- Dr Maheen Zaiba
- Mar 30, 2025
- 4 min read
Updated: Apr 6, 2025
Written by Dr Maheen Zaiba [PharmD, DOW University Of Health Sciences (DUHS)], Karachi, Pakistan)
Generic:
Ciprofloxacin
Available dosage forms:
Available as tablet form in 100mg, 250mg, 500mg, & 750mg
Injection form as 0.2g injection.
Therapeutic class:
Quinolones Antibiotics
Pharmacological class:
Inhibition of bacterial DNA gyrase and topoisomerase IV.
Mechanism of action:
Ciprofloxacin is a second generation fluoroquinolone that is active against many Gram negative and Gram positive bacteria. It produces its action through inhibition of bacterial DNA gyrase and topoisomerase IV, thereby inhibiting cell division. Bacterial DNA fragmentation will occur as a result of inhibition of the enzymes.
Manufacturer:
OBS Pharmaceuticals.
Storage:
15-30 degree Celsius
Prescription drug?
Yes
Indications and doses:
Acute Sinusitis
Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 10 days
Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for acute sinusitis
Bone & Joint Infections
Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for ≥4-6 weeks
Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for ≥4-6 weeks
Chronic Bacterial Prostatitis
Indicated for chronic bacterial prostatitis caused by Escherichia coli or Proteus mirabilis
Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 28 days
Infectious Diarrhea
Mild/moderate/severe: 500 mg PO q12hr for 5-7 days
Empirical Therapy in Febrile Neutropenic Patients
Severe: 400 mg IV q8hr for 7-14 days
Intra-abdominal Infections
Complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
Lower Respiratory Tract Infections
Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days
Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for acute bacterial exacerbation of chronic bronchitis
Nosocomial Pneumonia
Mild/moderate/severe: 400 mg IV q8hr for 10-14 days
Skin/Skin Structure Infections
Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days
Urinary Tract Infections
Acute uncomplicated: Immediate-release, 250 mg PO q12hr for 3 days; extended-release, 500 mg PO q24hr for 3 days
Mild/moderate: 250 mg PO q12hr or 200 mg IV q12hr for 7-14 days
Severe/complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for uncomplicated urinary tract infections
Urethral & Cervical Gonococcal Infections
Uncomplicated: 250-500 mg PO once
Anthrax Infection
Post exposure therapy
Inhalation (prophylaxis/post exposure): 500 mg PO q12hr or 400 mg IV q12hr for 60 days
Cutaneous: 500 mg PO q12hr or 400 mg IV q12hr for 60 days
Plague
Indication for treatment and prophylaxis of plague due to Yersinia pestis
500-750 mg PO q12hr x14 days, OR
400 mg IV q8-12hr x 14 days
Bronchiectasis (non-FDA approved use)
Noncystic Fibrosis Bronchiectasis (Orphan)
Dry powder for inhalation: Orphan designation for patients with NCFB who suffer from frequent severe acute pulmonary bacterial exacerbations which lead to further inflammation, airway, and lung parenchyma damage.
Dosage Modifications
Renal impairment
·         CrCl >50 mL/min
o   Dose adjustment not necessary
·        CrCl 30-50 mL/min
o   Immediate-release: 250-500 mg PO q12hr
o   Extended-release: 1 g PO q24hr
o   Intravenous: 400 mg IV q8-12hr
·        CrCl 5-29 mL/min
o   Immediate-release: 250-500 mg PO q18hr
o   Extended-release: 500 mg PO q24hr
o   Intravenous: 200-400 mg IV q12-24hr
·        Hemodialysis or peritoneal dialysis
o   Administer after dialysis
o   Immediate-release: 250-500 mg PO q24hr
o   Extended-release: 500 mg PO q24hr
o   Intravenous: 200-400 mg IV q24hr
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Side Effects:
Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
Increased pressure around the brain—severe headache, blurry vision, change in vision, nausea, vomiting
Joint, muscle, or tendon pain, swelling, or stiffness
Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
Pain, tingling, or numbness in the hands or feet
Redness, blistering, peeling, or loosening of the skin, including inside the mouth
Seizures
Severe diarrhea, fever
Sudden or severe chest, back, or stomach pain
Unusual vaginal discharge, itching, or odor
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Diarrhea
Dry mouth
Headache
Nausea
Interactions:
Do not take this medication with any of the following:
Cisapride
Dronedarone
Flibanserin
Lomitapide
Pimozide
Thioridazine
Tizanidine
This medication may also interact with the following:
Antacids
Birth control pills
Caffeine
Certain medications for diabetes, like glipizide, glyburide, or insulin
Certain medications that treat or prevent blood clots like warfarin
Clozapine
Cyclosporine
Didanosine buffered tablets or powder
Dofetilide
Duloxetine
Lanthanum carbonate
Lidocaine
Methotrexate
Multivitamins
NSAIDS, medications for pain and inflammation, like ibuprofen or naproxen
Olanzapine
Omeprazole
Other medications that prolong the QT interval (cause an abnormal heart rhythm)
Phenytoin
Probenecid
Ropinirole
Sevelamer
Sildenafil
Sucralfate
Theophylline
Ziprasidone
Zolpidem
Other Interactions
·        Caffeine
·        Dairy Food
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Pregnancy/lactation:
Not accepted
Precautions:
This medicine may increase your risk for aortic aneurysm (bulge in the wall of the largest artery). Check with your doctor right away if you have sudden chest, stomach, or back pain, trouble breathing, cough, or hoarseness. Some people who take ciprofloxacin may become more sensitive to sunlight than they are normally
Administration guide:
Avoid the administration of ciprofloxacin with dairy products (e.g., milk or yogurt) or calcium-fortified juices alone; however, ciprofloxacin may be taken with meals that contain calcium. Protect yourself from sunlight and avoid excessive exposure to the sun when taking ciprofloxacin. Wear sunblock when outdoors.
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