Ciprofloxacin Dosage

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How do you administer this medicine?

Dosage of Ciprofloxacin in details

infoThe dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Dosage

Ciprofloxacin and Ciprofloxacin immediate-release tablets are not interchangeable. Ciprofloxacin should beadministered orally once daily (Table 1).

Table 1: Dosage Guidelines

Indication Dose Frequency Usual Duration
Uncomplicated Urinary Tract Infection (Acute Cystitis) 500 mg every 24 hours 3 Days
Complicated Urinary Tract Infection and Acute Uncomplicated Pyelonephritis 1000 mg every 24 hours 7-14 Days

Patients whose therapy is started with CIPRO IV for UTIs may be switched to Ciprofloxacin when clinically indicated at the discretion of the physician.

Administration

  • Ciprofloxacin tablets should be taken whole and not split, crushed, or chewed.
  • Ciprofloxacin should be administered at least 2 hours before or 6 hours after antacids containing magnesium or aluminum, polymeric phosphate binders (for example, sevelamer, lanthanum carbonate), as well as sucralfate, VIDEX® (didanosine) chewable/buffered tablets or pediatric powder, other highly buffered drugs, metal cations such as iron, and multivitamin preparations with zinc.
  • Concomitant administration of Ciprofloxacin with dairy products (like milk or yogurt) or with calcium-fortified products alone should be avoided since decreased absorption is possible. A 2-hour window between substantial calcium intake (greater than 800 mg) and dosing with Ciprofloxacin is recommended.
  • Adequate hydration of patients receiving Ciprofloxacin should be maintained to prevent the formation of highly concentrated urine. Crystalluria has been reported with quinolones.

Impaired Renal Function

  • In patients with cUTI and acute uncomplicated pyelonephritis with a creatinine clearance of ≤ 30 mL/min, the dose of Ciprofloxacin should be reduced from 1000 mg to 500 mg daily. The use of Ciprofloxacin 1000 mg XR tablets is not recommended in this patient population.
  • For patients on hemodialysis or peritoneal dialysis, administer Ciprofloxacin after the dialysis procedure is completed (maximum dose should be Ciprofloxacin 500 mg XR every 24 hours). The use of Ciprofloxacin 1000 mg XR is not recommended in this patient population.
  • For patients on continuous ambulatory peritoneal dialysis (CAPD), the maximum dose should be 500 mg every 24 hours.

How supplied

Dosage Forms And Strengths

  • 500 mg white to slightly yellowish, film-coated, oblong-shaped tablets imprinted with the word “BAYER” on one side and “C500 QD” on the other
  • 1000 mg white to slightly yellowish, film-coated, oblong-shaped tablets imprinted the word “BAYER” on one side and “C1000 QD” on the other

Storage And Handling

Ciprofloxacin is available as nearly white to slightly yellowish, film-coated, oblong-shaped tablets containing 500 mg or 1000 mg Ciprofloxacin. The 500 mg tablet is coded with the word “BAYER” on one side and “C500 QD” on the reverse side. The 1000 mg tablet is coded with the word “BAYER” on one side and “C1000 QD” on the reverse side.

Strength NDC Code
Bottles of 50 500 mg 50419-788-01
Bottles of 50 1000 mg 50419-789-01

Store at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F).

Manufactured for: Bayer HealthCare Pharmaceuticals Inc. Whippany, NJ 07981. Manufactured in Germany. Revised: July 2016

What other drugs will affect Ciprofloxacin?

Do not take Ciprofloxacin together with tizanidine (Zanaflex).

Tell your doctor about all other medicines you use, especially:

  • a blood thinner such as warfarin (Coumadin, Jantoven);
  • clozapine (Clozaril, FazaClo);
  • cyclosporine (Gengraf, Neoral, Sandimmune);
  • glyburide (Micronase, Diabeta, Glynase);
  • methotrexate (Rheumatrex, Trexall);
  • metoclopramide (Reglan);
  • phenytoin (Dilantin);
  • probenecid (Benemid);
  • ropinirole (Requip);
  • theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);
  • an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others; or
  • steroid medication (prednisone and others).

This list is not complete and other drugs may interact with Ciprofloxacin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Ciprofloxacin interactions

infoInteractions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Ciprofloxacin, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Class IA or III Antiarrhythmics: Precaution should be taken when using Ciprofloxacin together with class IA or III antiarrhythmics as Ciprofloxacin may have an additive effect on the QT interval.

Chelation Complex Formation: The simultaneous administration of Ciprofloxacin (oral) and multivalent cation-containing medicinal products and mineral supplements (eg, calcium, magnesium, aluminum, iron), polymeric phosphate binders (eg, sevelamer, lanthanum carbonate), sucralfate or antacids, and highly buffered drugs (eg, didanosine tablets) containing magnesium, aluminum or calcium reduce the absorption of Ciprofloxacin. Consequently, Ciprofloxacin should be administered either 1-2 hrs before or at least 4 hrs after these preparations. This restriction does not apply to antacids belonging to the class of H2-receptor blockers.

Theophylline: Concurrent administration of Ciprofloxacin and theophylline can cause an undesirable increase in the serum theophylline concentration. This can lead to theophylline-induced side effects; in very rare cases, these side effects can be life-threatening or fatal. If concurrent use of the 2 products is unavoidable, the serum theophylline concentration should therefore be checked and the theophylline dose appropriately reduced.

