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Doxycycline vs. Cipro: What’s the difference?
- Doxycycline and Cipro (ciprofloxacin) are antibiotics used to treat many different types of bacterial infections.
- Brand names for doxycycline include Vibramycin, Oracea, Adoxa, Atridox, Acticlate, Acticlate Cap, Doryx, Doxteric, Doxy, and Monodox.
- Doxycycline and Cipro are different types of antibiotics. Doxycycline is a tetracycline antibiotic and Cipro is a fluoroquinolone antibiotic.
- Side effects of doxycycline and Cipro that are similar include diarrhea or loose stools, nausea, abdominal pain, and vomiting.
- Side effects of doxycycline that are different from Cipro include tooth discoloration if used in persons below 8 years of age and exaggerated sunburn.
- Side effects of Cipro that are different from doxycycline include rash, headache, and restlessness. Cipro and other fluoroquinolone antibiotics have been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon.
What is Doxycycline? What is Cipro?
Doxycycline is a tetracycline antibiotic used to treat various types of infections, including respiratory tract infections due to Streptococcus pneumoniae, Hemophilus influenzae, or Mycoplasma pneumoniae. Doxycycline is also used to treat non-gonococcal urethritis (due to Ureaplasma), Rocky Mountain spotted fever, typhus, brucellosis, anthrax, chancroid, cholera, syphilis, acne, and, periodontal disease.
Cipro (ciprofloxacin) is a fluoroquinolone antibiotic used to treat bacterial infections of the skin, lungs or airways, bones, joints, and urinary tract. Cipro is also used to treat infectious diarrheas caused by E. coli, Campylobacter jejuni, and Shigella bacteria; anthrax patients with fever and low white blood cell counts, and intra-abdominal infections; typhoid fever; cervical and urethral gonorrhea due to Neisseria gonorrhoeae; chronic bacterial prostatitis; and acute uncomplicated cystitis.
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What are the side effects of doxycycline and Cipro?
Doxycycline
Doxycycline is generally well-tolerated. The most common side effects are
- diarrhea or loose stools,
- nausea,
- abdominal pain, and
- vomiting.
Tetracyclines, such as doxycycline, may cause tooth discoloration if used in persons below 8 years of age. Exaggerated sunburn can occur with tetracyclines; therefore, sunlight should be minimized during treatment.
Cipro
Because of serious side effects associate with fluoroquinolones they should not be used for treating certain infections unless there are no other alternatives, and include:
- Uncomplicated urinary tract infections (UTI)
- Acute bacterial exacerbation of chronic bronchitis
- Acute bacterial sinusitis
Warning: Serious side effects adverse reactions of Cipro
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.
What are the common side effects Cirpo?
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
What are the serious side effects and adverse events of Cipro?
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
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.
- Cardiac arrest
- Respiratory failure
What is the dosage for doxycycline vs. Cipro?
Doxycycline
- The absorption of doxycycline is not markedly affected by food, and therefore, it can be taken with meals.
- For most infections, doxycycline is taken once or twice daily for 7 to 14 days.
- For adult infections, the usual dose of oral doxycycline is 200 mg on the first day of treatment (100 mg every 12 hours) followed by a dose of 100 to 200 mg/day as a single dose or divided and administered twice daily.
Cipro
- 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.
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What drugs interact with doxycycline and Cipro?
Doxycycline
- It is recommended that doxycycline not be taken at the same time as aluminum, magnesium, or calcium based antacids, such as Mylanta, Maalox, Tums, or Rolaids because, like food, these medications bind doxycycline in the intestine and prevent its absorption. Similarly, doxycycline should not be taken with minerals (such as calcium or iron) or with bismuth subsalicylate (Pepto Bismol).
- Doxycycline may enhance the activity of warfarin (Jantoven, Coumadin) and cause excessive "thinning" of the blood leading to exaggerated bleeding, necessitating a reduction in the dose of warfarin. Phenytoin (Dilantin), carbamazepine (Tegretol), and barbiturates (such as phenobarbital) may enhance the metabolism (destruction) of doxycycline thus making it less effective.
- Doxycycline may interfere with the action of penicillins and should not be combined with penicillins. It may also reduce the effect of oral contraceptives. Combining tetracycline and methoxyflurane (Penthrane) may reduce kidney function.
Cipro
- 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 doxycycline and Cipro safe to use while pregnant or breastfeeding?
Doxycycline
Tetracycline antibiotics, such as doxycycline, can have toxic effects on development of bone in the fetus. Therefore, tetracyclines are not recommended during pregnancy unless there is no other appropriate antibiotic.
Doxycycline is secreted into breast milk but the extent of absorption by the breastfed infant is not known. Since tetracyclines can cause toxic effects on bone, the use of tetracyclines in nursing mothers is of concern. The physician must decide whether to recommend that a nursing mother discontinue nursing during treatment with tetracyclines or change to a different antibiotic.
Cipro
Doctors suggest that should not use this antibiotic if you are pregnant or breastfeeding because they do not know if it is safe.