Ciprofloxacin Almus: detailed information

Patient Information Leaflet

CIPROFLOXACIN ALMUS 250 mg film-coated tablets, 500 mg film-coated tablets, 750 mg film-coated tablets

Generic Medicine
Please read this leaflet carefully before taking this medicine, as it contains important information for you.

Keep this leaflet. You may need to read it again.
If you have any questions, consult your doctor or pharmacist.
This medicine has been prescribed for you only. Do not give it to others, even if their symptoms are the same as yours, as it could be harmful.
If you experience any side effects, including those not listed in this leaflet, contact your doctor or pharmacist. See section 4.

Contents of this leaflet:

What Ciprofloxacin Almus is and what it is used for
What you need to know before taking Ciprofloxacin Almus
How to take Ciprofloxacin Almus
Possible side effects
How to store Ciprofloxacin Almus
Contents of the pack and other information

1. What Ciprofloxacina Almus is and what it is used for

Ciprofloxacina Almus contains the active substance ciprofloxacin. Ciprofloxacina Almus is an antibiotic belonging to the family of fluoroquinolones. Ciprofloxacin works by killing the bacteria that cause infections. It is effective only against specific strains of bacteria.

Adults
Ciprofloxacina Almus is used in adults to treat the following bacterial infections:

respiratory tract infections
long-lasting or recurrent ear or paranasal sinus infections
urinary tract infections
genital infections in men and women
gastrointestinal and intra-abdominal infections
skin and soft tissue infections
bone and joint infections
prevention of infections caused by the bacterium Neisseria meningitidis
exposure to inhaled anthrax spores

Ciprofloxacin may be used to manage patients with low white blood cell counts (neutropenia) who develop fever suspected to be due to bacterial infection.
If you have a severe infection, or one caused by more than one type of bacteria, your doctor may prescribe another antibiotic in addition to Ciprofloxacina Almus.

Children and adolescents
Ciprofloxacina Almus is used in children and adolescents, under specialist supervision, to treat the following bacterial infections:

lung and bronchial infections in children and adolescents with cystic fibrosis
complicated urinary tract infections, including infections that have reached the kidneys (pyelonephritis)
exposure to inhaled anthrax spores

Ciprofloxacina Almus may also be used to treat other specific severe infections in children and adolescents, when considered necessary by the physician.

2. What you need to know before taking Ciprofloxacin Almus

Do not take Ciprofloxacin Almus:

if you are allergic to the active substance, to other quinolones, or to any of the excipients of this medicine (listed in section 6);
if you are taking tizanidine (see section 2: “Other medicines and Ciprofloxacin Almus”).

Warnings and precautions
Before taking this medicine
You must not take quinolone/fluoroquinolone antibacterial medicines, including Ciprofloxacin Almus, if in the past you have experienced any serious adverse reaction during treatment with a quinolone or fluoroquinolone. In such a case, inform your doctor as soon as possible.
Tell your doctor before taking Ciprofloxacin Almus

If you have kidney problems, as your treatment may need adjustment.
If you suffer from epilepsy or other neurological disorders.
If you have had tendon problems during previous treatment with antibiotics such as Ciprofloxacin Almus.
If you are diabetic, as there may be a risk of hypoglycaemia when using ciprofloxacin.
If you have myasthenia gravis (a type of muscle weakness), as symptoms may worsen.
If you have been diagnosed with enlargement or “bulging” of a large blood vessel (aortic aneurysm or peripheral aneurysm of a large blood vessel).
If you have previously experienced episodes of aortic dissection (a tear in the wall of the aorta).
If you have been diagnosed with insufficiency of one of the heart valves (aortic or mitral regurgitation).
If you have a family history of aortic aneurysm or aortic dissection, congenital heart valve disease, or other risk factors or predisposing conditions (e.g., connective tissue disorders such as Marfan syndrome, Ehlers-Danlos syndrome, Turner syndrome, Sjögren’s syndrome [an autoimmune inflammatory disease], or vascular disorders such as Takayasu arteritis, giant cell arteritis, Behçet’s disease, known high blood pressure or atherosclerosis, rheumatoid arthritis [an autoimmune inflammatory disease], or endocarditis [inflammation of the heart]).
If you have heart problems. Special caution is required when using Ciprofloxacin Almus if you were born with or have a family history of prolonged QT interval (seen on ECG, an electrical recording of the heart), have an electrolyte imbalance in the blood (especially low potassium or magnesium levels), have a very slow heart rate (bradycardia), have a weak heart (heart failure), have a history of heart attack (myocardial infarction), if you are a woman or an elderly patient, or if you are taking other medicines that may cause abnormal changes on the ECG (see section 2: “Other medicines and Ciprofloxacin Almus”).
Inform your doctor if you or a family member is known to have glucose-6-phosphate dehydrogenase (G6PD) deficiency, as you may be at risk of haemolytic anaemia with ciprofloxacin.

For the treatment of certain genital tract infections, your doctor may prescribe another antibiotic in addition to ciprofloxacin. If there are no signs of improvement after 3 days of treatment, consult your doctor.
While taking Ciprofloxacin Almus
Inform your doctor immediately if any of the following conditions occur during treatment with Ciprofloxacin Almus. Your doctor will decide whether treatment with Ciprofloxacin Almus should be discontinued.

A severe and sudden allergic reaction (anaphylactic reaction/anaphylactic shock, angioedema). There is a remote possibility of a severe and sudden allergic reaction even after the first dose, with symptoms such as chest tightness, dizziness, nausea or fainting, or lightheadedness when standing. In such a case, stop taking Ciprofloxacin Almus and contact your doctor immediately.
Serious, prolonged, disabling, and potentially irreversible side effects. Fluoroquinolone/quinolone antibacterial medicines, including Ciprofloxacin Almus, have been associated with very rare but serious side effects, some of which are prolonged (lasting months or years), disabling, or may not resolve.

These include tendon, muscle, and joint pain in arms and legs, difficulty walking, unusual sensations such as tingling, prickling, tickling, numbness, or burning (paraesthesia), sensory organ disturbances such as changes in vision, taste, smell, or hearing, depression, memory impairment, severe fatigue, and severe sleep disturbances. If you experience any of these side effects after taking Ciprofloxacin Almus, contact your doctor immediately before continuing treatment. Your doctor will decide together with you whether to continue treatment and may consider switching to an antibiotic from another class.

Rarely, joint pain and swelling, and tendon inflammation or rupture may occur. The risk is higher if you are elderly (over 60 years), have received an organ transplant, have kidney problems, or are being treated with corticosteroids. Tendon inflammation and rupture may occur within the first 48 hours of treatment and up to several months after stopping Ciprofloxacin Almus. At the first signs of tendon pain or inflammation (e.g., in the ankle, wrist, elbow, shoulder, or knee), stop taking Ciprofloxacin Almus, contact your doctor, and rest the affected area. Avoid unnecessary movement, as the risk of tendon rupture may increase.
If you experience sudden, severe pain in the abdomen, chest, or back, which may be a symptom of aortic aneurysm or dissection, go immediately to the emergency room. The risk may be higher if you are taking systemic corticosteroid medicines.
Inform your doctor immediately if you notice sudden shortness of breath, especially when lying down, or swelling of the ankles, feet, or abdomen, or new episodes of palpitations (sensation of rapid or irregular heartbeat).
If you suffer from epilepsy or other neurological disorders, such as cerebral ischaemia or stroke, you may be at risk of central nervous system side effects. In case of seizures, stop taking Ciprofloxacin Almus and contact your doctor immediately.
Rarely, symptoms of nerve damage (neuropathy) may occur, such as pain, burning, tingling, numbness, and/or weakness, particularly in the feet and legs or hands and arms. In such a case, stop taking Ciprofloxacin Almus and inform your doctor immediately to prevent permanent nerve damage.
Psychiatric reactions may occur even when taking quinolone antibiotics, including Ciprofloxacin Almus, for the first time. If you suffer from depression or psychosis, your symptoms may worsen during treatment with Ciprofloxacin Almus. In rare cases, depression and psychosis may progress to suicidal thoughts and self-harming behaviours such as suicide attempts or suicide (see section 4: “Possible side effects”). If you experience depression, psychosis, or suicidal thoughts or behaviours, contact your doctor immediately.
Quinolone antibiotics may cause elevated blood sugar levels (hyperglycaemia) or decreased blood sugar levels below normal (hypoglycaemia), which in severe cases may potentially lead to loss of consciousness (hypoglycaemic coma) (see section 4: “Possible side effects”). This is particularly important for people with diabetes. If you have diabetes, your blood sugar levels must be closely monitored.
During treatment with antibiotics, including Ciprofloxacin Almus, or even several weeks afterwards, diarrhoea may develop. If it worsens or persists, or if you notice blood or mucus in your stools, you must stop taking Ciprofloxacin Almus and contact your doctor immediately, as this may be a life-threatening condition. Do not take medicines that block or reduce intestinal motility.
If your vision deteriorates or your eyes become otherwise affected, consult an ophthalmologist immediately.
While taking Ciprofloxacin Almus, your skin may become more sensitive to sunlight or ultraviolet (UV) light. Avoid exposure to intense sunlight and artificial UV light, such as sunbeds.
Inform your doctor or laboratory staff that you are taking Ciprofloxacin Almus if you are undergoing blood or urine tests.
If you have kidney problems, inform your doctor, as you may need a dosage adjustment.
Ciprofloxacin Almus may cause liver damage. If you notice symptoms such as loss of appetite, jaundice (yellowing of the skin), dark urine, itching, or abdominal pain, contact your doctor immediately.
Ciprofloxacin Almus may reduce the number of white blood cells, leading to reduced resistance to infections. If you develop an infection with symptoms such as fever and marked deterioration in general condition, or fever with signs of localized infection such as sore throat, mouth pain, or urinary problems, consult your doctor immediately. A blood test will be performed to check for a possible reduction in white blood cells (agranulocytosis). It is important that you inform your doctor about this medicine.

Other medicines and Ciprofloxacin Almus
Inform your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.
Do not take Ciprofloxacin Almus with tizanidine, as it may cause side effects such as low blood pressure and drowsiness (see section 2: “Do not take Ciprofloxacin Almus”).
The following medicines interact with Ciprofloxacin Almus in the body. Taking Ciprofloxacin Almus together with these medicines may affect their therapeutic effect and increase the likelihood of side effects.

Inform your doctor if you are taking:
vitamin K antagonists (e.g., warfarin, acenocoumarol, phenprocoumon, or fluindione) or other oral anticoagulants (to thin the blood)
probenecid (for gout)
methotrexate (for certain types of cancer, psoriasis, or rheumatoid arthritis)
theophylline (for respiratory problems)
tizanidine (for muscle spasticity in multiple sclerosis)
olanzapine (an antipsychotic)
clozapine (an antipsychotic)
ropinirole (for Parkinson’s disease)
phenytoin (for epilepsy)
metoclopramide (for nausea and vomiting)
ciclosporin (for skin conditions, rheumatoid arthritis, and organ transplants)
other medicines that may alter heart rhythm: medicines belonging to the antiarrhythmic group (e.g., quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide), tricyclic antidepressants, some antimicrobials (macrolide group), some antipsychotics
zolpidem (for sleep disorders).

Ciprofloxacin Almus may increase blood levels of the following medicines:

pentoxifylline (for circulatory disorders)
caffeine
duloxetine (for depression, diabetic neuropathy, or incontinence)
lidocaine (for heart problems or anaesthetic use)
sildenafil (e.g., for erectile dysfunction)
agomelatine (for depression).

Certain medicines reduce the effect of Ciprofloxacin Almus. Inform your doctor if you are taking or intend to take:

antacids
omeprazole
mineral supplements
sucralfate
a polymeric phosphate binder (e.g., sevelamer or lanthanum carbonate)
medicines or supplements containing calcium, magnesium, aluminium, or iron. If these preparations are essential, take Ciprofloxacin Almus approximately two hours before or no sooner than four hours after taking them.

