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Overview

Ciprofloxacin 250 MG Tablet

Ciprofloxacin 250 MG Tablet

Manufacturer: Blue Cross Laboratories Ltd
Medicine composition: Ciprofloxacin
Prescription vs.OTC: Prescription by Doctor required

Ciprofloxacin 250 MG Tablet is an antibiotic that is a member of the quinolone family of medicines. It is effective in treating infections that are caused by bacteria. Ciprofloxacin 250 MG Tablet is used to treat patients with bacterial infections such as pneumonia, anthrax, syphilis, gonorrhea, bronchitis, gastroenteritis and plague. This antibiotic is also used to fight against infections of the throat, skin, ears, nose, sinus, bones, respiratory system and urinary tract.

Ciprofloxacin 250 MG Tablet inhibits the regular synthesis of bacterial DNA, obstructing the process of their cell division. Therefore, it destroys the existing bacteria that are causing the infection, and it inhibits the growth of new bacteria.

Ciprofloxacin 250 MG Tablet is an anti-biotic, which is a member of the fluoroquinolone family. It helps fight against infections caused by bacteria. It is used to treat severe bacterial infections including pneumonia, respiratory or urinary tract infections, gonorrhea, anthrax, gastroenteritis as well as infections of the sinus, bones, skin and joints. It is also effective in treating septicemic plague.

Ciprofloxacin 250 MG Tablet works by destroying the existing bacteria, that cause infections, from within the body and preventing the growth of new bacteria. The regular synthesis of DNA requires the presence of enzymes of bacterial DNA gyrase and topoisomerase IV. Ciprofloxacin 250 MG Tablet inhibits the activity of DNA gyrase, thus preventing DNA relaxation, encouraging the damage of double stranded DNA and inhibiting the cell division of bacteria. In this way, Ciprofloxacin 250 MG Tablet is efficient in fighting against bacterial infections within the body.

Ciprofloxacin 250 MG Tablet is available in many forms such as tablets, oral solution, ophthalmic ointment and a solution that can be injected. It is important to read the label of this medicine and follow the exact guidelines of the doctor’s prescription. Do not take an extra pill to make up for a missed dose, if you forget to take a dose. Instead, just continue with the next dose.

Ciprofloxacin 250 MG Tablet can cause a few common side effects like headaches, diarrhea, vomiting, nausea, mouth sores, heartburn and fatigue. Consult your doctor, if you notice any of these side effects. Some of the major side effects that can occur in rare cases include loss of consciousness, irregular heartbeats, difficulty breathing, muscle aches, liver dysfunction, increased risk of tendonitis and severe rashes. If you detect any of the symptoms mentioned above, you must seek immediate medical attention. If you are allergic to Ciprofloxacin 250 MG Tablet, you will experience rashes, hives, breathing problems, swelling of the throat, tongue, face or limbs and itchiness. If you notice these symptoms, it is advisable to stop taking this medicine immediately and contact your doctor.

In some cases, patients having certain disorders, who take this antibiotic, are more susceptible to its side effects. Therefore, before starting a prescription of this medicine, you should consult the doctor if you are allergic to Ciprofloxacin 250 MG Tablet, blood disorders, conditions of the heart and low levels of magnesium in the blood. Children and pregnant women should exercise caution before taking this medication. Although this antibiotic does treat infections, it does not treat infections like influenza, cold and viral infections.

