Cipro for UTI: Uses, side effects, and alternatives

For many people, Cipro is a safe treatment for a urinary tract infection or UTI. But it is not the only option.

The United States Foods and Drug Administration (FDA) warn doctors about prescribing Cipro to certain people, as there is a potential for serious side effects.

Understanding how Cipro works and its possible side effects can help a person make an informed choice about their UTI treatment.

What is Cipro?

Cipro is the brand name for ciprofloxacin, which is a type of antibiotic known as a fluoroquinolone.

Doctors use fluoroquinolones to treat a range of different bacterial infections. Which fluoroquinolone they prescribe depends on the underlying infection, and if the bacteria are resistant to a specific drug.

Fluoroquinolones work by interfering with the bacteria’s ability to replicate and grow, and so it kills the infection.

Cipro for UTIs

Doctors often prescribe Cipro for people with UTIs, as these infections are usually bacterial and respond well to this drug.

When taking Cipro for a UTI, it is essential to follow the doctor or pharmacist’s instructions exactly. The drug will likely come in the form of a take-home oral tablet or oral solution, and the treatment course may be anywhere from a few days to 2 weeks.

For an antibiotic to be most effective, a person should always complete the full course. Even if symptoms start to clear up, it is essential for people to finish all the medication to ensure they kill the infection completely.

People should never stop treatment early unless a doctor tells them to do so. Doing so may allow the infection to return and potentially be worse.

When taking Cipro or any other antibiotic for a UTI, drinking extra fluids and often urinating can help flush out the infection and speed up recovery.

Fluoroquinolone antibiotics also have what is known as a boxed warning. This is the most serious warning from the FDA, and it means that the FDA consider the drug to be potentially dangerous in some capacity.

The boxed warning for Cipro is for two separate risks.

Firstly, Cipro may increase the risk of tendinitis and tendon rupture in people of all ages, which can lead to serious side effects, such as:

• nerve pain and a sensation of pins and needles
• chronic pain
• burning, numbness, or weakness in the joints and muscles
• swelling and pain in the joints and tendons
• tendon rupture
• changes in the nerves of the hands, arms, feet, and legs

These symptoms may come on after just one or two doses and may last for years. It is unknown yet whether some of the symptoms and changes, especially nerve changes, are permanent.

The risk of tendinitis and tendon rupture is greater for people who are:

• more than 60 years of age
• taking corticosteroid drugs
• recipients of kidney, lung, or heart transplants

Secondly, fluoroquinolones may worsen muscle weakness in people who have myasthenia gravis.

People from these high-risk groups should not take Cipro.

It is also important to understand that several other antibiotics have similar side effects, though they may affect a person in slightly different ways.

A 2015 systematic review concluded that Cipro is a safe and effective drug for treating UTIs most of the time and that adverse events were lower than with other antimicrobial treatments.

However, adverse events are still possible and occur often enough for the FDA to release a warning that doctors should only use fluoroquinolones, such as Cipro, for people who have uncomplicated UTIs.

It is possible for Cipro to interact with other drugs. These drugs may change the way Cipro works, which could be harmful or cause serious side effects.

There are many drugs that may interact with fluoroquinolones, such as Cipro, including:

• warfarin
• phenytoin
• antiarrhythmic drugs, such as amiodarone and quinidine
• tricyclic antidepressants, such as imipramine and amitriptyline
• theophylline
• ropinirole
• duloxetine
• cyclosporine
• diabetes drugs, such as glimepiride and glyburide
• methotrexate
• clozapine

Again, people must always discuss any current medications, vitamins, and supplements with a doctor before taking Cipro or another antibiotic.

Bacterial resistance

The bacteria Escherichia coli cause most cases of UTIs.

A 2015 systematic review concluded that E. coli resistance to ciprofloxacin is increasing, and that the medical community should consider restricting the use of this antibiotic.

In other words, doctors may need to start looking at other methods for treating UTIs.

Alternatives for Cipro

Other drugs that doctors may recommend for UTIs include:

• trimethoprim
• sulfamethoxazole
• ampicillin
• levofloxacin
• nitrofurantoin
• fosfomycin trometamol
• pivmecillinam (not available in the U.S.)

However, some of these drugs may also have issues with bacterial resistance. Researchers are currently investigating new treatment options for UTIs and other bacterial infections, including combination drug therapy, vaccines, and small molecules that attack specific functions in the bacteria.

When to see a doctor

If a person suspects they have a UTI, they should see a doctor. While Cipro may be effective for many people with uncomplicated UTIs, some doctors may recommend other treatment options first.

Anyone who has concerns about taking Cipro, or any of its possible side effects, should discuss them with a doctor. By working directly with a doctor, most people can find the right solution for their UTI.

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