Ciprofloxacin Almus with food and drinks
Calcium intake as part of a meal, including dairy products and calcium-rich drinks (such as milk or yoghurt) or fortified fruit juices (e.g., calcium-enriched orange juice), does not significantly affect the absorption of this medicine.
However, administering ciprofloxacin tablets together with dairy products or calcium-rich drinks when these products or drinks are taken alone, away from meals, may reduce the effectiveness of this medicine.
Therefore, ciprofloxacin tablets should be taken one or two hours before or no sooner than four hours after consuming dairy products or calcium-rich drinks taken alone, away from meals (see also section 3).
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to become pregnant, consult your doctor or pharmacist before taking this medicine.
It is preferable to avoid using Ciprofloxacin Almus during pregnancy.
Do not take Ciprofloxacin Almus while breastfeeding, as ciprofloxacin is excreted in breast milk and may be harmful to your baby.
Driving and using machines
This medicine may affect your ability to concentrate. Since neurological adverse events may occur, check how you react to Ciprofloxacin Almus before driving a vehicle or operating machinery. If in doubt, discuss with your doctor.
Ciprofloxacin Almus contains sodium
This medicine contains less than 1 mmol (23 mg) of sodium per tablet, i.e., essentially ‘sodium-free’.

3. How to take Ciprofloxacin Almus

Your doctor will explain exactly how much Ciprofloxacin Almus you should take, how often, and for how long. This will depend on the type of infection you have and its severity.
Inform your doctor if you have kidney problems, as your dosage may need to be adjusted.
Treatment usually lasts from 5 to 21 days, but may last longer for severe infections. Always take this medicine exactly as instructed by your doctor. Consult your doctor or pharmacist if you are unsure about how many tablets to take or how to take Ciprofloxacin Almus.

Swallow the tablets with plenty of fluid.
If you are unable to swallow the tablets, inform your doctor.
Do not chew or crush the tablets, as they have an unpleasant taste.
Try to take the tablets at about the same time each day.
You may take the tablets with meals or between meals. You may take ciprofloxacin tablets with meals containing dairy products (such as milk or yoghurt) or calcium-rich drinks (e.g. calcium-fortified orange juice). However, do not take this medicine at the same time as dairy products or calcium-rich drinks when these dairy products or calcium-rich drinks are consumed alone and away from meals. Ciprofloxacin tablets must be taken either one or two hours before, or at least four hours after, consuming dairy products or calcium-rich drinks taken alone and away from meals.

Remember to drink plenty of fluids during treatment with Ciprofloxacin Almus.
If you take more Ciprofloxacin Almus than you should
If you take more than the prescribed dose, contact your doctor immediately. If possible, bring the tablets or the pack with you to show the doctor.
If you forget to take Ciprofloxacin Almus
If you forget to take Ciprofloxacin Almus and:

There are 6 hours or more until your next scheduled dose, take the missed dose immediately. Then take the next dose as scheduled.
There are less than 6 hours until your next scheduled dose, do not take the missed dose. Take the next dose as scheduled.

Do not take a double dose to make up for a forgotten dose. Make sure you complete the full course of treatment.
If you stop taking Ciprofloxacin Almus
It is important that you complete the full course of treatment, even if you start to feel better after a few days. If you stop taking this medicine too early, the infection may not be completely cured and symptoms may return or worsen. You may also develop resistance to the antibiotic.
If you have any doubts about how to use this medicine, consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everyone gets them.
The following section lists the most serious side effects that you may notice on your own:
Stop taking Ciprofloxacin Almus and contact your doctor immediately, who will evaluate an alternative antibiotic treatment, if you experience any of the following serious side effects:
Rare (may affect up to 1 in 1,000 people):

seizures (see section 2: "Warnings and precautions").

Very rare (may affect up to 1 in 10,000 people):

severe and sudden allergic reaction with symptoms such as chest tightness, dizziness, feeling unwell or fainting, or dizziness when standing (anaphylactic reaction/anaphylactic shock) (see section 2: "Warnings and precautions")
muscle weakness, tendon inflammation which may lead to tendon rupture – especially of the large tendon at the back of the ankle (Achilles tendon) (see section 2: "Warnings and precautions")
a life-threatening skin rash, usually presenting as blisters or ulcers in the mouth, throat, nose, eyes, and other mucous membranes such as the genital area, which may progress to widespread blistering or skin peeling (Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis).

Not known (frequency cannot be estimated from the available data):

unusual sensation of pain, burning, tingling, numbness, or muscle weakness in the extremities (neuropathy) (see section 2: "Warnings and precautions")
a reaction causing skin rashes, fever, inflammation of internal organs, blood abnormalities, and systemic symptoms (DRESS: Drug Reaction with Eosinophilia and Systemic Symptoms; AGEP: Acute Generalized Exanthematous Pustulosis).