Erosive Esophagitis
Ciprofloxacin 250 MG Tablet is used in the treatment of severe ulcers caused by chronic acidity.
Gastroesophagal Reflux Disease
Ciprofloxacin 250 MG Tablet is used in the treatment of a reflux disease where acid from the stomach and bile irritates the food pipe.
Helicobacter pylori Infection
Ciprofloxacin 250 MG Tablet is used to treat Helicobacter Pylori infection in combination with other drugs.
Zollinger-Ellison Syndrome
Ciprofloxacin 250 MG Tablet is used to treat a condition where excessive amount of acid is produced in the stomach due to tumors in the small intestine.
Other forms of Ulcers
Ciprofloxacin 250 MG Tablet is also used to treat ulcers in the stomach (Gastric) and small intestines (Duodenal). It is also used to prevent ulcers caused due to stress.
Ciprofloxacin 250 MG Tablet is not recommended for patients who are allergic to Pantoprazole or any other drug of the same group i.e Benzimidazoles.
In addition to its intended effect, Ciprofloxacin 250 MG Tablet may cause some unwanted effects too. In such cases, you must seek medical attention immediately. This is not an exhaustive list of side effects. Please inform your doctor if you experience any adverse reaction to the medication.
Headache Moderate Common
Ciprofloxacin 250 MG Tablet can cause headache and dizziness especially in pediatric patients and patients on triple therapy.
Altered sense of taste Moderate Common
Ciprofloxacin 250 MG Tablet can cause altered taste. The most common is metallic or bitter taste.
Running Nose and Cough Moderate Common
Ciprofloxacin 250 MG Tablet can cause running nose, cough, blocked nose, breathing difficulties.
Diarrhea Moderate Common
Ciprofloxacin 250 MG Tablet can cause stomach discomforts including diarrhea, abdominal pain, flatulence etc.
Nausea or Vomiting Moderate Less Common
Ciprofloxacin 250 MG Tablet can cause nausea or vomiting.
Unusual tiredness and weakness Minor Less Common
Ciprofloxacin 250 MG Tablet on long term usage can cause tiredness and weakness along with muscle pain and occasional cramps.
Skin Rash Major Less Common
Ciprofloxacin 250 MG Tablet can cause skin rashes and Pruritis like symptoms.
Anorexia Moderate Less Common
Ciprofloxacin 250 MG Tablet can cause severe loss of appetite resulting in under-nourishment.
Injection site Thrombophlebitis Minor Common
Ciprofloxacin 250 MG Tablet injections can cause veins under the skin to swell. This effect is present only at the site of injection.
How long is the duration of effect?
Ciprofloxacin 250 MG Tablet remains active in the body up to 24 hours after administration and is excreted in the urine.
What is the onset of action?
Ciprofloxacin 250 MG Tablet is rapidly absorbed from the Gastro-intestinal tract and reaches its peak levels after 2 to 2.5 hours of oral administration.
Are there any pregnancy warnings?
Ciprofloxacin 250 MG Tablet is considered safe for consumption by pregnant women. But there is a lack of conclusive evidence and hence, it must be used only when necessary after consulting a Doctor. Potential benefits and risks involved should be considered before taking the drug.
Is it habit forming?
No habit forming tendencies were reported.
Are there any breast-feeding warnings?
Ciprofloxacin 250 MG Tablet is not expected to cause any adverse effects on the breastfed baby. However, a Doctor must be consulted before taking the drug.
Below is the list of medicines, which have the same composition, strength and form as Ciprofloxacin 250 MG Tablet, and hence can be used as its substitute.
Are there any missed dose instructions?
The missed dose should be taken as soon possible. It is advisable to skip the missed dose if it's already time for your next scheduled dose.
Are there any overdose instructions?
Seek emergency medical treatment or contact your doctor in case of an overdose.
India
United States
Japan
Whenever you take more than one medicine, or mix it with certain foods or beverages, you're at risk of a drug interaction.
Interaction with Disease
Liver Disease Moderate
Any incidence of liver disease should be reported to the Doctor. Suitable adjustment in dosage can be done based on the extent of the liver impairment.
Osteoporosis Moderate
Suitable adjustment in dosage and duration should be made for patients who are at risk for Osteoporosis related fracture. Established treatment guidelines should be strictly followed in such cases.
Hypomagnesemia Moderate
Any incidences of magnesium level imbalance should be reported to the Doctor. The imbalance could occur due to a disease or due to other medication used by the patient. Regular monitoring is recommended for patients taking Ciprofloxacin 250 MG Tablet.
Interaction with Alcohol
Alcohol
Interaction with alcohol is unknown. It is advisable to consult your doctor before consumption.
Interaction with Lab Test
Lab
Information not available.
Interaction with Food
Food
Information not available.
Interaction with Medicine
Nelfinavir Major
Ciprofloxacin 250 MG Tablet is not recommended for use when the patient is already taking anti-viral medications like Nelfinavir or other drugs used in the management of HIV Infection.
Digoxin Moderate
Ciprofloxacin 250 MG Tablet should be used with caution if the patient is on Digoxin. Prior usage of any of these drugs should be informed to the Doctor. Any symptoms like nausea, vomiting, diarrhea, loss of appetite, disturbances in vision, and abnormalities in heartbeat should be reported immediately.
Ketoconazole Moderate
Usage of Ciprofloxacin 250 MG Tablet with Ketoconazole or other antifungals of the same group should be avoided. Inform the doctor about the usage of either of these medications so that safer alternatives can be prescribed.
Warfarin Moderate
Usage of Ciprofloxacin 250 MG Tablet with Warfarin should be strictly monitored by the Doctor. Suitable adjustment in dosage and monitoring of Prothrombin time is necessary to ensure safety. Any symptoms like unusual bleeding, swelling, vomiting, presence of blood in urine should be reported immediately.
Methotrexate Major
Ciprofloxacin 250 MG Tablet should not be used with Methotrexate. Use of either of the drugs should be reported to the Doctor so that safer substitute could be prescribed.

Popular Questions & Answers

My doc has prescribed Ciprofloxacin 500 mg to me for acne, I want to know whether its going to be effective or not for acne?

Bachelor of Unani Medicine and Surgery (B.U.M.S)
Ayurveda, Kanpur
My doc has prescribed Ciprofloxacin 500 mg to me for acne, I want to know whether its going to be effective or not fo...
Don't need to take that. take khadirarishta bd chandrakanta lep local application sootshekhar ras swarn yukta 125 mg BD
1 person found this helpful

What would be the impact of ciprofloxacin on blood glucose level? Would blood glucose go high after taking ciprofloxacin and other effects please suggest?

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Hubli-Dharwad
What would be the impact of ciprofloxacin on blood glucose level? Would blood glucose go high after taking ciprofloxa...
Mr. lybrate-user, Thanks for the query. Ciprofloxacin has hardly any effect on blood glucose. Thanks.

I am 32 years old male. I have been using etizolam 0.5 mg daily for last 3 years. Presently I am being treated for Anal fissure and on Ciprofloxacin. Can I use etizolam and Ciprofloxacin together?

MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
I am 32 years old male. I have been using etizolam 0.5 mg daily for last 3 years. Presently I am being treated for An...
Hello dear Lybrate user, Warm welcome to Lybrate.com I have evaluated your query thoroughly. Yes can be taken together without problems Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance at my private URL https://www.Lybrate.com/gandhinagar/doctor/dr-bhagyesh-patel-general-surgeon Regards take care.

Hi, I am diagnosed with mild diarrhoea since the past 2 weeks after taking ciprofloxacin. Please suggest me something for that.

BHMS
Homeopath, Chennai
Acute diarrhea is a disorder which leads to a person passing a number of watery stools. It may be accompanied by cramping pain in the abdomen and at times fever too. Food and water-borne bacteria, parasites and viruses cause such problems. Rapid loss of water in the form of watery stool can cause a situation known as dehydration which can disrupt the normal functioning of the body. Along with it, the essential salts (electrolytes) of the body are also lost. While the oral rehydration salts and fluids significantly reduce fatalities from dehydration, they do not treat the underlying infection that is causing diarrhoea. Homeopathic medicines Veratrum Album, Arsenic Album, Podophyllum lead the homeopathic table for treating diarrhoeas and provide quick relief to patients by eliminating the infection. You can easily take an online consultation for further treatment guidance and permanent cure without any side effects

Popular Health Tips

Mycobacterium Avium Complex

MBBS, D.P.H
General Physician, Gurgaon
Mycobacterium Avium Complex

MYCOBACTERIUM AVIUM COMPLEX

  • Caused by Bacteria M. avium "M.A.C." / M. intrracelulare "M.A.I"

  • MAC is a AIDS-defining condition.
  • MAC is common in persons having CD4 count <50 cell/mm.
  • Respiratory symptoms are not common in HIV -related MAC.
  • Mycobacterium avium complex or M. kansasii  dessiminated  or extramulmonary, almost any internal organ especially the Liver, Spleen, and Bone marrow
  • SYMPTOMS

  •  Night sweats

  • Fever
  • Weight loss
  • Diarrhoea
  • Low level of red and white blood cells.
  • High blood level of liver enzyme ( alkaline phosphatase)
  • Painful intestines.
  • Almost half of those with late -stage HIV disease (AIDS) are infected with the MAC bacteria, not all of those show symptoms of MAC.
  • Elevated alkaline phosphatase levels in blood tests can indicate MAC.
  • TREATMENT:

  • As advised by consulting physician  ( Clarithomycin, Azithromycin, Etambutol , Rifampin, Rifabutin, Ciprofloxacin, Amikacin

5 people found this helpful

Typhoid - Signs You Are Suffering From It!

MBBS, Diploma in Tuberculosis and Chest Diseases (DTCD), MD - General Medicine
General Physician, Delhi
Typhoid - Signs You Are Suffering From It!

Typhoid is as an acute illness commonly characterized by high fever and an impaired digestive system. This illness is caused by the bacterium ‘Salmonella Typhi’ and generally spreads from one person to another by means of food or water.

Causes of typhoid

  • Salmonella Typhi, the bacterium responsible for typhoid, primarily spreads on consumption of unhygienic street food and water.
  • Typhoid can also occur as a result of a poor sanitation system. In these cases, the bacterium spreads through fecal matters and the contaminated urine of the infected person.
  • Typhoid can also spread if you share the same food and water consumed by the infected person.

Symptoms 
The symptoms generally appear within 1-3 weeks, after coming in contact with the already infected individual. The ensuing fever and discomfort remains for about 3-4 weeks. The symptoms are:

  • Severe headache and loss of appetite
  • High fever
  • Severe discomfort in the whole body coupled with pain in the abdomen area
  • Drowsiness
  • Diarrhea or constipation
  • A dry cough and appearance of rashes

However, in most of the cases, the symptoms tend to improve from the third week itself.

Treatment
The following treatments can be implemented in order to cure typhoid fever:

  • Doctors generally recommend a prescribed dosage of antibiotics in order to deal with the disease. 
  • Along with the prescribed dosage of antibiotics, the doctors recommend balanced consumption of various fluids such as natural fruit juices and water to restore hydration. A healthy diet packed with all the essential nutrients is another necessity that has to complement the dosage of antibiotics.
  • Choice of antibiotics should be Ceftriaxone, Cefixime, Azithromycin and Ciprofloxacin.

Complications

  1. The two most common complications are haemorrhage (including disseminated intravascular coagulation) and perforation of the bowel. Before antibiotics, perforation had a mortality of around 75%.
  2. Jaundice may be due to hepatitis, cholangitis, cholecystitis, or haemolysis.
  3. Pancreatitis with acute kidney injury and hepatitis with hepatomegaly are rare.
  4. Toxic myocarditis occurs in 1-5% of patients (ECG changes may be present). It is a significant cause of death in endemic areas.
  5. Toxic confusional states and other neurological and psychiatric disturbances have been reported.

Needs and Indications for Hospitalization-

Hospital admission is usually recommended if you have severe symptoms of typhoid fever, such as persistent vomiting, severe diarrhoea or a swollen stomach. As a precaution, young children who develop typhoid fever may be admitted to hospital. In hospital, you'll have antibiotic injections and you may also be given fluids and nutrients directly into a vein through an intravenous drip. Surgery may be needed if you develop life-threatening complications of typhoid fever, such as internal bleeding or a section of your digestive system splitting. However, this is very rare in people being treated with antibiotics. Most people respond well to hospital treatment and improve within three to five days. However, it may be several weeks until you're well enough to leave hospital.

