Cifran 250 is ciprofloxacin 250 mg, a fluoroquinolone antibiotic. It treats urinary, gut, bone, skin and some chest infections. It is powerful and it is deliberately held in reserve, because this class carries side effects that other antibiotics do not.
What is Cifran 250?
Cifran 250 is a Schedule 4 tablet containing ciprofloxacin 250 mg, listed in the South African Medicine Price Registry.
Ciprofloxacin is a fluoroquinolone. It blocks two bacterial enzymes — DNA gyrase and topoisomerase IV — that unwind and rewind bacterial DNA during replication. Without them the DNA cannot be copied and the bacterium dies.
It is a broad-spectrum antibiotic, and unusually strong against gram-negative organisms such as E. coli, Pseudomonas, Salmonella and Campylobacter. That makes it valuable in urinary and gut infections, and in some infections that other oral antibiotics simply cannot reach.
It is not a first-line antibiotic, and that is a deliberate choice rather than a limitation. Medicines regulators worldwide — including the FDA and EMA — have restricted fluoroquinolone use because of rare but serious and sometimes permanent side effects affecting tendons, nerves, muscles and the nervous system. The guidance is now explicit: do not use them for mild infections that other antibiotics can treat, such as uncomplicated sinusitis, bronchitis or simple bladder infections where an alternative exists.
If ciprofloxacin has been prescribed, it should be because the infection needs it — resistance, severity, or an organism nothing else covers.
What is Cifran 250 commonly used for?
- Complicated urinary tract infections and kidney infections (pyelonephritis).
- Bacterial gastroenteritis — travellers’ diarrhoea, Salmonella, Shigella, Campylobacter.
- Typhoid fever.
- Bone and joint infections, including osteomyelitis, often over long courses.
- Skin and soft tissue infections, including some diabetic foot infections.
- Prostatitis, where its tissue penetration is particularly useful.
- Gonorrhoea, in some settings — though resistance has made it unreliable in many.
- Serious ear infections, including malignant otitis externa.
- Anthrax exposure, as prophylaxis.
- Some chest infections, particularly in cystic fibrosis or where Pseudomonas is involved.
It does not treat colds, flu or most sore throats and coughs — all viral.
Complete the course, and do not save leftover tablets. Fluoroquinolone resistance is rising, and partial courses drive it.
How Cifran 250 fits into this medicine category
| Group | Examples | Typical role |
|---|---|---|
| Fluoroquinolones | Ciprofloxacin (Cifran), levofloxacin, moxifloxacin | Reserved: complicated urinary, gut, bone and Pseudomonas infections |
| Aminopenicillins | Amoxicillin | Broad first-line cover |
| Penicillin + inhibitor | Co-amoxiclav | Where resistance defeats amoxicillin |
| Nitrofurans | Nitrofurantoin | First-line for simple bladder infections |
| Sulfonamides | Co-trimoxazole | Urinary and other infections |
| Macrolides | Azithromycin (Azrotrin) | Atypical chest infections; penicillin allergy |
| Nitroimidazoles | Metronidazole | Anaerobic infections — often paired with ciprofloxacin |
Note the fourth row: for an uncomplicated bladder infection, nitrofurantoin is generally preferred precisely so that ciprofloxacin is kept in reserve. See the antibiotics and antimicrobials hub.
What to check before using Cifran 250
The interactions that stop it working are the ones people miss. Ciprofloxacin binds to metal ions and is then not absorbed:
- Antacids, and supplements containing calcium, magnesium, iron or zinc, including multivitamins and dairy products taken in quantity.
- Take ciprofloxacin at least two hours before, or six hours after, any of these. Getting this wrong can render the antibiotic useless while you believe you are treating an infection.
Also tell your doctor or pharmacist if you:
- Have a history of tendon problems, or take corticosteroids. The combination substantially raises tendon rupture risk.
- Have epilepsy or a seizure history — ciprofloxacin lowers the seizure threshold.
- Have myasthenia gravis, where it can cause serious worsening.
- Have a heart rhythm problem or a long QT interval, or take other QT-prolonging medicines.
- Take theophylline, tizanidine, warfarin, methotrexate, clozapine or caffeine in quantity — ciprofloxacin raises levels of several of these substantially. Tizanidine is contraindicated.
- Have kidney disease, liver disease, or diabetes.
- Have an aortic aneurysm or risk factors for one.
- Are pregnant or breastfeeding, or under 18 — fluoroquinolones are generally avoided in children.
Practical points: drink plenty of fluid; avoid strong sun and sunbeds, as it causes photosensitivity; take it at evenly spaced times; and stop exercising and contact your doctor at the first sign of tendon pain.
Possible cautions and when to ask a pharmacist or doctor
Common effects are nausea, diarrhoea, abdominal pain, headache, dizziness and rash.
Stop taking it and contact your doctor immediately for:
- Pain, swelling or inflammation in a tendon — most often the Achilles, at the back of the ankle. Rupture can occur suddenly, can happen weeks after the course, and can be permanent. Rest the limb and seek advice the same day.
- Numbness, tingling, burning or weakness in the hands or feet — peripheral neuropathy, which can be irreversible if the medicine is continued.
- Confusion, hallucinations, severe anxiety, depression, agitation, or thoughts of self-harm.
- Seizures.
- Sudden severe pain in the chest, abdomen or back — get emergency help; fluoroquinolones are associated with aortic aneurysm and dissection.
Get emergency help also for swelling of the face, lips or tongue, difficulty breathing, a widespread blistering rash, palpitations or fainting, or severe, watery or bloody diarrhoea with fever during or after the course.
Contact your doctor if the infection is not improving after two to three days, if you develop joint or muscle pain, if you notice yellowing of the skin or eyes, or if any symptom seems out of proportion. With this class specifically, it is better to report something early than to finish the course and hope — several of its serious effects are far more recoverable when the medicine is stopped promptly.
Related medicine guides
Frequently asked questions
What is Cifran 250 used for? Complicated urinary and kidney infections, bacterial gut infections including typhoid and travellers’ diarrhoea, bone and joint infections, prostatitis, and some skin and ear infections. It contains ciprofloxacin.
Why isn’t it used for simple infections? Fluoroquinolones carry rare but serious and sometimes permanent side effects, so regulators advise against using them where another antibiotic would do. Nitrofurantoin is usually preferred for a simple bladder infection.
Can I take it with milk or an antacid? No — separate them. Calcium, magnesium, iron and zinc bind ciprofloxacin and stop it being absorbed. Take it two hours before or six hours after.
What should I do if my ankle hurts? Stop the medicine, rest the limb and contact your doctor the same day. Tendon rupture is a recognised risk and can occur weeks after the course.
Can I go in the sun? Avoid strong sun and sunbeds — it causes photosensitivity and burning happens more easily.
Will it treat flu? No. Flu and colds are viral, and antibiotics have no effect on them.
Can children take it? Fluoroquinolones are generally avoided in children and under-18s except in specific circumstances decided by a specialist.
Can I stop when I feel better? Finish the course. Partial courses drive resistance, which is already rising with this class.