C. diff Risk


Oral Bioavailability


Approximate Cost

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


250-500 mg PO q12h

10-15 mg/kg/dose PO/IV q12h
Maximum: IV: 400 mg/dose PO:750 mg/dose

10 mg/kg/dose IV q8h
Maximum: 400 mg/dose 20 mg/kg/dose PO BID
Maximum: 1000 mg/dose

5-20 mg/kg/dose IV q12h

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

General Information

Common Usage

Cystic fibrosis, Pseudomonal infection

Drug Monitoring

  • Renal and liver function

  • CBC

  • QTc in patients with increased risk

  • Tendinopathy and rupture have been reported.

Adverse Effects

  • Dizziness

  • Insomnia

  • Rash

  • Nausea, vomiting, abdominal pain

  • Tendinopathy and rupture

  • QTc prolongation have been reported

Major Interactions

Strong CYP1A2 inhibitor and weak CYP3A4 inhibitor - Multiple interactions possible

QTc prolongation - Increased risk with other agents that prolong QTc

Increased risk of tendon rupture especially with concomitant use of corticosteroids.

Monitor INR with warfarin.

Avoid concurrent oral administration with calcium, antacids, iron. Administer ciprofloxacin 2 hours before or 4 hours after dose of calcium, antacids and iron.

Ciprofloxacin suspension should never be given through an enteral feeding tube. Ciprofloxacin immediate-release tablets can be given via tube, but should not be administered concurrently with enteral feedings. Discontinue feed for 1-2 hours prior to and after ciprofloxacin administration.

Oral Liquids

Concentration: 100 mg/mL

Taste: metallic taste, less palatable
Not all strengths of oral liquids are listed nor are available on IWK formulary

Tablet/Capsule Strengths

250 mg tablet
750 mg tablet

Tablets and capsules are preferred especially over an unpleasant tasting liquid.
Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary.

Additional Information

Not first-line therapy in children.


Antimicrobial class: Fluoroquinolone

Average serum half life: Pediatrics: 4-5 hours

Route of Elimination: 30% to 50% excreted as unchanged drug in urine via glomerular filtration and active tubular secretion;
20% to 40% excreted in feces primarily from biliary excretion;
<1% excreted in bile as unchanged drug