Vaccines

Two types of vaccines are available

  • Injected
  • Oral 

The injected vaccine is more commonly used and  is also known as inactivated typhoid shot . It is injected in one single shot an it can easily provide protection against typhoid. This type is widely prevalent in cases where one has to travel to a typhoid infected place. However, one must be careful and should keep a tab as to what they eat or drink at the time of travelling. Also, this type of vaccine should not be administered on kids below 2 years old.

If you wish to discuss about any specific problem, you can consult a doctor.

6989 people found this helpful

Avoid The Ban Medicines To Be Safe

BHMS
Homeopath, Singrauli
Avoid The Ban Medicines To Be Safe

Govt bans 344 drugs, including phensedyl, corex
Sr. No. Product name (irrational fdc) 
1 aceclofenac + paracetamol + rabeprazole
2 nimesulide + diclofenac
3 nimesulide + cetirizine + caffeine
4 nimesulide + tizanidine
5 paracetamol + cetirizine + caffeine
6 diclofenac + tramadol + chlorzoxazone
7 dicyclomine + paracetamol + domperidone
8 nimesulide + paracetamol
9 paracetamol + phenylephrine + caffeine
10 diclofenac+ tramadol + paracetamol
11 diclofenac + paracetamol + chlorzoxazone + famotidine
12 naproxen + paracetamol
13 nimesulide + serratiopeptidase
14 paracetamol + diclofenac + famotidine
15 nimesulide + pifofenone + fenpiverinium + benzyl alcohol
16 omeprazole + paracetamol + diclofenac
17 nimesulide + paracetamol injection
18 tamsulosin + diclofenac
19 paracetamol + phenylephrine + chlorpheniramine + dextromethorphan + caffeine
20 diclofenac + zinc carnosine
21 diclofenac + paracetamol + chlorpheniramine maleate + magnesium trisillicate
22 paracetamol + pseudoephedrine + cetrizine
23 phenylbutazone + sodium salicylate
24 lornoxicam + paracetamol + trypsin
25 paracetamol + mefenamic acid + ranitidine + dicylomine
26 nimesulide + dicyclomine
27 heparin + diclofenac
28 glucosamine + methyl sulfonyl methane + vitamini d3 + maganese + boron + copper + zinc
29 paracetamol + tapentadol
30 tranexamic acid + proanthocyanidin
31 benzoxonium chloride + lidocaine
32 lornoxicam + paracetamol + tramadol
33 lornoxicam + paracetamol + serratiopeptidase
34 diclofenac + paracetamol + magnesium trisilicate
35 paracetamol + domperidone + caffeine
36 ammonium chloride + sodium citrate + chlorpheniramine maleate + menthol
37 paracetamol + prochlorperazine maleate
38 serratiopeptidase (enteric coated 20000 units) + diclofenac potassium &amp; 2 tablets of doxycycline
39 nimesulide + paracetamol suspension
40 aceclofenac + paracetamol + famotidine
41 aceclofenac + zinc carnosine
42 paracetamol + disodium hydrogen citrate + caffeine
43 paracetamol + dl methionine
44 disodium hydrogen citrate + paracetamol
45 paracetamol + caffeine + codeine
46 aceclofenac (sr) + paracetamol
47 diclofenac + paracetamol injection
48 azithromycin + cefixime
49 amoxicillin + dicloxacillin
50 amoxicillin 250 mg + potassium clavulanate diluted 62.5 mg
51 azithromycin + levofloxacin
52 cefixime + linezolid
53 amoxicillin + cefixime + potassium clavulanic acid
54 ofloxacin + nitazoxanide
55 cefpodoxime proxetil + levofloxacin
56 azithromycin, secnidazole and fluconazole kit
57 levofloxacin + ornidazole + alpha tocopherol acetate
58 nimorazole + ofloxacin
59 azithromycin + ofloxacin
60 amoxycillin + tinidazole
61 doxycycline + serratiopeptidase
62 cefixime + levofloxacin
63 ofloxacin + metronidazole + zinc acetate
64 diphenoxylate + atropine + furazolidonee
65 fluconazole tablet, azithromycin tablet and ornidazole tablets
66 ciprofloxacin + phenazopyridine
67 amoxycillin + dicloxacillin + serratiopeptidase
68 azithromycin + cefpodoxime
69 lignocaine + clotrimazole + ofloxacin + beclomethasone
70 cefuroxime + linezolid
71 ofloxacin + ornidazole + zinc bisglycinate
72 metronidazole + norfloxacin
73 amoxicillin + bromhexine
74 ciprofloxacin + fluticasone + clotrimazole + neomycin is
75 metronidazole + tetracycline
76 cephalexin + neomycin + prednisolone
77 azithromycin + ambroxol
78 cilnidipine + metoprolol succinate + metoprolol tartrate
79 l-arginine + sildenafil
80 atorvastatin + vitamin d3 + folic acid + vitamin b12 + pyridoxine
81 metformin + atorvastatin
82 clindamycin + telmisartan
83 olmesartan + hydrochlorothiazide + chlorthalidone
84 l-5-methyltetrahydrofolate calcium + escitalopram
85 pholcodine + promethazine
86 paracetamol + promethazine
87 betahistine + ginkgo biloba extract + vinpocetine + piracetam
88 cetirizine + diethyl carbamazine
89 doxylamine + pyridoxine + mefenamic acid + paracetamol
90 drotaverine + clidinium + chlordiazepoxide
91 imipramine + diazepam
92 flupentixol + escitalopram
93 paracetamol + prochloperazine
94 gabapentin + mecobalamin + pyridoxine + thiamine
95 imipramine + chlordiazepoxide + trifluoperazine + trihexyphenidyl
96 chlorpromazine + trihexyphenidyl
97 ursodeoxycholic acid + silymarin
98 metformin 1000/1000/500/500mg + pioglitazone 7.5/7.5/7.5/7.5mg + glimepiride
99 gliclazide 80 mg + metformin 325 mg
100 voglibose+ metformin + chromium picolinate
101 pioglitazone 7.5/7.5mg + metformin 500/1000mg
102 glimepiride 1mg/2mg/3mg + pioglitazone 15mg/15mg/15mg + metformin 1000mg/1000mg/1000mg
103 glimepiride 1mg/2mg+ pioglitazone 15mg/15mg + metformin 850mg/850mg
104 metformin 850mg + pioglitazone 7.5 mg + glimepiride 2mg
105 metformin 850mg + pioglitazone 7.5 mg + glimepiride 1mg
106 metformin 500mg/500mg+gliclazide sr 30mg/60mg + pioglitazone 7.5mg/7.5mg
107 voglibose + pioglitazone + metformin
108 metformin + bromocriptine
109 metformin + glimepiride + methylcobalamin
110 pioglitazone 30 mg + metformin 500 mg
111 glimepiride + pioglitazone + metformin
112 glipizide 2.5mg + metformin 400 mg
113 pioglitazone 15mg + metformin 850 mg
114 metformin er + gliclazide Mr. + voglibose
115 chromium polynicotinate + metformin
116 metformin + gliclazide + piogllitazone + chromium polynicotinate
117 metformin + gliclazide + chromium polynicotinate
118 glibenclamide + metformin (sr)+ pioglitazone
119 metformin (sustainded release) 500mg + pioglitazone 15 mg + glimepiride 3mg
120 metformin (sr) 500mg + pioglitazone 5mg
121 chloramphenicol + beclomethasone + clomitrimazole + lignocaine
122 of clotrimazole + ofloxaxin + lignocaine + glycerine and propylene glycol
123 chloramphennicol + lignocaine + betamethasone + clotrimazole + ofloxacin + antipyrine
124 ofloxacin + clotrimazole + betamethasone + lignocaine
125 gentamicin sulphate + clotrimazole + betamethasone + lignocaine
126 clotrimazole + beclomethasone + ofloxacin + lignocaine
127 becloemthasone + clotrimazole + chloramphenicol + gentamycin + lignocaine ear
128 flunarizine + paracetamole + domperidone
129 rabeprazole + zinc carnosine
130 magaldrate + famotidine + simethicone
131 cyproheptadine + thiamine
132 magaldrate + ranitidine + pancreatin + domperidone
133 ranitidine + magaldrate + simethicone
134 magaldrate + papain + fungul diastase + simethicone
135 rabeprazole + zinc + domperidone
136 famotidine + oxytacaine + magaldrate
137 ranitidine + domperidone + simethicone
138 alginic acid + sodium bicarbonate + dried aluminium hydroxide + magnesium hydroxide
139 clidinium + paracetamol + dicyclomine + activated dimethicone
140 furazolidone + metronidazole + loperamide
141 rabeprazole + diclofenac + paracetamol
142 ranitidine + magaldrate
143 norfloxacin+ metronidazole + zinc acetate
144 zinc carnosine + oxetacaine
145 oxetacaine + magaldrate + famotidine
146 pantoprazole (as enteric coated tablet) + zinc carnosine (as film coated tablets)
147 zinc carnosine + magnesium hydroxide + dried aluminium hydroxide + simethicone
148 zinc carnosine + sucralfate
149 mebeverine &amp; inner hpmc capsule (streptococcus faecalis + clostridium butyricum + bacillus
Mesentricus + lactic acid bacillus)
150 clindamycin + clotrimazole + lactic acid bacillus
151 sildenafil + estradiol valerate
152 clomifene citrate + ubidecarenone + zinc + folic acid + methylcobalamin + pyridoxine + lycopene
+ selenium + levocarnitine tartrate + l-arginine
153 thyroxine + pyridoxine + folic acid
154 gentamycin + dexamethasone + chloramphenicol + tobramycin + ofloxacin
155 dextromethorphan + levocetirizine + phenylephrine + zinc
156 nimesulide + loratadine + phenylephrine + ambroxol
157 bromhexine + phenylephrine + chlorepheniramine maleate
158 dextromethorphan + bromhexine + guaiphenesin
159 paracetamol + loratadine + phenylephrine + dextromethorphan + caffeine
160 nimesulide + phenylephrine + caffeine + levocetirizine
161 azithromycin + acebrophylline
162 diphenhydramine + terpine + ammonium chloride + sodium chloride + menthol
163 nimesulide + paracetamol + cetirizine + phenylephrine
164 paracetamol + loratadine + dextromethophan + pseudoepheridine + caffeine
165 chlorpheniramine maleate + dextromethorphan + dextromethophan + guaiphenesin + ammonium
Chloride + menthol
166 chlorpheniramine maleate + ammonium chloride + sodium citrate
167 cetirizine + phenylephrine + paracetamol + zinc gluconate
168 ambroxol
+ guaiphenesin + ammonium chloride + phenylephrine + chlorpheniramine maleate + menthol
169 dextromethorphen + bromhexine + chlorpheniramine maleate + guaiphenesin
170 levocetirizine + ambroxol + phenylephrine + guaiphenesin
171 dextromethorphan + chlorpheniramine + chlorpheniramine maleate 
172 cetirizine + ambroxol + guaiphenesin + ammonium chloride + phenylephrine +
Menthol
173 hlorpheniramine + phenylephrine + caffeine
