Ciprofloxacin for UTI causing debilitating headache

Resolved question:
Hi, I am a 20 year old female. I am currently taking Ciprofloxacin for my UTI. Ever since I have started taking it, I have been experiencing very severe, throbbing headaches and vomiting. I have read online that headaches are a side effect of Cipro but my headaches have left me bed-ridden for two days now. I have been on Cipro for two days and am prescribed to take it for a total of seven days. I have tried taking extra strength tylenol and advil with litte to no results. I do not have health insurance so I wanted to run this question by here before I go back to my doctor. Thank you for your time.

Submitted: 4 Days
Category: OBGYN

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello,
Thanks for your query at DoctorSpring.

Your symptoms very closely resemble those of an acute urinary tract infection. The classical symptoms include painful urination and the feeling of incomplete evacuation - that you havent completely voided yourself, and have to go again and again. The fever is also supportive of this.

The numbness is not classical, however, it could indicate a small impacted stone somewhere in the urinary tract, which could be responsible for the infection.

Common reasons for urinary infection ( bladder infection ) could be less than adequate intake of water, excessive sweating and dehydration whilst you work and live in hot and humid climates, a coexisting pelvic infection ( could somehow explain the vaginal discharge too ), recent sexual intercourse, impacted stones etc.

A urine infection could be easily diagnosed by a urine microscopic examination and culture sent for identifying the bacteria. I would do this as a first step.

Also in order would be a per vaginum and per speculum internal examination to know the cause of the brownish discharge.

You would give me more information if you tell me about the pattern of your menstrual cycles, when was your last period, whether this is the first such incident of spotting, whether you are sexually active and on any contraceptives etc. This would help me to explain the vaginal discharge better. Otherwise, minor discharge off and on is common in women.

As I said, a coexisting vaginal infection also could present with a discharge.

Spotting while on birth control is common, and the last possibility is a pregnancy related complication.

Polycystic ovaries and endometrial hyperplasia ( thickening of the lining of the uterus ) can lead to spotting in between cycles, as can any cervical growth .

A per speculum and per vaginum examination would rule out those.
A pelvic ultrasound and ultrasound of the abdomen also should be done, as it will pinpoint any pathology in the bladder and kidneys, as well as in the uterus or ovaries.

Meanwhile, till you schedule your appointment, please increase your intake of water. Take atleast 4 - 5 litres of fluids per day. Avoid keeping the perineal area wet and damp.

Wear clean cotton non allergic undergarments. Avoid use of tampons, medicated or perfumed cleansers, soaps, douches, toilet paper that is not vouched for, latex condoms etc.

Take care, and I would be happy to address any follow up questions that you might have.
Regards

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Patient replied :

Thank you so much Dr. Vazirani for your response.
My last period was July 14. My periods have been skipping a month ever since I started having them.
I spoke to a doctor and she confirmed that I did indeed have a urinary tract infection and suggested that the brown discharge was a bit of spotting.
I have been given medicine for the UTI but I have been experiencing a severe headache and vomiting since yesterday. Do you know if Cipro will help with my headaches? Thank you for your time.


Expert:  Dr. Aarti Vazirani replied 3 Days.

Hi again
Nice to hear from you.

Ciprofloxacin would not help with the headaches, but both headaches and vomiting are a common side effect of Ciprofloxacin. Would help if you do not take the medication on an empty stomach.

Taking an Aspirin for the headache is also fine if the headache is severe and unbearable.

You would need to complete the course of antibiotics for the prescribed days to have full cure of the urinary infection.

Please have an ultrasound of the kidneys and pelvis as I suggested earlier, to know the cause of recurrent UTIs.

Cranberry juice is protective against UTIs, and is a natural cure.

Also, intake of lots of fluids is essential.
All the best.

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Patient replied :

Hi, I am a 20 year old female. I am currently taking Ciprofloxacin for my UTI. Ever since I have started taking it, I have been experiencing very severe, throbbing headaches and vomiting. I have read online that headaches are a side effect of Cipro but my headaches have left me bed-ridden for two days now. I have been on Cipro for two days and am prescribed to take it for a total of seven days. I have tried taking extra strength tylenol and advil with litte to no results. I do not have health insurance so I wanted to run this question by here before I go back to my doctor. Thank you for your time.


Expert:  Dr. Aarti Vazirani replied 2 Days.

Hi

Generally, your urine culture report would show a number of antibiotics to which the organisms are responsive.

If Ciprofloxacin is causing intolerable headaches, please request your doctor to prescribe an alternative, which would be equally effective, yet would not have such side effects.

All the best.

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Patient replied :

Hi thank you for your response Dr. Vazirani.

These headaches started happening a day before I started taking this medicine, but while most of the usual symptoms of UTI have gone away, my headache is still as severe as it was before I started this prescription. Today the doctor, after hearing the situation, prescribed me promethazine for my headaches instead of offering an alternative drug. The promethazine has helped a little but is still a long way from aiding my headaches.

I have heard that the typical prescription period for Cipro is three days which, as of today, I will have passed. I believe that the doctor prescribed me Cipro for seven days because of the chance that my kidneys were affected by the UTI, something I believe is called pyelonephritis.

I guess my real questions are 1)Severe headaches are both a symptom of Pyelonephritis and a side effect of Cipro; if my headaches were happening before the medicine, will that not rule out Cipro as the agent? 2) If so, if Cipro isn't the source of my severe headaches, is there a chance that the Cipro is somewhat aggravating the headaches?
3) I have heard that the treatment for early pyelonephritis is also antibiotic treatment. If we rule out Cipro as the source and aggravator of the headaches, would it be safe for me to continue on through the pain until the prescription period is over?

I apologize for all the questions, but I hope you can understand my worries. I look for to hearing back from you.

Thank you for your time.


Expert:  Dr. Aarti Vazirani replied 1 Day.

Hi again,

No apologies are in order. It is my pleasure to be able to assist you through your queries. Feel free to write in whenever you want to.

Firstly, isolated headaches would not be indicative of pyelonephritis.
If the kidneys were involved, you would have extreme high grade fever, chills, nausea alongwith the headache.

Also, it would help me if you told me WHY the doctor suspected pyelonephritis, and whether specific tests to diagnose the same ( kidney scan etc ) were done, or it was just presumptive long term antibiotic therapy to PREVENT pyelonephritis, which often results from frequent UTI.
Since the headaches started BEFORE Cipro, yes we can eliminate that as a source, not as an aggravator.

Cipro definitely could aggravate a headache that could be there earlier.
The headache might be due to general illness, stress, lack of proper sleep, change of season, of course a refractory error.

Treatment for pyelonephritis is also antibiotics, so yes, if you CAN manage the headaches then it is best to complete the requisite 7 day course of Cipro. Stopping it midway doesnt make sense right now, as you are already on the fourth day, and only have three more.

Try resting more, and head massage plus a tight bandage, as it seems medications are not going a long way towards alleviating your headache.
Apart from Tylenol and Advil, Try and pop a simple Aspirin.

Sometimes it is much more effective than the other generic NSAIDs.

Wish you luck, and do get well soon.

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