Other side effects observed during treatment with ciprofloxacin are listed below according to their frequency:
Common (may affect up to 1 in 10 people):

nausea, diarrhoea
joint pain and joint inflammation in children.

Uncommon (may affect up to 1 in 100 people):

joint pain in adults
fungal superinfections
high concentration of eosinophils, a type of white blood cells
decreased appetite
hyperactivity, restlessness
headache, dizziness, sleep disturbances, taste disturbances
vomiting, abdominal pain, digestive problems (such as stomach upset, indigestion/heartburn) or intestinal gas
increase in certain substances in the blood (transaminases and/or bilirubin)
skin rash, itching, urticaria
reduced kidney function
muscle and bone pain, malaise (asthenia) or fever
increased alkaline phosphatase in the blood (a substance present in the blood).

Rare (may affect up to 1 in 1,000 people):

muscle pain, joint inflammation, increased muscle tone and cramps
inflammation of the bowel (colitis) associated with antibiotic use (in very rare cases may be fatal) (see section 2: "Warnings and precautions")
changes in blood cell counts (leukopenia, leukocytosis, neutropenia, anaemia), increase or decrease in a blood coagulation factor (platelets)
allergic reaction, swelling (oedema), sudden swelling of the skin and mucous membranes (angioedema) (see section 2: "Warnings and precautions")
increased blood sugar (hyperglycaemia)
decreased blood sugar (hypoglycaemia) (see section 2: "Warnings and precautions")
confusion, disorientation, anxious reaction, unusual dreams, depression (which in rare cases may progress to suicidal thoughts, suicide attempts or suicide) (see section 2: "Warnings and precautions"), or hallucinations
tingling, unusual sensitivity to sensory stimuli, reduced skin sensitivity, tremors, dizziness
visual disturbances including double vision (see section 2: "Warnings and precautions")
tinnitus, hearing loss, decreased hearing
rapid heartbeat (tachycardia)
dilation of blood vessels (vasodilation), low blood pressure, fainting
shortness of breath, including asthma-like symptoms
liver disorders, jaundice (cholestatic jaundice) or hepatitis
sensitivity to light (photosensitivity) (see section 2: "Warnings and precautions")
kidney failure, blood or crystals in urine, inflammation of the urinary tract
fluid retention or excessive sweating
increased levels of the enzyme amylase.

Very rare (may affect up to 1 in 10,000 people):

a specific type of reduction in red blood cells (haemolytic anaemia), a dangerous reduction in a type of white blood cells (agranulocytosis) (see section 2: "Warnings and precautions"), a reduction in red blood cells, white blood cells and platelets (pancytopenia), which may be fatal
bone marrow depression, which may also be fatal
an allergic reaction called serum sickness-like reaction (see section 2: "Warnings and precautions")
psychiatric disorders (psychotic reactions which in rare cases may progress to suicidal thoughts, suicide attempts or suicide) (see section 2: "Warnings and precautions")
migraine, coordination disorders, unsteady gait (gait disturbances), disturbances of smell (olfactory disturbances), pressure in the brain (increased intracranial pressure including pseudotumor cerebri)
distortions in colour perception
inflammation of blood vessel walls (vasculitis)
inflammation of the pancreas (pancreatitis)
death of liver cells (hepatic necrosis), which very rarely may lead to life-threatening liver failure (see section 2: "Warnings and precautions")
pinpoint bleeding under the skin (petechiae), various types of skin rashes or rash
worsening of symptoms of myasthenia gravis (see section 2: "Warnings and precautions").

Not known (frequency cannot be estimated from the available data):

syndrome associated with impaired water excretion and low sodium levels (SIADH)
intense feeling of excitement (mania) or extreme optimism and hyperactivity (hypomania)
abnormally fast heart rate, life-threatening irregular heart rhythm, changes in heart rhythm (known as "prolongation of the QT interval", seen on ECG, electrical activity of the heart)
effects on blood clotting (in patients treated with vitamin K antagonists)
loss of consciousness due to a severe drop in blood sugar levels (hypoglycaemic coma). See section 2.

