Monograph Details
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Infections & Infestations
> Bacterial infections
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CIPRO IV CONCENTRATE |
| Manufacturer |
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Bayer Corp, Pharmaceutical Div. |
| Legal Classification |
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Rx
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| Generic Name |
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Ciprofloxacin 10mg/mL; soln for IV infusion after dilution. |
| Also |
• CIPRO
• 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. See literature. Infuse over 60 minutes. Switch to oral form when appropriate. 1–17yrs: Complicated UTIs or pyelonephritis: 6–10mg/kg (max 400mg) IV every 8 hrs for 10–21 days (see literature). Postexposure prophylaxis of inhalational anthrax, or treatment of cutaneous anthrax with systemic involvement, extensive edema, or head/neck lesions: 10mg/kg (CDC recommends 10–15mg/kg) IV every 12hrs (start as soon as possible after exposure). Treatment of inhalational, GI, or oropharyngeal anthrax (CDC): 10–15mg/kg IV every 12hrs. For all anthrax: treat for a total of 60days; max 800mg/day IV (per manufacturer) or 1g/day (per CDC). |
| Adults |
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See literature. Infuse over 60 minutes. Switch to oral form when appropriate. ≥18yrs: Lower respiratory tract: 400mg every 8–12hrs for 7–14 days. Nosocomial pneumonia: 400mg every 8hrs for 10–14 days. Intraabdominal (w. metronidazole): 400mg every 12hrs for 7–14 days. Skin and skin structure: 400mg every 8–12hrs for 7–14 days. Bone and joint: 400mg every 8–12hrs for ≥4–6 weeks. Postexposure prophylaxis of inhalational anthrax, or treatment of cutaneous anthrax without systemic involvement: use oral forms. Treatment of inhalational, GI, or oropharyngeal anthrax, or cutaneous anthrax with systemic involvement, extensive edema, or head/neck lesions (CDC recommendations): initially 400mg IV every 12hrs, then switch to oral form dosed at 500mg every 12hrs, for a total of 60days. Sinusitis: 400mg every 12hrs for 10 days. UTIs: 200–400mg every 12hrs for 7–14 days. Prostatitis: 400mg every 12hrs for 28 days. Febrile neutropenia: 400mg every 8hrs (+ piperacillin sodium 50mg/kg IV every 4hrs; max 24g/day) for 7–14 days. Renal dysfunction (CrCl 5–29mL/min): 200–400mg every 18–24hours. |
| 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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