Adult Dosing
Bacterial infections
Respiratory tract infections
- Mild/Moderate: 500 mg PO q12 hrs x 7-14 days
- Severe/complicated: 750 mg PO q12 hrs x 7-14 days
Urinary tract infections
- Acute, uncomplicated (Mild/Moderate); Immediate Release (IR) form; 250 mg PO q12 hrs x 3 days. Extended Release (ER) form: 500 mg PO q24 hrs x 3 days
- Complicated; Immediate Release form: 500 mg PO q12 hrs x 7-14 days. Extended Release form: 1000 mg PO q24 hrs x 7-14 days
- Acute uncomplicated pyelonephritis; ER form: 1000 mg PO q24 hrs x 7-14 days
Chronic bacterial prostatitis; mild to moderate
- 500 mg PO q12 hrs x 28 days
Skin & Skin structure infections
- Mild/Moderate: 500 mg PO q12 hrs x 7-14 days
- Severe/complicated: 750 mg PO q12 hrs x 7-14 days
Bone/Joint infections
- Mild/Moderate: 500 mg PO q12 hrs for at least 4-6 wks
- Severe/complicated: 750 mg PO q12 hrs for at least 4-6 wks
Complicated intra-abdominal infections
- 500 mg PO q12 hrs x 7-14 days in combination with metronidazole
Infectious diarrhea
- 500 mg PO q12 hrs x 5-7 days
Typhoid fever
- 500 mg PO q12 hrs x 10 days
Urethral/Cervical gonococcal infections; uncomplicated
- 250 mg PO as a single dose
Inhalational Anthrax; post exposure
- 500 mg PO q12 hrs x 60 days
Traveler's Diarrhea [Not FDA Approved]
- 500-750 mg PO bid x 1–3 days
Chancroid [Non-FDA Approved]
Notes:
- Dose and duration of therapy varies with the type of infection, severity and clinical condition of the individual patient
Crohn's Disease [Non-FDA approved]
Pediatric Dosing
Complicated urinary tract infections, Pyelonephritis
- Child (1-17 yrs): 20-40 mg/kg/day PO divided q12 hrs x 10-21 days. [Max: 750 mg/dose]
Inhalational Anthrax; post exposure
- Child: 30 mg/kg/day PO divided q12 hrs x 60 days. [Max: 500 mg/dose]
Traveler's Diarrhea [Not FDA Approved]
- 20–30 mg/kg/day PO divided bid x 3 days; max: 1.5 g/day
Bronchiectasis [Not FDA Approved]
- 40 mg/kg/day PO divided bid × 7–10 days
Cellulitis [Non-FDA Approved]
- 20-40 mg/kg/day q12 hr, max; 1.5 g/day
Chancroid [Non-FDA Approved]
- 20-30 mg/kg/day divided q12 hrs x 3 days. Max: 1 g/day
Crohn's Disease [Non-FDA approved]
Notes:
- Dose and duration of therapy varies with the type of infection, severity and clinical condition of the individual patient. Safety and effectiveness of ciprofloxacin in patients < 18 yrs of age is not established
[Outline]
Renal Dose Adjustment (Based on CrCl)
IR form
- >50 mL/min: Use usual dose
- 30-50 mL/min: 250-500 mg PO q12 hrs
- 5-29 mL/min: 250-500 mg PO q18 hrs
- HD/CAPD: 250-500 mg q24 hrs after dialysis
ER form
- <30 mL/min: 500 mg q24 hrs for complicated UTI/uncomplicated pyelonephritis
- HD/CAPD: Give dose after dialysis, no supplement
Hepatic Dose Adjustment
- Use with caution; dose adjustment not defined
See Supplemental Patient Information
- Safety and effectiveness of ciprofloxacin in pregnant and lactating women have not been established
- Ciprofloxacin may increase risk of tendinitis and tendon rupture in all ages. Discontinue treatment if pain or inflammation in a tendon occurs
- Serious and occasionally fatal hypersensitivity and/or anaphylactic reactions have been reported in patients receiving therapy with fluoroquinolones, including ciprofloxacin
- Prolongation of the QT interval and isolated cases of torsade de pointes have been reported
- Avoid use in patients with known QT prolongation, those with hypokalemia, and with other drugs that prolong the QT interval
- Clostridium difficile-associated diarrhea (CDAD) has been reported with use the drug and may range in severity from mild diarrhea to fatal colitis.
