Ciprofloxacin (IV)

Criteria & Principles

Comparison of Fluoroquinolones:

Ciprofloxacin IV should only be used in patients unable to take oral formulations, or in patients with serious or life-threatening illness as initial therapy.

FDA Black Box Warning: health care professionals should not prescribe systemic fluoroquinolones to patients who have other treatment options for acute bacterial sinusitis (ABS), acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated urinary tract infections (UTI) because the risks outweigh the benefits in these patients. Stop fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course. These medicines are associated with disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system (such as irreversible peripheral neuropathy) that can occur together in the same patient.

Usual Dose & Administration

Usual Adult Dose

200-400 mg q12h

Adjustment of Dose & Administration

Renal Adjustment

Drug	Usual Dose	CrCl (mL/min)
	>30	10-30	<10, IHD	CRRT
ciprofloxacin IV	400mg q12h	400mg q24h	200-400mg q24h	400mg q12h
Pseudomonas coverage	400mg q8h	400mg q12h	400mg q24h	400mg q12h

 

Drug-Specific Information

IV to PO Conversion:

200 mg IV q12h = 250 mg PO q12h

200 mg IV q24h = 250 mg PO q24h

400 mg IV q12h = 500 mg PO q12h

400 mg IV q24h = 500 mg PO q24h

400 mg IV q8h =   750 mg PO q12h

Bioavailability: 60-80%

Avoid concurrent divalent and trivalent cation administration 2 hrs before or 6 hrs after. Avoid administration with tube feeds. 

General Notes

1. Up-to-date cost information, click here 
2. IV antimicrobials outpatient (OPAT) dosing, click here
3. Obesity dosing weight recommendations here
4. Helpful drug-drug interaction check website here 
5. When dosing guidance is provided it is important to note the following:

Fixed (ie non weight-based) doses in adults are historically based on a 70 kg patient. Specific disease states or individual patients may warrant dosages that differ from the above recommendations. Since product-specific criteria for dose adjustment based on creatinine clearance exist, consult product information regarding specific recommendations for dosage adjustment based on estimated creatinine clearance.