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. Renal (except XR tabs for uncomplicated UTIs) or hepatic dysfunction: reduce dose. Increased risk of tendinitis or tendon rupture esp. in patients >60yrs, or those with kidney, heart or lung transplants. Discontinue if tendon pain, inflammation, or rupture occurs; if rash, phototoxicity, or other sign of hypersensitivity occurs; or if CNS disorders or neuropathy occurs. History of myasthenia gravis; avoid. Conditions that increase seizure risk. History of prolonged QT interval. Hypokalemia. History of joint-related disorders (esp. children). Maintain adequate hydration, avoid alkaline urine to avoid crystalluria. Avoid excessive sun and UV light. 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. Elderly. Pregnancy (Cat.C), nursing mothers: usually not recommended.
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. Potentiated by probenecid. Severe hypoglycemia with glyburide (rare). Increased serum creatinine with cyclosporine. Monitor methotrexate, oral anticoagulants (potentiation), phenytoin (variable effects). Increased risk of tendinitis and tendon rupture with corticosteroids. Caution with other drugs that lower seizure threshold. Increased risk of QT prolongation with Class IA or III antiarrhythmics. Reduced absorption with omeprazole (XR).
GI upset, 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, C. difficile-associated diarrhea.
See MMWR Vol 50, No.42 (Oct. 26, 2001) for more information on anthrax.
Tabs 250mg, 500mg—100; Oral Susp—100mL; Inj Conc (20mL, 40mL)—1; Infusion (100mL, 200mL)—1; XR Tabs—50, 100