Cipro (ciprofloxacin) for UTI in multiple sclerosis
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Cipro (ciprofloxacin) is an antibiotic that’s approved in the U.S. for treating a wide range of bacterial infections. In people with multiple sclerosis (MS), it is primarily used to treat urinary tract infections (UTIs).
Damage to the nerves that control the bladder lead to bladder issues for many MS patients, including a bladder that doesn’t fully empty with urination. Urine that remains in the bladder for too long can then become a breeding ground for bacteria, leaving patients prone to UTIs.
Cipro belongs to the fluoroquinolone class of antibiotics. It works to halt an infection by preventing bacteria from replicating their DNA.
The brand-name medication is sold in the U.S. by Bayer and comes in various formulations, including oral tablets, oral solution, and an infusion version. Generic versions are also available, and include additional formulations such as eye drops and ear drops.
For treating UTIs, Cipro is often taken orally, but it may also sometimes be infused into the bloodstream intravenously.
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| Treatment name | Cipro |
| Usage | Used to treat UTIs in MS patients |
| Administration | Usually taken orally, but may be infused |
Who can take Cipro?
Cipro is approved in the U.S. for treating adults with various types of infections, including UTIs caused by certain bacterial strains. It should only be used for infections that are proven or strongly suspected to be caused by bacteria.
It can also be used in children, but in more limited circumstances, with it being indicated only for more complicated urinary tract infections that affect one or both kidneys.
Due to a risk of disabling and potentially long-lasting side effects, Cipro and other fluoroquinolones should only be used for more serious infections or instances where other antibiotics aren’t suitable.
Cipro is contraindicated, or should not be used:
- by anyone with a known history of hypersensitivity — strong immune reactions — to ciprofloxacin or other antibiotics in its class.
- at the same time as tizanidine, a muscle relaxant that’s used to treat MS spasticity
How is Cipro administered?
Cipro for UTIs is most often taken orally. It comes in immediate-release and extended-release tablets, as well as liquid suspension formulations.
Depending on the formulation, Cipro is taken once or twice a day, and may be used for up to around two weeks. The exact dosage and duration will depend on the severity of the infection and the specific formulation that’s used. Oral Cipro should be taken with plenty of fluids, with or without food. It shouldn’t be taken with dairy or calcium-fortified juices.
There’s also a formulation of Cipro that can be infused directly into the bloodstream. It is usually administered by a provider in a hospital setting for more severe cases, two to three times per day for up to two weeks.
Potential side effects of Cipro
Common side effects of oral Cipro include:
- nausea
- diarrhea
- abnormal liver function tests
- vomiting
- rash
- headache
- dizziness
The medication also comes with a boxed warning that fluoroquinolone antibiotics, including Cipro, have been associated with disabling and potentially irreversible serious adverse reactions, including:
- inflammation or tearing of tendons, the fibrous tissue that connects muscles and bones
- peripheral neuropathy, or symptoms of nerve damage such as numbness, tingling, or pain, often in the hands and feet
- central nervous system effects, such as hallucinations, anxiety, depression, insomnia, severe headaches, psychosis, agitation, confusion, seizures, or tremors
- exacerbated muscle weakness in people with myasthenia gravis
Treatment must be immediately discontinued if these events occur. Due to the risk of side effects, uncomplicated cases of bladder inflammation (cystitis) — which are often caused by a UTI — should only be treated with Cipro if there are no alternative options.
The medication has also been linked to other potentially serious side effects, including:
- hypersensitivity reactions
- liver toxicity
- heart issues
- light sensitivity
- blood sugar disturbances
- diarrhea
- development of antibiotic-resistant bacteria
Cipro may interact with other drugs, leading to potentially serious side effects. Patients should tell their healthcare providers about all medications they are using, including any vitamins or over-the-counter supplements.
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