Uses

This combination is indicated for mixed infections involving gram-negative bacteria and anaerobes or protozoa, such as complicated intra-abdominal infections, pelvic inflammatory disease, and gastrointestinal infections including traveler's diarrhea with protozoal involvement.

Do not use if

Contraindicated in hypersensitivity to fluoroquinolones or nitroimidazoles, in patients with myasthenia gravis (ciprofloxacin), in the first trimester of pregnancy, and in breastfeeding. Avoid concurrent use with tizanidine.

Side effects

Common side effects include nausea, vomiting, diarrhea, and abdominal discomfort. Ciprofloxacin may cause tendinopathy, peripheral neuropathy, and CNS effects. Tinidazole may cause a metallic taste and disulfiram-like reaction with alcohol.

Warnings

Ciprofloxacin carries a risk of tendon rupture, peripheral neuropathy, and QT prolongation. Tinidazole should not be used with alcohol. Avoid in growing children and adolescents due to potential cartilage effects from ciprofloxacin.

How it works

Ciprofloxacin is a fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and transcription. Tinidazole is a 5-nitroimidazole that undergoes intracellular reduction to cytotoxic intermediates that disrupt anaerobic and protozoal DNA.

Storage

Store at room temperature (15–25°C), protected from light and moisture.