174 dextromethorphan + triprolidine + phenylephrine
175 dextromethorphan + phenylephrine + zinc gluconate + menthol
176 chlorpheniramine + codeine + sodium citrate + menthol syrup
177 enrofloxacin + bromhexin
178 bromhexine + dextromethorphan + phenylephrine + menthol
179 levofloxacin + bromhexine
180 levocetirizine + phenylephrine + ambroxol + guaiphenesin + paracetamol
181 cetirizine + dextromethorphan + phenylephrine + zinc gluconate + paracetamol + menthol
182 paracetamol + pseudoephedrine + dextromethorphan+cetirizine
183 diphenhydramine + guaiphenesin + ammonium chloride + bromhexine
184 chlorpheniramine + dextromethorphan + phenylephrine + paracetamol
185 dextromethorphen + promethazine
186 diethylcabamazine citrate + cetirizine + guaiphenesin
187 chlorpheniramine + phenylephrine + dextromethophan + menthol
188 ambroxol + terbutaline + dextromethorphan
189 dextromethorphan + chlorpheniramine + guaiphenesin
190 terbutaline + bromhexine + guaiphenesin + dextromethorphan
191 dextromethorphan + tripolidine + phenylephirine
192 paracetamol + dextromethorphan + chlorpheniramine
193 codeine + levocetirizine + menthol
194 dextromethorphan + ambroxol + guaifenesin + phenylephrine + chlorpheniramine
195 cetirizine + phenylephrine + dextromethorphan + menthol
196 roxithromycin + serratiopeptidase
197 paracetamol + phenylephrine + triprolidine
198 cetirizine + acetaminophen + dextromethorphan + phenyephrine + zinc gluconate 
199 diphenhydramine + guaifenesin + bromhexine + ammonium chloride + menthol
200 chlopheniramine maleate + codeine syrup
201 cetirizine + dextromethorphan + zinc gluconate + menthol
202 paracetamol + phenylephrine + desloratadine + zinc gluconate + ambroxol
203 levocetirizine + montelukast + acebrophylline
204 dextromethorphan + phenylephrine + ammonium chloride + menthol
205 acrivastine + paracetamol + caffeine + phenylephrine
206 naphazoline + carboxy methyl cellulose + menthol + camphor + phenylephrine
207 dextromethorphan + cetirizine
208 nimesulide + paracetamol + levocetirizine + phenylephrine + caffeine
209 terbutaline + ambroxol + guaiphenesin + zinc + menthol
210 dextromethorphan + phenylephrine + guaifenesin + triprolidine
211 ammomium chloride + bromhexine + dextromethorphan 
212 diethylcarbamazine + cetirizine + ambroxol
213 ethylmorphine + noscapine + chlorpheniramine
214 cetirizine + dextromethorphan + ambroxol
215 ambroxol + guaifenesin + phenylephrine + chlorpheniramine
216 paracetamol + phenylephrine + chlorpheniramine + zinc gluconate
217 dextromethorphan + phenylephrine + cetirizine + paracetamol + caffeine
218 dextromethophan + chlorpheniramine + guaifenesin + ammonium chloride
219 levocetirizine + dextromethorphan + zinc
220 paracetamol + phenylephrine + levocetirizine + caffeine
221 chlorphaniramine + ammonium chloride + sodium chloride
222 paracetamol + dextromethorphan + bromhexine + phenylephrine + diphenhydramine
223 salbutamol + bromhexine + guaiphenesin + menthol
224 cetirizine + dextromethorphan + bromhexine + guaifenesin
225 diethyl carbamazine + chlorpheniramine + guaifenesin
226 ketotifen + cetirizine
227 terbutaline + bromhexine + etofylline
228 ketotifen + theophylline
229 ambroxol + salbutamol + theophylline
230 cetririzine + nimesulide + phenylephrine
231 chlorpheniramine + phenylephrine + paracetamol + zink gluconate
232 acetaminophen + guaifenesin + dextromethorphan + chlorpheniramine
233 cetirizine + dextromethorphan + phenylephrine + tulsi
234 cetirizine + phenylephrine + paracetamol + ambroxol + caffeine
235 guaifenesin + dextromethorphan
236 levocetirizine + paracetamol + phenylephirine + caffeine
237 caffeine + paracetamol + phenylephrine + chlorpheniramine
238 levocetirizine + paracetamol + phenylephirine + caffeine
239 caffeine + paracetamol + phenylephrine + chlorpheniramine
240 ketotifen + levocetrizine
241 paracetamol + levocetirizine + phenylephirine + zink gluconate
242 paracetamol + phenylephrine + triprolidine + caffeine
243 caffeine + paracetamol + phenylephrine + cetirizine
244 caffeine + paracetamol + chlorpheniramine
245 ammonium chloride + dextromethorphan + cetirizine + menthol
246 dextromethorphan + paracetamol + cetirizine + phenylephrine
247 chlorpheniramine + terpin + antimony potassium tartrate + ammonium chloride + sodium
Citrate + menthol
248 terbutaline + etofylline + ambroxol
249 paracetamol + codeine + chlorpheniramine
250 paracetamol+pseudoephedrine+certirizine+caffeine
251 chlorpheniramine+ammonium chloride + menthol
252 n-acetyl cysteine + ambroxol + phenylephrine + levocertirizine
253 dextromethorphan + phenylephrine + tripolidine + menthol
254 salbutamol + certirizine + ambroxol
255 dextromethorphan + phenylephrine + bromhexine + guaifenesin + chlorpheniramine
