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Ciprofloxacin

CIPROFOLXACIN

Manufacturer: NuCare Pharmaceutical, Inc.

Score: 141.0

Quick Summary

Ciprofloxacin is a fluoroquinolone antibacterial agent used to treat various infections, including skin and skin structure infections, bone and joint infections, and urinary tract infections. It is available in 250 mg and 500 mg strengths and should be taken orally, with or without food. The drug has several important safety considerations, including the risk of tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects. Ciprofloxacin is contraindicated in patients with a history of hypersensitivity to the drug or other quinolones, and in patients taking tizanidine. The recommended dosage varies depending on the infection being treated, and dose adjustments may be necessary for patients with renal impairment. Special population considerations include use during pregnancy, nursing mothers, pediatric use, and geriatric use.

Key Clinical Findings and Indications

  • Skin and skin structure infections
  • Bone and joint infections
  • Complicated intra-abdominal infections
  • Infectious diarrhea
  • Typhoid fever
  • Uncomplicated cervical and urethral gonorrhea
  • Inhalational anthrax (post-exposure)
  • Plague
  • Chronic bacterial prostatitis
  • Lower respiratory tract infections
  • Urinary tract infections
  • Acute sinusitis

Important Safety Information

Warning

Fluoroquinolones, including ciprofloxacin, have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together, including tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects.

Contraindications

  • Hypersensitivity to ciprofloxacin or other quinolones
  • Concomitant administration with tizanidine

Adverse Reactions

  • Nausea
  • Diarrhea
  • Liver function tests abnormal
  • Vomiting
  • Rash
  • Tendinitis and tendon rupture
  • Peripheral neuropathy
  • Central nervous system effects

Dosing Recommendations

General Guidance

Dosage adjustments may be necessary for patients with renal impairment.

Skin and skin structure infections

Adult Dose

500-750 mg every 12 hours

Pediatric Dose

Not recommended

Bone and joint infections

Adult Dose

500-750 mg every 12 hours

Pediatric Dose

Not recommended

Complicated intra-abdominal infections

Adult Dose

500 mg every 12 hours

Pediatric Dose

Not recommended

Infectious diarrhea

Adult Dose

500 mg every 12 hours

Pediatric Dose

Not recommended

Typhoid fever

Adult Dose

500 mg every 12 hours

Pediatric Dose

Not recommended

Uncomplicated cervical and urethral gonorrhea

Adult Dose

250 mg single dose

Pediatric Dose

Not recommended

Inhalational anthrax (post-exposure)

Adult Dose

500 mg every 12 hours

Pediatric Dose

15 mg/kg every 12 hours

Plague

Adult Dose

500-750 mg every 12 hours

Pediatric Dose

15 mg/kg every 8-12 hours

Chronic bacterial prostatitis

Adult Dose

500 mg every 12 hours

Pediatric Dose

Not recommended

Lower respiratory tract infections

Adult Dose

500-750 mg every 12 hours

Pediatric Dose

Not recommended

Urinary tract infections

Adult Dose

250-500 mg every 12 hours

Pediatric Dose

10-20 mg/kg every 12 hours

Acute sinusitis

Adult Dose

500 mg every 12 hours

Pediatric Dose

Not recommended

Special Population Considerations

Pregnancy

  • Prolonged experience with ciprofloxacin in pregnant women over several decades has not identified any drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.

Nursing Mothers

  • Ciprofloxacin is excreted in human milk, and the extent of absorption in infants is not known.

Pediatric Use

  • Although effective in clinical trials, ciprofloxacin is not a drug of first choice in the pediatric population due to an increased incidence of adverse reactions compared to controls.

Geriatric Use

  • Geriatric patients are at increased risk for developing severe tendon disorders, including tendon rupture, when being treated with a fluoroquinolone such as ciprofloxacin.