Cyclosporin: A transient rise in the concentration of serum creatinine was observed when Ciprofloxacin and cyclosporin were administered simultaneously. Therefore, it is necessary to control the serum creatinine concentrations in these patients frequently (twice a week).

Vitamin K Antagonists: Simultaneous administration of Ciprofloxacin with a vitamin K antagonist may augment its anticoagulant effects. The risk may vary with the underlying infection, age and general status of the patient so that the contribution of Ciprofloxacin to the increase in International Normalized Ratio (INR) is difficult to assess. The INR should be monitored frequently during and shortly after co-administration of Ciprofloxacin with a vitamin K antagonist (eg, warfarin, acenocoumarol, phenprocoumon or fluindione).

Glibenclamide: In particular cases, concurrent administration of Ciprofloxacin and glibenclamide containing products can intensify the action of glibenclamide (hypoglycemia).

Probenecid: Probenecid interferes with renal secretion of Ciprofloxacin. Co-administration of probenecid and Ciprofloxacin increases the Ciprofloxacin serum concentrations.

Metoclopramide: Metoclopramide accelerates the absorption of Ciprofloxacin (oral) resulting in a shorter time to reach maximum plasma concentrations. No effect was seen on the bioavailability of Ciprofloxacin.

Omeprazole: Concomitant administration of Ciprofloxacin and omeprazole containing medicinal products results in a slight reduction of Cmax and AUC of Ciprofloxacin.

Tizanidine: In a clinical study in healthy subjects, there was an increase in tizanidine serum concentrations (Cmax increase: 7-fold, range: 4- to 21-fold; AUC increase: 10-fold, range: 6- to 24-fold) when given concomitantly with Ciprofloxacin. Associated with the increased serum concentrations was a potentiated hypotensive and sedative effect. Tizanidine containing medicinal products must not be administered together with Ciprofloxacin.

Other Xanthine Derivatives: On concurrent administration of Ciprofloxacin and caffeine or pentoxifylline (oxpentifylline) containing products, raised serum concentrations of these xanthine derivatives were reported.

Methotrexate: Renal tubular transport of methotrexate may be inhibited by concomitant administration of Ciprofloxacin, potentially leading to increased plasma levels of methotrexate. This might increase the risk of methotrexate-associated toxic reactions. Therefore, patients under methotrexate therapy should be carefully monitored when concomitant Ciprofloxacin therapy is indicated.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Animal studies have shown that the combination of very high doses of quinolones (gyrase inhibitors) and certain nonsteroidal anti-inflammatory agents (but not acetylsalicylic acid) can provoke convulsions.

Duloxetine: In clinical studies, it was demonstrated that concomitant use of duloxetine with strong inhibitors of the CYP450 1A2 isozyme eg, fluvoxamine, may result in an increase of AUC and Cmax of duloxetine. Although no clinical data are available on a possible interaction with Ciprofloxacin, similar effects can be expected upon concomitant administration.

Ropinirole: It was shown in a clinical study that concomitant use of ropinirole with Ciprofloxacin, a moderate inhibitor of the CYP450 1A2 isozyme, results in an increase of Cmax and AUC of ropinirole by 60% and 84%, respectively. Monitoring ropinirole-related side effects dose adjustment as appropriate is recommended during and shortly after co-administration with Ciprofloxacin.

Lidocaine: It was demonstrated in healthy subjects that concomitant use of lidocaine containing medicinal products with Ciprofloxacin, a moderate inhibitor of CYP450 1A2 isozyme, reduces clearance of IV lidocaine by 22%. Although lidocaine treatment was well tolerated, a possible interaction with Ciprofloxacin associated with side effects may occur upon concomitant administration.

Clozapine: Following concomitant administration of Ciprofloxacin 250 mg with clozapine for 7 days, serum concentrations of clozapine and N-desmethylclozapine were increased by 29% and 31%, respectively. Clinical surveillance and appropriate adjustment of clozapine dosage during and shortly after co-administration with Ciprofloxacin are advised.

Sildenafil: Cmax and AUC of sildenafil were increased approximately 2-fold in healthy subjects after an oral dose of 50 mg given concomitantly with Ciprofloxacin 500 mg. Therefore, caution should be used in prescribing Ciprofloxacin concomitantly with sildenafil taking into consideration the risks and the benefits.


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References

  1. DailyMed. "CIPROFLOXACIN; DEXAMETHASONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. FDA/SPL Indexing Data. "5E8K9I0O4U: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
  3. MeSH. "Topoisomerase II Inhibitors". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Ciprofloxacin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Ciprofloxacin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

2 consumers reported frequency of use

How frequently do I need to take Ciprofloxacin?
It was reported by ndrugs.com website users that Ciprofloxacin should ideally be taken Once in a day as the most common frequency of the Ciprofloxacin. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Ciprofloxacin should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
Users%
Once in a day2
100.0%


5 consumers reported doses

What doses of Ciprofloxacin drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Ciprofloxacin drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
Users%
201-500mg4
80.0%
1-5mg1
20.0%


Consumer reviews

Elias08 May 2015 09:45
its hard to find. have been to so many chemists all in vain


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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