This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start.
You have stated that you wish to take a medication for your symptoms of Urinary Tract Infection (bladder infection, UTI). The medication you have been prescribed is ciprofloxacin 250mg tablets, which you are to take 1 tablet 2 times each day (morning and evening approximately 12 hours apart) for 3 days. This medication is used to kill the infection of bacteria growing in your urinary bladder. >90% of these infections are caused by E. coli and are due to the proximity of the female urethra (urine tube) to the end of the gastrointestinal (GI) tract.
Signs of this infection include burning with urination, foul-smelling urine without itching or abnormal vaginal discharge. You may experience fullness or tenderness of the lower abdomen, more frequent need to urinate, or a sensation of being unable to fully empty your bladder. A slight pink or red tinge to the urine can be common, but bleeding is not and should be addressed immediately with an in-person physician.
You will automatically be sent a refill every 90 days (subject to a refill visit to help screen for side effects). You may request a refill early by logging into your Account (Subscriptions > Next Refill). If you placed a one-time order, please order as normal.
If your symptoms aren't getting better after you start taking the medicine or if you develop new or worsening symptoms such as fever, chills, nausea, vomiting, or pain, in the mid to upper back, you should see a doctor in-person immediately. More than 3 UTIs in a year should also be managed in person with testing and a referral to Urology to identify potential underlying causes.
This medicine contains the following active ingredients. If you are allergic to any of these components, similar components, or any of the others components listed in the manufacturer's pamphlet do not take it and call or message us immediately:
Do not take ciprofloxacin if you have myasthenia gravis.
This medicine, like all medications, may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following please do not take the medicine and call or message us or see your doctor in-person:
- Other fluoroquinolone antibiotics
We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately:
- Kidney problems
- Rash or mouth sores
- Abdominal pain or nausea
- Muscle aches
- Fever (temperature greater than 100.4 degrees Fahrenheit)
- History of prolonged QT syndrome or heart arrhythmias
- Myasthenia Gravis
- Tendonitis, especially at the heel
Pregnancy and Breastfeeding
Based on available data, an increased risk of major birth defects, miscarriage, or other adverse fetal and maternal outcomes have not been observed following ciprofloxacin use during pregnancy. Based on adverse outcomes observed in animal studies, the manufacturer recommends that breastfeeding be discontinued during therapy and for 2 days after the last ciprofloxacin dose.
Emergency Side Effects
This medicine can cause dangerous and potentially life-threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person:
- Irritated or torn tendons (10-22%) Boxed warning
- Anxiety or agitation
- Difficulty swallowing or throat swelling
- Jaundice or yellow skin
- Liver and kidney disease
- Acute renal failure
- Severe skin rash or changes
- Severe weakness or fatigue
- Shortness of breath or wheezing
- Debilitating muscle aches with blood in the urine
Other Side Effects
This medicine can also cause other side effects. If any of the other side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call or message us or see your doctor in person:
- Abdominal pain
- Dark red urine
- Lightheadedness or passing out
- Nausea or vomiting
- Ringing in ears
- Vision Changes
- Photosensitivity/easily sunburned
Medicines, Supplements, and Foods
We have evaluated your health history and the specific health information you provided us, however, if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan:
- HIV medications
- Narcotic pain medications
- Anti-seizure medications
- Antipsychotic medications
- Blood pressure medicine
- Blood thinners
NOTE: Birth control - Please use a backup form of contraception such as condoms while taking antibiotics as they can theoretically decrease the efficacy of oral contraceptive pills. You should continue to take your daily birth control pill while taking the antibiotic as well.
We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.
This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.
Misdiagnosis or Delayed Diagnosis
There is also a risk that we may incorrectly diagnose or fail to diagnose the correct conditions that you may have, thereby affecting our recommendation for treatment. This risk exists with in-person care as well, but they may have additional clinical history, physical exam findings, and tests to aid their evaluation. We use evidence-based practice guidelines and clinical decision-making to try to minimize these risks. Here are some other diagnoses that we attempt to rule out:
- Sexually Transmitted Infections (STIs)
- Yeast infection
- Bacterial Vaginosis (BV)
- Kidney infection
- Kidney Stones
- Overactive Bladder
Accepting or Declining Our Recommendation
We are recommending this treatment for you because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer's pamphlet, any input from your in-person healthcare team, or other relevant information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although, doing so may prolong symptoms and can be associated with other risks or negative outcomes.
We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:
- In-person exam with urine sample testing
Share with Your In-Person Healthcare Team
You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.
You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.