Ciprofloxacin

Generic Name: Ciprofloxacin

Brand Names:

Availability: Available with Prescription

Drug Class: Second generation fluoroquinolone

Therapeutic action

Fluoroquinolone antibacterial

Indications

Shigellosis, uncomplicated cutaneous anthrax
Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis in non-pregnant women in the event of previoustreatment failure
Plague, alone or in combination with other antibacterials
Completion treatment following therapywith parenteral ciproﬂoxacin

Forms and strengths

250 mg and 500 mg tablets
250 mg/5 ml granules and solvent for oral suspension

Dosage

Shigellosis, uncomplicated cutaneous anthrax

Child 1 month and over: 15 mg/kg (max. 500 mg) 2 times daily
Adult: 500 mg 2 times daily

Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis

Adult: 500 mg 2 times daily

Age	Weight	250 mg/5 ml susp.	250 mg tablet	500 mg tablet
1 to < 3 months	4to < 6 kg	1.5 ml x 2	–	–
3 to < 7 months	6to < 8 kg	2 ml x 2	–	–
7 months to < 2 years	8to < 12 kg	2.5 ml x 2	–	–
2 to < 3 years	12to < 15 kg	4 ml x 2	–	–
3 to < 8 years	15to < 26 kg	5 ml x 2	1 tab x 2	–
8 to < 11 years	26to < 36 kg	8 ml x 2	–	–
≥ 11 years and adult	≥36 kg	–	2 tab x 2	1 tab x 2

Plague

Child 1 month and over: 15 mg/kg 2 to 3 times daily (max. 750 mg 2 times daily or 500 mg 3 times daily)
Adult: 750 mg 2 times daily (500 mg 3 times daily in pregnant women)

Duration

Shigellosis, cystitis:3 days
Cutaneous anthrax:7 to 14 days depending on severity
Pyelonephritis, plague: 10 to 14 days
Prostatitis: 14 days (if signs and symptoms are ongoing after 14 days, continue the same treatment for a further14 days)

Contra-indications, adverse effects, precautions

Do not administer to patients with history of allergy or serious adverse effects due to a ﬂuoroquinolone, e.g. tendinitis, tendon rupture.
Administer with caution to epileptic patients(risk of seizures), older patients and patients with hypertension and heart disorders.
Reduce the dose by half in patients with renal impairment.
May cause: gastrointestinal disturbances, neurological disorders (headache, dizziness, confusion, hallucinations, seizures), allergic reaction, peripheral neuropathy, photosensitivity (protect skin from sun exposure), joint and muscle pain, tendinitis (especially Achilles tendinitis), QT interval prolongation, hypo/hyperglycaemia, haemolytic anaemia in patients with G6PD deﬁciency. In the event of allergic reaction, severe neurological disorders, peripheral neuropathy, joint or muscle pain or tendinitis, stop treatment immediately.
Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co- artemether, ﬂuconazole, haloperidol, meﬂoquine, ondansetron, pentamidine, quinine, etc.). Monitorpatients taking glibenclamide (risk of hypoglycaemia), NSAIDs (risk of seizure) and corticosteroids (risk of tendinitis).
Do not administer simultaneously with:
- antacids (aluminium or magnesium hydroxide, etc.): take ciproﬂoxacin 2 hours before or 4 hours after antacids;
- iron salts, calcium, zinc sulfate: take 2 hours apart.
Drink a lot of liquid during treatment (risk of crystalluria).
Pregnancy: reserved for severe infections, when there is no therapeutic alternative.
Breast-feeding: no contra-indication

Remarks

Ciproﬂoxacin is also used:

as ﬁrst-line treatment of typhoid fever in some countries, however ﬂuoroquinolone resistance is endemic in Asia and is increasing in several parts of the world;
as an alternative to ﬁrst-line treatment for septicaemia (child: 15 to 20 mg/kg (max. 750 mg) 2 times daily; adult: 500 to 750 mg 2 times daily), in combination with other antibacterials.

Storage

– Below 25 °C