can enhance the action of the anticoagulant (blood thinner) warfarin (Coumadin), and increase the risk of bleeding. Both high and low blood sugar levels have been reported, especially in patients with diabetes who were also receiving insulin or other medications used to lower the blood sugar. Careful monitoring of blood sugar levels is recommended. Sucralfate (Carafate), iron, multivitamins containing zinc, didanosine (Videx), as well as antacids containing calcium, magnesium, or aluminum should not be taken within two hours before or after taking ofloxacin.

Ciprofloxacin

Ciprofloxacin administered together with theophylline (Respbid, Slo-Bid, Theo-24, Theolair) can lead to elevated, toxic blood levels of theophylline. Theophylline is used to open airways in the treatment of asthma. Toxic levels of theophylline can lead to seizures, and disturbances in heart rhythm. If concurrent use of ciprofloxacin and theophylline cannot be avoided, frequent blood tests to monitor theophylline blood levels are recommended.

Ciprofloxacin increases the effect of tizanidine (Zanaflex) that is used to treat muscle spasticity. Therefore, the two drugs should not be combined.

Iron salts (for example, ferrous sulfate) may reduce the absorption of ciprofloxacin because of formation of a ciprofloxacin-iron complex that is not absorbable. Antacids also may reduce the absorption of ciprofloxacin. If patients are receiving iron salts or antacids and ciprofloxacin, the ciprofloxacin should be given two hours before or six hours after the iron salt or antacid.

Ciprofloxacin may increase the blood thinning effect of warfarin (Coumadin, Jantoven). The reason for this is unknown. Anticoagulant activity should be monitored after starting or stopping ciprofloxacin.

Sevelamer (Renagel) may reduce the absorption of ciprofloxacin and possibly reduce the effectiveness of ciprofloxacin. Milk and orange juice also may reduce the absorption of ciprofloxacin. Ciprofloxacin, as with iron and antacids, should be given two hours before or six hours after milk or orange juice.

Administration of ciprofloxacin with diabetic medications (for example glyburide [Micronase, Diabeta, Glynase, Prestab]) may lead to severe low blood glucose.

Ciprofloxacin may increase blood concentrations of sildenafil (Viagra) that is used for treating erectile dysfunction. This combination should be avoided if possible.

Patients taking Cipro, Cipro XR can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.

Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas, for example, glyburide (Micronase, Diabeta, Glynase, Prestab).

Are ofloxacin and ciprofloxacin safe to use while pregnant or breastfeeding?

Ofloxacin

Ofloxacin should be avoided during pregnancy because it is secreted in breast milk and can cause adverse events in the infant.

Ofloxacin should be avoided in nursing mothers, as safe use has not been established.

Ciprofloxacin

Doctors suggest that should not use this antibiotic if you are pregnant or breastfeeding because they do not know if it is safe.