256 nimesulide + certirizine + phenylephrine
257 naphazoline + chlorpheniramine + zinc sulphate + boric acid + sodium chloride + chlorobutol
258 paracetamol + bromhexine + phenylephrine + chlorpheniramine + guaifenesin
259 salbutamol + bromhexine
260 dextromethorphan + phenylephrine + guaifenesin + certirizine + acetaminophen
261 guaifenesin + bromhexine + chlorpheniramine + paracetamo
262 chlorpheniramine + ammonium chloride + chloroform + menthol
263 salbutamol + choline theophylinate + ambroxol
264 chlorpheniramine + codeine phosphate + menthol syrup
265 pseudoephedrine + bromhexine
266 certirizine + phenylephrine + paracetamol + caffeine + nimesulide
267 dextromethorphan + cetirizine + guaifenesin + ammonium chloride
268 dextromethorphan + cetirizine + guaifenesin + ammonium chloride
269 ambroxol + salbutamol + choline theophyllinate + menthol
270 paracetamol + chlorpheniramine + ambroxol + guaifenesin + phenylephrine
271 chlorpheniramine + vasaka + tolubalsm + ammonium chloride + sodium citrate + menthol
272 bromhexine + cetrizine + phenylephrine ip+guaifenesin + menthol
273 dextromethorphan + ambroxol + ammonium chloride + chlorpheniramine + menthol
274 dextromethorphan + phenylephrine + cetirizine + zinc + menthol
275 terbutaline + n-acetyl l-cysteine + guaifenesin
276 calcium gluconate + levocetirizine
277 paracetamol + levocetirizine + pseudoephedrine
278 salbutamol + choline theophylinate + carbocisteine
279 chlorpheniramine + vitamin c
280 calcium gluconate + chlorpheniramine + vitamin c
281 chlorpheniramine + paracetamol + pseudoephedrine + caffeine
282 guaifenesin + bromhexine + chlorpheniramine + phenylephrine + paracetamol + serratiopeptidase
(as enteric coated granules) 10000 sp units
283 paracetamol + pheniramine
284 betamethasone + fusidic acid + gentamycin + tolnaftate + lodochlorhydroxyquinoline (ichq
285 clobetasol + ofloxacin + miconazole + zinc sulphate
286 clobetasole + gentamicin + miconazole + zinc sulphate
287 levocetirizine + ambroxol + phenylephrine + paracetamol
288 permethrin + cetrimide + menthol
289 beclomethasone + clotimazole + neomycin + lodochlorohydroxyquinone
290 neomycin + doxycycline
291 ciprofloxacin + fluocinolone + clotrimazole + neomycin + chlorocresol
292 clobetasol + ofloxacin + ketoconazol + zinc sulphate
293 betamethasone + gentamicin + tolnaftate + lodochlorhydroxyquinoline
294 clobetasol + gentamicin + tolnaftate + lodochlorhydroxyquinone + ketoconazole
295 allantoin + dimethieone + urea + propylene + glycerin + liquid paraffin
296 acriflavine + thymol + cetrimide
297 betamethasone + neomycin + tolnaftate + lodochlorohydroxyquinoline + cholorocresol
298 clobetasol + neomycin + miconazole + clotrimazole
299 ketoconazole + tea tree oil + allantion + zinc oxide + aloe vera + jojoba oil +
Lavander oil + soa noodels
300 clobetasol propionate + ofloxacin + ornidazole + terbinafine
301 clobetasol + neomycin + miconazole + zinc sulphate
302 beclomethasone diproprionate + neomycin + tolnaftate + lodochlorhydroxyquinoline +
Chlorocresol
303 betamethasone + gentamycin + zinc sulphate + clotrimoazole + chlorocresol
304 borax + boric acid + naphazoline + menthol + camphor + methyl hydroxy benzoate
305 bromhexine + dextromethorphan
306 dextromethophan + chlopheniramine + bromhexine
307 menthol + anesthetic ether
308 dextrometharphan + chlopheniramine + ammonium + sodium citrate + menthol
309 ergotamine tartrate + belladona dry extarct+caffeine + paracetamol
310 phenytoin + phenobarbitone
311 gliclazide 40mg + metformin 400mg
312 paracetamol + ambroxol + phenylephrine + chlorpheniramine
313 oflaxacin + ornidazole suspension
314 albuterol + etofylline + bromhexine + menthol
315 albuterol + bromhexine + theophylline
316 salbutamol+hydroxyethyltheophylline (etofylline) + bromhexine
317 paracetamol+phenylephrine+levocetirizine+sodium citrate
318 paracetamol + propyphenazone + caffeine
319 guaifenesin + diphenhydramine + bromhexine + phenylephrine
320 dried alumnium hydroxie gel + prophantheline + diazepam
321 bromhenxine + phenylephrine + chlorpheniramine + paracetamol
322 beclomethasone + clotrimazole + gentamicin + lodochlorhydroxyquinoline
323 telmisartan + metformin
324 ammonium citrate + vitamin b 12 + folic acid + zinc sulphate
325 levothyroxine + phyridoxine + nicotinamide
326 benfotiamine + metformin
327 thyroid + thiamine + riboflavin + phyridoxine + calcium pantothenate + tocopheryl acetate +
Nicotinamide
328 ascorbic acid + manadione sodium bisulphate + rutin + dibasic calcium phosphate +
Adrenochrome mono semicarbazone
329 phenylephrine + chlorpheniramine + paracetamol + bromhexine + caffeine
330 clotrimazole + beclomethasone + lignocaine + ofloxacin + acetic aicd + sodium methyl paraben +
Propyl paraben

