Generic Name and Formulations:
Ciprofloxacin (as HCl and betaine) 500mg, 1000mg; ext-rel tabs.
Susceptible infections including UTIs, acute uncomplicated pyelonephritis.
Swallow whole. ≥18yrs: Uncomplicated UTIs: 500mg once daily for 3 days. Complicated UTIs, acute uncomplicated pyelonephritis: 1000mg once daily for 7–14 days; renal impairment (CrCl <30mL/min): 500mg once daily for 7–14 days. Coincide dose for end of dialysis.
<18yrs: not recommended.
XR not interchangeable with other forms. Increased risk of tendinitis or tendon rupture esp. in patients >60yrs, or those with kidney, heart or lung transplants. Discontinue if tendon pain, inflammation, rupture occur. History of myasthenia gravis; avoid. Renal (except XR tabs for uncomplicated UTIs) or hepatic dysfunction: reduce dose. CNS disorders (eg, cerebral arteriosclerosis, epilepsy) that increase seizure risk. History of QT prolongation or proarrhythmic conditions (eg, hypokalemia, bradycardia, recent MI). Discontinue if rash, jaundice, phototoxicity, other signs of hypersensitivity, hepatitis, CNS disorders, or peripheral neuropathy occur. History of joint-related disorders (esp. children). Maintain adequate hydration, avoid alkaline urine to avoid crystalluria. May mask symptoms of syphilis; test for syphilis before treating gonorrhea, then follow-up after 3 months. Monitor blood, renal, hepatic function in prolonged use. Avoid excessive sun and UV light. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
See Contraindications. Potentiates hypotensive and sedative effects of tizanidine. Avoid theophylline (increases theophylline levels; may potentiate other CYP1A2 substrates), urinary alkalinizers; oral forms with antacids, calcium, iron, zinc, sucralfate, buffered forms of didanosine, other highly buffered drugs (may give ciprofloxacin 2 hrs before or 6 hrs after); high ciprofloxacin doses with NSAIDs (increases seizure risk). Potentiates caffeine and lidocaine. Potentiated by probenecid. Severe hypoglycemia with glyburide (rare). Increased serum creatinine with cyclosporine. Monitor methotrexate, oral anticoagulants (potentiation), phenytoin (variable effects), clozapine and ropinirole (potentiation). Increased risk of tendinitis and tendon rupture with corticosteroids. Caution with sildenafil and other drugs that lower seizure threshold. Increased risk of QT prolongation with Class IA or III antiarrhythmics. Reduced absorption with omeprazole (XR).
Nausea, diarrhea, vomiting, headache, CNS disturbances (eg, convulsions, dizziness, nervousness, insomnia, nightmares, paranoia), rash, eosinophilia, elevated liver enzymes, photosensitivity, Stevens-Johnson syndrome, myalgia, tendinitis/rupture, joint-related disorders (children), local reactions (inj); rare: increased intracranial pressure, toxic psychosis; peripheral neuropathy (may be irreversible), C. difficile-associated diarrhea.
See MMWR Vol 50, No.42 (Oct. 26, 2001) for more information on anthrax.
Tabs—100; Oral Susp—100mL; Inj Conc (20mL, 40mL)—1; Infusion (100mL, 200mL)—1; XR Tabs—50, 100