Ciprofloxacin

C. diff Risk

High

Oral Bioavailability

Good (70 to 90%)

Approximate Cost

$0.12 (PO)
$6.42 (IV)

Dosing

PO: 500-750mg po q12h

IV: 400mg IV q8-12h

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.

Divalent & 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

Tablet/Capsule Strengths

OPEN BENEFIT (PO)
No prescribing restrictions

Additional Information

IV Administration
- Premixed bags of 200 mg and 400 mg; Infuse over 60 min
- NOTE: premixed bags are incompatible with pumps used in Community IV program

EH Prescribing Restrictions
- NONE
- Pharmacist review of therapy for IV

Community IV Formulary (Metro Region)
NO

Ciprofloxacin suspension clogs enteral feeding tubes. Crush tablets for administration via tube if required.

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4 hours

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic