Cipro is an antibiotic that has been found be effective against anthrax, as well as many other types of bacteria. It will also kill E. coli bacteria and is helpful in treating bacterial infections that cause everything from bronchitis to gonorrhea.

Cipro works like this:

It inhibits bacterial nuclear DNA synthesis, so that bacteria rapidly die. The target is the enzyme DNA gyrase (topoisomerase II), which is responsible for the supercoiling and uncoiling of the DNA. Supercoiling of the DNA allows the long DNA molecule to fit into the cell. Uncoiling of the structure is the initiative step for replication, transcription and repair of the DNA. Thus, prolonged inhibition will eventually lead to the death of the cell.

In other words, inside both E. Coli bacteria and anthrax bacteria is an enzyme, called topoisomerase II, that helps the cell to wind DNA into a compact structure and then unwind it when needed. Cipro blocks topoisomerase II and prevents it from doing its job. A bacterial cell that has Cipro in it can no longer uncoil its DNA in order to create enzymes or reproduce. The bacteria containing Cipro eventually die.

There are reports that Soviet scientists have created antibiotic-resistant strains of anthrax. One way to accomplish ths may have been be to grow large quantities of anthrax and then treat it with Cipro to see if any of the cells lived. Examining those few living cells an allowing them to reproduce. These would be Cipro-resistant cells. However, they would not be resistant to other antibiotics that happen to work against anthrax.

Is Cipro approved for anthrax?

Cipro is approved for use in patients who have been exposed to the inhaled form of anthrax.

Is Cipro the only product approved to treat anthrax infections?

No. There are a number of antibiotics that are currently indicated to treat anthrax infections including doxycycline and penicillin. These older antibiotics are readily available. FDA is stressing that any antibiotic should only be used by those who really need it because unnecessary antibiotic use exposes patients to the risks of a drug without any potential benefit.

If I know someone who was exposed to anthrax should I be treated with Cipro?

Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is no need to treat contacts of persons ill with anthrax, such as household contacts, friends, or coworkers, unless they also were also exposed to the same source of infection.

Should I ask my doctor to write a prescription for Cipro in case it’s needed?

No. Although FDA does not regulate the practice of medicine, the agency is strongly recommending that physicians not prescribe Cipro for individual patients to have on hand for possible use against inhaled anthrax. Any needed antibiotics from the current stockpile will be made available if they are needed. In the meantime, Cipro should not be prescribed unless there is a clear need, so that the drug will be available when it is needed to treat other more common infections.

Why is FDA discouraging widespread use of Cipro?

Random prescribing and extensive use of Cipro could speed up the development of drug-resistant organisms, and the usefulness of Cipro as an antibiotic may be lost.

What are some possible side effects of Cipro? (This list is NOT a complete list of side effects reported with Cipro. Your health care provider can discuss with you a more complete list of side effects.)

Some possible side effects of Cipro include:

  • central nervous system (CNS) side effects including: dizziness, confusion, tremors, hallucinations, depression, increased risk of seizures
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives)
  • pain, inflammation, or rupture of a tendona severe tissue inflammation of the colon
  • increased sensitivity of the skin to sunlight

Is it safe to purchase Cipro online?

There are online pharmacies that provide legitimate prescription services. Unfortunately, there are also questionable sites that make purchasing medicines online risky. Purchasing a medication from an illegal Website puts you at risk. You may receive a contaminated or counterfeit product, the wrong product, an incorrect dose, or no product at all.

Can individuals import Cipro under FDA’s personal importation policy?

Cipro is a powerful antibiotic that should only be started after consultation with a health care provider. Because Cipro is associated with side effects (some of which may be serious) and may interact with other drugs, it is important to have access to the prescribing health care provider during Cipro treatment. Cipro should not be administered unless exposure to the bacterium that causes anthrax (Bacillus anthracis) is suspected or confirmed. Cipro does not prevent exposure to anthrax and use of Cipro in the absence of suspected or confirmed anthrax exposure could result in the development of antibiotic resistance, a serious risk to the public’s health.

FDA cannot assure that Cipro (or any other drug) purchased abroad is safe, effective, and not a counterfeit product, even if the labeling appears to be that of the genuine product. The counterfeiting and adulteration of drugs is a widespread problem in many foreign countries.

The Federal Food, Drug, and Cosmetic Act (FFDCA) does not permit the importation (including importation for personal use) of unapproved foreign versions of drugs which are approved for use in the US. FDA does exercise limited enforcement discretion in the case of individuals wishing to import an unapproved drug for their personal use, but only if the drug in question does not have an approved version available in the US. Since an approved version of Cipro is available in the US, personal importation of any unapproved version is not permitted.

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