CIPROFLOXACIN

Indications & Dose:

Infections of the lower respiratory tract, skin and skin structure, bone arid joints, urinary tract, external auditory canal; uncomplicated gonorrhea; typhoid fever; chronic prostatitis; intra-abdominal infections (in combination with metronidazole); infectious iarrhea; empirical therapy in febrile neutropenia (IV); superficial ocular infections caused by susceptible organisms (ophthalmic)

DOSE 

• BY MOUTH

Adult: 250-750 mg twice daily, usually 5-10 days depending on severity and response., Acute complicated cystitis in women; 100mg twice daily for 3 days, Gonorrhoea; single 500mg dose , Chronic prostatitis; 500mg twice daily for 25 days, Prophylaxis; single dose 750mg 60-90 mins, preop., Surgical prophylaxis; 750mg 60-90 minutes before the surgery

Children: Acute exacerbation of cystic fibrosis, under 5 years, not recommended;  5-17 years, 20mg/kg twice daily for 10-14 days. Also where benifit exceeds risk, 5-15 mg/kg twice daily 

• BY INFUSION

Adult: 100-400mg daily by i.v. infusion over 30-60 minutes, usually for 5-7 days, depend upon the severity of infection and response, Gonorrhoea; 100mg by i.v. infusion

Children: Acute exacerbation of cystic fibrosis, under 5 years, not recommended., 5-17 years, 10mg/kg i.v. infusion over 60 minutes three times daily. Also where benefit exceeds risk; 4-8mg/kg by i.v infusion twice daily 

Contraindications:

Side Effects:

Cautions:

Precautions:

Children (arthropathy in juvenile-animals), renal disease, excessive sunlight, caution with known or suspected CNS disorders

Interaction:

Drugs

Aluminum: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Antacids: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Antipyrine: Inhibits metabolism of antipyrine; increased plasma antipyrine level

Caffeine: Inhibits metabolism of caffeine; increased plasma caffeine level

Calcium: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Diazepam: Inhibits metabolism of diazepam; increased plasma diazepam level

Didanosine: Markedly reduced absorption of ciprofloxacin; take ciprofloxacin 2 hr before didanosine

Foscarnet: Coadministration increases seizure risk

Iron: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Magnesium: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Metoprolol: Inhibits metabolism of metoprolol; increased plasma metoprolol level

Pentoxifylline: Inhibits metabolism of pentoxifylline; increased plasma pentoxifylline level

Phenytoin: Inhibits metabolism of phenytoin; increased plasma phenytoin level

Propranolol: Inhibits metabolism of propranolol; increased plasma propranolol level

Ropinirole: Inhibits metabolism of ropinirole; increased plasma ropinirole level

Sodium bicarbonate: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Sucralfate: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose

Theobromine: Inhibits metabolism of theobromine; increased plasma theobromine level

Theophylline: Inhibits metabolism of theophylline; cut maintenance theophylline dose in half during therapy with ciprofloxacin

Warfarin: Inhibits metabolism of warfarin; increases hypoprothrombinemic response to warfarin

Zinc: Reduced absorption of ciprofloxacin; do not take within 4 hr of dose 

Warnings:

Adverse Effects:

Lactations:

Appears in breast milk at levels similar to serum; allow 48 hr to elapse after last dose, before resuming breast feeding 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Chills, depression, dizziness, fatigue, fever, hallucinations, headache, insomnia, nightmares, restlessness

EENT: Blurred vision, tinnitus

GI: Abdominal pain/discomfort, nausea, constipation; diarrhea, dysphasia, flatulence, heartburn, increased ALT, AST; oral candidiasis, vomiting

SKIN: Flushing, photosensitivity, pruritus, rash, urticaria 

Patient And Carer Advice: