- See Fluoroquinolone
-
Myasthenia Gravis (exacerbates motor weakness)
-
Tizanidine use
- Children
- Relative contraindication due to risk of Arthropathy in animals
- Studies have not demonstrated Arthropathy (other than transient large joint Arthralgias)
- Ciprofloxacin is commonly used off label in children with Cystic Fibrosis (due to Pseudomonas coverage)
- Tablets: 250, 500 and 750 mg
- Oral Suspension 250 and 500 mg per 5 ml
- Shake container well for 15 seconds before administering dose
- Do not give via nasogastric or Feeding Tube
- Extended release tablets: 500 and 1000 mg
- Not interchangeable with regular, non-extended release formulations
- See Anthrax
-
Urinary Tract Infection
- Use higher dose of range for Pyelonephritis for 7 to 14 days
- Give 200 to 400 mg IV every 12 hours OR
- Take 250 to 500 mg orally twice daily OR
- Extended Release Ciprofloxacin 1000 mg orally daily
-
Chronic Bacterial Prostatitis
- Take 500 mg orally twice daily for up to 28 days
-
Diverticulitis or Complicated intraabdominal infections (with Metronidazole)
- Give 400 mg IV every 12 hours OR
- Take 500 mg orally twice daily
-
Infectious Diarrhea
- Take 500 mg orally twice daily for 5 to 7 days
- Use 1 to 3 days (or 750 mg for one dose) for Traveler's Diarrhea
- Use 10 days for Typhoid Fever
-
Malignant Otitis Externa (not FDA approved)
- Give 400 mg IV every 12 hours, or
- Take 750 mg orally every 12 hours
- Foot Osteomyelitis due to Pseudomonas Osteochondritis (Sweaty Tennis Shoe Syndrome)
- Take 750 mg orally twice daily for up to 6 to 8 weeks
- Bone and joint infections (based on sensitivity testing, treated for 4 to 8 weeks)
- Give 400 mg IV every 8 to 12 hours initially, then
- Take 500 to 750 mg orally twice daily
-
Plague (treated for 14 days)
- Give 400 mg IV every 8 to 12 hours OR
- Take 500 mg orally twice daily
-
Chancroid (not FDA approved)
- Take 500 mg orally twice daily for 3 days
-
Renal Dosing (immediate release)
- eGFR 30 to 50 ml/min: 250 to 500 mg orally every 12 hours
- eGFR 5 to 29 ml/min: 200 to 400 mg IV every 18 to 24 hours OR 250 to 500 mg every 18 hours
- Hemodialysis: 250 to 500 mg orally every 24 hours after Dialysis
- See Anthrax
- See Precautions above under contraindications
- Complicated Urinary Tract Infection or Pyelonephritis (age 1 to 17 years)
- Give 6 to 10 mg/kg IV (up to 400 mg/dose) every 8 hours, then
- Give 10 to 20 mg/kg (up to 750 mg/dose) orally every 12 hours
-
Plague (age birth to 17 years, treated for 10 to 21 days)
- Give 10 mg/kg IV (up to 400 mg/dose) every 8 to 12 hours, then
- Give 15 mg/kg (up to 500 mg/dose) orally every 8 to 12 hours
- Acute respiratory exacerbation of Cystic Fibrosis
- Give 10 mg/kg IV (up to 400 mg/dose) every 8 to 12 hours for 7 days, then
- Give 20 mg/kg (up to 750 mg/dose) orally every 12 hours for a total course of 10 to 21 days
- See Fluoroquinolone
-
Fluoroquinolones have several serious warnings (e.g. tendon rupture, Neuropathy, Aortic Dissection)
-
QTc Prolongation
-
Hypersensitivity
-
Urine Crystal formation (in alkaline urine)
- Photosensitivity (Sunburn risk)
- Gastrointestinal (Nausea, Vomiting, Diarrhea, Abdominal Pain)
- Neurologic (Headache, Dizziness, confusion)
- Rash
- Serum transaminase increase
-
Serum Creatinine increase
- White cell changes (Eosinophilia, Neutropenia)
-
Seizure risk (class effect due to GABA inhibition)
- Avoided in pregnancy (despite pregnancy Category C)
- Cartilage damage risk
- Considered safe in Lactation
- However, risk of pediatric Arthropathy
- Rapid but variable absorption, reaching peak levels within 1 to 2 hours of ingestion
-
Half-Life: 4 hours
- Partial hepatic metabolism and renal excretion
- Urine concentrations remain high for many hours after dose
- Distributes widely (except CSF), with high concentrations in urine, stool, bile, Prostate, bone and Sputum
-
Sulfonylureas
- Hypoglycemia risk
-
Warfarin
- May potentiate Anticoagulant effects
-
Tizanidine
- Do not use with Ciprofloxacin
- Ciprofloxacin is a strong CYP1A2 Inhibitor and increases drug levels of its substrates
- Olanzapine
- Ropinirole
- Zolpidem
- Drugs that interfere with absorption (give at least 2 hours before or after dose)
- Antacids containing Calcium, aluminum or Magnesium
- Sucralfate
- Iron
- Zinc
- Yogurt, milk or Calcium fortified juice (but may take with dairy containing meals)
loading