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Coadministration of ciprofloxacin, a cyp3a4 inhibitor, with diltiazem, a cyp3a4 substrate, may result in elevated diltiazem serum concentrations.

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Alert patients of the symptoms of hypoglycemia and carefully monitor blood glucose levels in these patientsand discuss with them how to treat themselves if they have symptoms of hypoglycemiaInform patients about the risk of psychiatric adverse reactions that can occur after just one doseStop fluoroquinolone treatment immediately if a patient reports any central nervous system side effectsincluding psychiatric adverse reactionsor blood glucose disturbances and switch to a non-fluoroquinolone antibiotic if possibleStop fluoroquinolone treatment immediately if a patient reports serious side effects involving the tendonsmusclesjointsor nervesand switch to a non-fluoroquinolone antibiotic to complete the patient’s treatment course.

Calcium-rich foodsincluding dairy productssuch as milkyogurtor calcium-enriched juicecan also decrease the effect of this medicationTake this medication at least 2 hours before or 6 hours after eating calcium-rich foodsunless you are eating these foods as part of a larger meal that contains othernon-calcium-richfoodsThese other foods decrease the calcium binding effect.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effectsMany people using this medication do not have serious side effects.

Ciprofloxacin may cause problems with bonesjointsand tissues around joints in childrenCiprofloxacin should not normally be given to children younger than 18 years of age unless they have certain serious infections that cannot be treated with other antibiotics or they have been exposed to plague or anthrax in the airIf your doctor prescribes ciprofloxacin for your childbe sure to tell the doctor if your child has or has ever had joint-related problemsCall your doctor if your child develops joint problems such as pain or swelling while taking ciprofloxacin or after treatment with ciprofloxacin.

Get medical help right away if you have any very serious side effectsincludingsevere dizzinessfaintingfast/irregular heartbeat.

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