Antimicrobials
Ciprofloxacin

Ciprofloxacin

C difficile risk
High
Oral Bioavailability
Good (70 to 90%)
Cost
$0.12 (PO) $6.42 (IV)

Dosing

PO: 500-750mg po q12h

IV: 400mg IV q8-12h

eGFR < 50eGFR > 50400mg IV q24h or 200 mg IV q12h

250 PO q12h or 500 mg PO q24h400mg IV q8-12h

500-750mg PO q12h

400mg IV or q24h or 200 mg IV q12h

250 mg PO q12h or 500mg PO q24h

Dose after HD on dialysis days

Peritoneal Dialysis 200 to 400 mg every 12 to 24 hours 400mg IV or q24h or 200 mg IV q12h

500mg PO q24h OR 250 mg PO q12h

General Information

Pseudomonal and other gram negative infections of urinary tract, bone/joint, abdomen and other sites

Monitor QTc in patients with increased risk

  • QTc prolongation

  • Dysglycemia

  • Tendinopathy and rupture

  • GI upset

  • Rash

  • Retinal detachment

  • CNS toxicity including confusion, psychosis

  • Weakness exacerbation in myasthenia gravis

CYP1A2 inhibitor - Multiple interactions possible.

QTc prolongation - Increased risk with other agents that prolong QTc.

Divalent & trivalent cations including Al, Ca, Fe, Mg (antacids, dairy products, iron supplements, some enteral feeds) - Decreased absorption

Cyclosporine - Increased levels of cyclosporine

Warfarin - Increased INR

Methadone - Lowered seizure threshold

IV Administration

  • Premixed bags of 200 mg and 400 mg; Infuse over 60 min

  • NOTE: premixed bags are incompatible with pumps used in Community IV program

EH Prescribing Restrictions

  • NONE

  • Pharmacist review of therapy for IV

Community IV Formulary (Metro Region)

  • NO

Ciprofloxacin suspension clogs enteral feeding tubes. Crush tablets for administration via tube if required.

SPECIAL AUTHORIZATION REQUIRED (PO)

  • Effective Feb 1, 2021

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4 hours

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic