Monograph Details
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Infections & Infestations
> Bacterial infections
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CIPRO |
| Manufacturer |
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Bayer Corp, Pharmaceutical Div. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Quinolone. |
| Generic Name |
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Ciprofloxacin (as HCl) 250mg, 500mg, 750mg; tabs. |
| Also |
• CIPRO IV CONCENTRATE
• CIPRO IV PREMIXED
• CIPRO ORAL SUSPENSION
• CIPRO XR
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| Indications |
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Susceptible infections, including lower respiratory tract, skin and skin structures, bone and joint, acute sinusitis, complicated intraabdominal (w. metronidazole), UTIs, chronic bacterial prostatitis. Postexposure prophylaxis and treatment of anthrax. Infectious diarrhea, typhoid fever, uncomplicated cervical and urethral gonorrhea: oral form only. Nosocomial pneumonia, empiric therapy in febrile neutropenia: IV form only. |
| Children |
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<18yrs: usually not recommended. 1–17yrs: Complicated UTIs or pyelonephritis: 10–20mg/kg (max 750mg) every 12 hrs for 10–21 days (see literature). Postexposure prophylaxis of inhalational anthrax, or treatment of cutaneous anthrax: 15mg/kg (CDC recommends 10–15mg/kg) every 12 hrs for 60 days (start as soon as possible after exposure). Treatment of inhalational, GI, or oropharyngeal anthrax (CDC recommendations): use IV form first (see below) then switch to oral form at 10–15mg/kg every 12 hrs, for a total of 60 days. Max 1g/day. |
| Adults |
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See literature. Do not chew microcapsules for susp. ≥18yrs: Sinusitis, typhoid fever: 500mg every 12 hrs for 10 days. Lower respiratory tract, skin and skin structure: 500–750mg every 12 hrs for 7–14 days. Intraabdominal (w. metronidazole): 500mg every 12 hrs for 7–14 days. Bone and joint: 500–750mg every 12 hrs for at least 4–6 weeks. Infectious diarrhea: 500mg every 12 hrs for 5–7 days. Postexposure prophylaxis of inhalational anthrax, or treatment of cutaneous anthrax: 500mg orally every 12 hrs for 60 days (start as soon as possible after exposure). Treatment of inhalational, GI, or oropharyngeal anthrax (CDC recommendations): use IV form first (see below), then 500mg orally every 12 hrs, for a total of 60 days. Acute uncomplicated cystitis due to E. coli, S. saprophyticus in females: 250mg every 12 hrs for 3 days (oral forms only). Other UTIs: 250–500mg every 12 hrs for 7–14 days. Prostatitis: 500mg every 12 hrs for 28 days. Gonorrhea: 250mg once. Renal dysfunction (CrCl 30–50mL/min): 250–500mg every 12 hrs; (CrCl 5–29mL/min): 250–500mg every 18 hrs; hemo- or peritoneal dialysis: 250–500mg every 24 hrs (after dialysis). |
| Contraindications |
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Concomitant tizanidine. |
| Precautions |
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XR not interchangeable with other forms. Renal (except XR tabs for uncomplicated UTIs) or hepatic dysfunction: reduce dose. Discontinue if tendon pain, inflammation, or rupture occurs; if rash, phototoxicity, or other sign of hypersensitivity occurs; or if CNS disorders or neuropathy occurs. Conditions that increase seizure risk. History of joint-related disorders (esp. children). Maintain adequate hydration, avoid alkaline urine to avoid crystalluria. Avoid excessive sun and UV light. Pregnancy (Cat.C), nursing mothers: usually not recommended. |
| Interactions |
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Avoid theophylline (increases theophylline levels; may potentiate other CYP1A2 substrates), urinary alkalinizers; oral forms with antacids, calcium, iron, zinc, sucralfate, buffered forms of didanosine, other highly buffered drugs (may give ciprofloxacin 2 hrs before or 6 hrs after); high ciprofloxacin doses with NSAIDs (increases seizure risk). Potentiates caffeine. Potentiated by probenecid. Severe hypoglycemia with glyburide (rare). Increased serum creatinine with cyclosporine. Monitor methotrexate, oral anticoagulants (potentiation), phenytoin (variable effects). Caution with other drugs that lower seizure threshold. Reduced absorption with omeprazole (XR). |
| Adverse Reactions |
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GI upset, headache, CNS disturbances (eg, convulsions, dizziness, nervousness, insomnia, nightmares, paranoia), rash, eosinophilia, elevated liver enzymes, photosensitivity, Stevens-Johnson syndrome, myalgia, tendinitis/rupture, joint-related disorders (children), local reactions (inj); rare: increased intracranial pressure, toxic psychosis. |
| Extra Text |
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Note: See MMWR Vol 50, No.42 (Oct. 26, 2001) for more information on anthrax. |
| How Supplied |
Tabs 250mg, 500mg—100
750mg—50
Oral Susp—100mL
Inj Conc (20mL, 40mL)—1
Infusion (100mL, 200mL)—1
XR Tabs—50, 100 |
| Additional Resources |
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• Related Prescribing Note |
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