- An increased incidence of musculoskeletal disorders (arthralgia, arthritis, tendonopathy, and gait abnormality) compared to controls has been observed in pediatric patients treated with this drug. It is not drug of first choice in children due to increased adverse reactions related to joints and surrounding tissue. Do not use in patients < 18 yrs of age, except for listed indications
- Seizures, increased ICP and toxic psychosis have been reported in patients taking ciprofloxacin. It may also cause nervousness, agitation, insomnia, anxiety, nightmares, paranoia, dizziness, confusion, tremors, hallucinations, depression
- Moderate to severe photosensitivity reactions have occurred with some fluoroquinolones. Avoid excessive sunlight exposure
- Monitor creatinine at baseline, then periodically if elderly or prolonged therapy
- Monitor CBC, LFTs if prolonged therapy
- Cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias and weakness have occurred in patients
- Discontinue therapy if the patient experiences symptoms of neuropathy including pain, burning, tingling, numbness, and/or weakness or other alterations of sensation including light touch, pain, temperature, position sense, and vibratory sensation in order to prevent the development of an irreversible condition
Cautions: Use cautiously in
- Renal impairment (refer dose adjustment section)
- Hepatic impairment
- Kidney, heart or lung transplant
- QT prolongation
- Seizure disorder
- CNS disorder
- Dehydration
- Diabetes mellitus
Supplemental Patient Information
- Advise on the use of sunscreen for phototoxicity
- Report any CNS effect to health professional. Avoid activities requiring coordination until effects are realized
- Should not take drug with dairy products or with in 2 hr and 6 hr after magnesium or aluminum antacids
- Inform of tendon rupture risk
Pregnancy Category:C
Breastfeeding: Fluoroquinolones have not been used in infants because of concern about adverse effects on the infants developing joints. Avoiding breastfeeding for 3 to 4 hours after a dose can decrease infant exposure; however other agents might be preferred. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 2 November 2009)
US Trade Name(s)
- Cipro
- Cipro XR
- Proquin XR (Discontinued)
US Availability
ciprofloxacin (generic)
- TABS: 100, 250, 500, 750 mg
- ETABS: 500, 1000 mg
Cipro
- TABS: 100, 250, 500, 750 mg
- SOLN: 250 mg/5 mL
- SOLN: 500 mg/5 mL
Cipro XR
Proquin XR
Canadian Trade Name(s)
- Cipro
- Cipro XL
- RAN-Ciproflox
Canadian Availability
ciprofloxacin (generic)
- TABS: 100, 250, 500, 750 mg
Cipro
- TABS: 250, 500, 750 mg
- SOLN: 500 mg/5 mL (100 mL)
Cipro XL
RAN-Ciproflox
UK Trade Name(s)
UK Availability
ciprofloxacin (generic)
- TABS: 100, 250, 500, 750 mg
Ciproxin
- TABS: 100, 250, 500, 750 mg
- SUSP: 250 mg/5 mL (100 mL)
Australian Trade Name(s)
- C-Flox
- Cifran
- Ciprol
- Ciproxin
- Profloxin
- Proquin
Australian Availability
ciprofloxacin (generic)
C-Flox, Cifran, Ciprol, Ciproxin, Profloxin
Proquin
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Cipro 500 MG TABS [Bottle] (BAYER HEALTHCARE PHARMA)
30 mg = $177.09
90 mg = $497.73 - Ciprofloxacin HCl 500 MG TABS [Bottle] (WATSON LABS)
100 mg = $39
300 mg = $97.2
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