Avoid this combinations and be safe.

71 people found this helpful

Sinusitis: Management and Prevention

MBBS, Fellowship In Endocrinology
Endocrinologist, Tumkur
Sinusitis: Management and Prevention

Sinusitis: Management and Prevention

Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows:
● acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms
● subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms
● recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which

Recur at intervals of at least 10 days apart
● chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms
● acute bacterial sinusitis superimposed on chronic sinusitis:

New symptoms that occur in patients with residual symptoms from prior infection (s). With treatment, the new symptoms resolve but the residual ones do not.
Physical findings and clinical presentation
● patients often give a history of a recent upper respiratory illness with some improvement, then a relapse.
● mucopurulent secretions in the nasal passage
● purulent nasal and postnasal discharge lasting more than 7 to 10 days
● facial tightness, pressure, or pain
● nasal obstruction
● headache
● decreased sense of smell
● purulent pharyngeal secretions, brought up with cough, often worse at night
● erythema, swelling, and tenderness over the infected sinus&nbsp;in a small proportion of patients
● diagnosis cannot be excluded by the absence of such findings.
● these fi ndings are not common, and do not correlate with number of positive sinus aspirates.
● intermittent low-grade fever in about one half of adults with acute bacterial sinusitis
toothache is a common complaint when the maxillary sinus is involved.
● periorbital cellulitis and excessive tearing with ethmoid sinusitis
● orbital extension of infection: chemosis, proptosis, impaired extraocular movements.

Characteristics of acute sinusitis in children with upper respiratory tract infections:
● persistence of symptoms
● cough
bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● fever
facial pain or pressure
● headache
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.

Cause
● each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum).
● acute viral infection
● infection with the common cold or infl uenza
● mucosal edema and sinus infl ammation
● decreased drainage of thick secretions, obstruction of the sinus ostia
● subsequent entrapment of bacteria

A. Multiplication of bacteria
B. Secondary bacterial infection

Other predisposing factors
tumors
● polyps
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● allergies
asthma
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● rhinovirus
● coronavirus
● adenovirus
● parainfluenza virus
● respiratory syncytial virus
● the principal bacterial pathogens in sinusitis are streptococcus pneumoniae, nontypeable haemophilus influenzae, and moraxella catarrhalis.
● in the remainder of cases, fi ndings include streptococcus pyogenes, staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (peptostreptococcus, fusobacterium, bacteroides, prevotella).

Infection is polymicrobial in about one third of cases.
● anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children.
● fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon
Pathogens in the paranasal sinuses. Fungal pathogens include aspergillus, pseudallescheria, sporothrix, phaeohyphomycoses, zygomycetes.
● nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised.
● s. Aureus
● pseudomonas aeruginosa
● klebsiella pneumoniae
● enterobacter spp.
● proteus mirabilis

Organisms typically isolated in chronic sinusitis:
● s. Aureus
● s. Pneumoniae
● h. Infl uenzae
● p. Aeruginosa
● anaerobes

Differential diagnosis
migraine headache
cluster headache
● dental infection
trigeminal neuralgia

Workup
● water’s projection: sinus radiograph
● ct scan
● much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses
● recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to
 

Guide therapy:
● transillumination
● used for diagnosis of frontal and maxillary sinusitis
● place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses.
● absence of light transmission indicates that sinus is filled with fluid.
● dullness (decreased light transmission) is less helpful in diagnosing infection.
● endoscopy
● used to visualize secretions coming from the ostia of infected sinuses
● culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture
● sinus puncture
● gold standard for collecting sinus cultures
● generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis.

Treatment Nonpharmacologic therapy
● sinus drainage
● nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5%

● topical decongestants should not be used for more than a few days because of the risk of rebound congestion.
● systemic decongestants
● nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone
● nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow)
● use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting,

Which blocks the ostia, thus interfering with sinus drainage.
● analgesics, antipyretics.

Antimicrobial therapy
● most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics.
● current treatment recommendations favor symptomatic treatment for those with mild symptoms.
● antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of

Bacterial sinusitis.

● antibiotic therapy is usually empirical, targeting the common pathogens.
● first-line antibiotics include amoxicillin, tmp-smz.
● second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin.
● for patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the

Costlier second-line agents.

Surgery
● surgical drainage indicated
● if intracranial or orbital complications suspected
● for many cases of frontal and sphenoid sinusitis
● for chronic sinusitis recalcitrant to medical therapy
● surgical débridement imperative for treatment of fungal sinusitis

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