Ciprofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

IV-$4/d PO-$3/d

Dosing

PO: 500-750mg po q12h

IV: 400mg IV q8-12h

0 - 29 eGFR30 - 50 eGFR50+ eGFR400mg IV q24h
500mg PO q24h200-400mg IV q12h
250-500mg PO q12h400mg IV q8-12h
500-750mg PO q12h

400mg IV or 500mg PO q24h, dose after HD on dialysis days

400mg IV q12h

500 mg po q24h

General Information

Common Usage

Pseudomonal and other gram negative infections of urinary tract, bone/joint, abdomen, and other sites.

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

  • QTc prolongation

  • Dysglycemia

  • Tendinopathy and rupture

  • GI upset

  • Rash

  • Retinal detachment

  • CNS toxicity including confusion, psychosis

  • Weakness exacerbation in myasthenia gravis

Major Interactions

CYP1A2 inhibitor - multiple interactions possible

QTc prolongation - Increased risk with other agents that prolong QTc

Di- & Trivalent cations including Al, Ca, Fe, Mg (antacids, dairy products, iron supplements, some enteral feeds) - decreased absorption

Cyclosporine - increased levels of cyclosporine

Warfarin - increased INR

Methadone - lowered seizure threshold

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4.0

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Therapeutic