Very rare cases of prolonged (lasting months or years) or permanent adverse drug reactions, such as tendon inflammation, tendon rupture, joint pain, pain in arms or legs, difficulty walking, abnormal sensations such as pricking, tingling, tingling, burning, numbness or pain (neuropathy), fatigue, memory and concentration impairment, effects on mental health (which may include sleep disturbances, anxiety, panic attacks, depression and suicidal ideation), as well as changes in hearing, vision, taste and smell, have been associated with the use of quinolone and fluoroquinolone antibiotics, in some cases regardless of pre-existing risk factors.
Cases of dilation and weakening of the aortic wall or tearing of the aortic wall (aneurysms and dissections), with possible rupture that may be fatal, as well as cases of regurgitation of blood from heart valves, have been reported in patients treated with fluoroquinolones. See also section 2.
Reporting of side effects
If you experience any side effect, including those not listed in this leaflet, talk to your doctor or pharmacist. You can also report side effects directly via the national reporting system at https://www.aifa.gov.it/content/segnalazioni-reazioni-avverse. By reporting side effects, you can help provide more information on the safety of this medicine.

5. How to store Ciprofloxacina Almus

Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date stated on the packaging after "Exp.".
The expiry date refers to the last day of that month.
Do not dispose of any medicine via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. This will help protect the environment.

Contents of the pack and other information

What Ciprofloxacina Almus contains
Ciprofloxacina Almus 250 mg tablets

The active substance is ciprofloxacin hydrochloride monohydrate. Each tablet contains 291 mg of ciprofloxacin hydrochloride monohydrate, equivalent to 250 mg of ciprofloxacin.
The other components are: microcrystalline cellulose (E460), sodium starch glycolate (type A), crospovidone (E1202), maize starch, anhydrous colloidal silica, magnesium stearate (E572), titanium dioxide (E171), hypromellose (E464), macrogol 4000.

Ciprofloxacina Almus 500 mg tablets

The active substance is ciprofloxacin hydrochloride monohydrate. Each tablet contains 582 mg of ciprofloxacin hydrochloride monohydrate, equivalent to 500 mg of ciprofloxacin.
The other components are: microcrystalline cellulose (E460), sodium starch glycolate (type A), crospovidone (E1202), maize starch, anhydrous colloidal silica, magnesium stearate (E572), titanium dioxide (E171), hypromellose (E464), macrogol 4000.

Ciprofloxacina Almus 750 mg tablets

The active substance is ciprofloxacin hydrochloride monohydrate. Each tablet contains 873 mg of ciprofloxacin hydrochloride monohydrate, equivalent to 750 mg of ciprofloxacin.
The other components are: microcrystalline cellulose (E460), sodium starch glycolate (type A), crospovidone (E1202), maize starch, anhydrous colloidal silica, magnesium stearate (E572), titanium dioxide (E171), hypromellose (E464), macrogol 4000.

Description of the appearance of Ciprofloxacina Almus and contents of the pack
Film-coated tablets
250 mg film-coated tablets – 10 tablets
500 mg film-coated tablets – 6 tablets
750 mg film-coated tablets – 12 tablets
Marketing Authorization Holder
Almus S.r.l. – Via Cesarea, 11/10 – 16121 Genoa – Italy
E-mail: [email protected]
Manufacturer
Laboratorio Farmacologico Milanese S.r.l. – Via Monterosso, 273 – 21042 Caronno Pertusella (VA) – Italy

Health advice/education
Antibiotics are used to treat bacterial infections. They are not effective against viral infections.
If your doctor has prescribed antibiotics, you need them specifically for your current illness.
Despite antibiotic treatment, certain bacteria may survive or multiply. This phenomenon is known as resistance: some antibiotic treatments become ineffective.
Improper use of antibiotics increases resistance. You may even promote the development of bacterial resistance and delay recovery or reduce antibiotic effectiveness if you do not adhere to:

dosage
frequency of administration
duration of treatment

Therefore, to preserve the effectiveness of this medicine:
1 – Use antibiotics only when prescribed.
2 – Follow your doctor's instructions strictly.
3 – Do not reuse an antibiotic without a medical prescription, even if you wish to treat a similar illness.
4 – Never give your antibiotic to another person; it may not be suitable for their illness.
5 – At the end of treatment, return all unused medicines to your pharmacy, to ensure they are properly disposed of.