Cipro Dosage

Generic name: ciprofloxacin hydrochloride
Dosage form: tablets, oral suspension

See also:

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Adults

CIPRO Tablets and Oral Suspension should be administered orally to adults as described in the Dosage Guidelines table.

The determination of dosage for any particular patient must take into consideration the severity and nature of the infection, the susceptibility of the causative organism, the integrity of the patient's host-defense mechanisms, and the status of renal function and hepatic function.

The duration of treatment depends upon the severity of infection. The usual duration is 7 to 14 days; however, for severe and complicated infections more prolonged therapy may be required. Ciprofloxacin should be administered at least 2 hours before or 6 hours after magnesium/aluminum antacids, polymeric phosphate binders (for example, sevelamer, lanthanum carbonate) or sucralfate, Videx® (didanosine) chewable/buffered tablets or pediatric powder for oral solution, other highly buffered drugs, or other products containing calcium, iron or zinc.

ADULT DOSAGE GUIDELINES
Infection Severity Dose Frequency Usual Durations*
This indication is based on a surrogate endpoint, ciprofloxacin serum concentrations achieved in humans, reasonably likely to predict clinical benefit.6 For a discussion of ciprofloxacin serum concentrations in various human populations, see Inhalational Anthrax, Additional Information.
*
Generally ciprofloxacin should be continued for at least 2 days after the signs and symptoms of infection have disappeared, except for inhalational anthrax (post-exposure).
Used in conjunction with metronidazole
Drug administration should begin as soon as possible after suspected or confirmed exposure.

Urinary Tract

Acute Uncomplicated

250 mg

q 12 h

3 days

Mild/Moderate

250 mg

q 12 h

7 to 14 days

Severe/Complicated

500 mg

q 12 h

7 to 14 days

Chronic Bacterial

Mild/Moderate

500 mg

q 12 h

28 days

Prostatitis

Lower Respiratory Tract

Mild/Moderate

500 mg

q 12 h

7 to 14 days

Severe/Complicated

750 mg

q 12 h

7 to 14 days

Acute Sinusitis

Mild/Moderate

500 mg

q 12 h

10 days

Skin and

Mild/Moderate

500 mg

q 12 h

7 to 14 days

Skin Structure

Severe/Complicated

750 mg

q 12 h

7 to 14 days

Bone and Joint

Mild/Moderate

500 mg

q 12 h

≥ 4 to 6 weeks

Severe/Complicated

750 mg

q 12 h

≥ 4 to 6 weeks

Intra-Abdominal*

Complicated

500 mg

q 12 h

7 to 14 days

Infectious Diarrhea

Mild/Moderate/Severe

500 mg

q 12 h

5 to 7 days

Typhoid Fever

Mild/Moderate

500 mg

q 12 h

10 days

Urethral and Cervical

Uncomplicated

250 mg

single dose

single dose

Gonococcal Infections

Inhalational anthrax

500 mg

q 12 h

60 days

(post-exposure)**

Conversion of IV to Oral Dosing in Adults:

Patients whose therapy is started with CIPRO IV may be switched to CIPRO Tablets or Oral Suspension when clinically indicated at the discretion of the physician (See CLINICAL PHARMACOLOGY and table below for the equivalent dosing regimens).

Equivalent AUC Dosing Regimens

Cipro Oral Dosage

Equivalent Cipro IV Dosage

250 mg Tablet q 12 h

  200 mg IV q 12 h

500 mg Tablet q 12 h

  400 mg IV q 12 h

750 mg Tablet q 12 h

400 mg IV q 8 h

Adults with Impaired Renal Function:

Ciprofloxacin is eliminated primarily by renal excretion; however, the drug is also metabolized and partially cleared through the biliary system of the liver and through the intestine. These alternative pathways of drug elimination appear to compensate for the reduced renal excretion in patients with renal impairment. Nonetheless, some modification of dosage is recommended, particularly for patients with severe renal dysfunction. The following table provides dosage guidelines for use in patients with renal impairment:

RECOMMENDED STARTING AND MAINTENANCE DOSES FOR PATIENTS WITH IMPAIRED RENAL FUNCTION

Creatinine Clearance (mL/min)

      Dose

> 50

See Usual Dosage.

30 – 50

250 – 500 mg q 12 h

5 – 29

250 – 500 mg q 18 h

Patients on hemodialysis
or Peritoneal dialysis

250 – 500 mg q 24 h (after dialysis)

When only the serum creatinine concentration is known, the following formula may be used to estimate creatinine clearance.

   Men: Creatinine clearance (mL/min) =

   Weight (kg) x (140 - age)

72 x serum creatinine (mg/dL)

   Women: 0.85 x the value calculated for men.

 

The serum creatinine should represent a steady state of renal function.

In patients with severe infections and severe renal impairment, a unit dose of 750 mg may be administered at the intervals noted above. Patients should be carefully monitored.

Pediatrics

CIPRO Tablets and Oral Suspension should be administered orally as described in the Dosage Guidelines table. An increased incidence of adverse events compared to controls, including events related to joints and/or surrounding tissues, has been observed. (See ADVERSE REACTIONS and CLINICAL STUDIES.)

Dosing and initial route of therapy (that is, IV or oral) for complicated urinary tract infection or pyelonephritis should be determined by the severity of the infection. In the clinical trial, pediatric patients with moderate to severe infection were initiated on 6 to 10 mg/kg IV every 8 hours and allowed to switch to oral therapy (10 to 20 mg/kg every 12 hours), at the discretion of the physician.

PEDIATRIC DOSAGE GUIDELINES
*
The total duration of therapy for complicated urinary tract infection and pyelonephritis in the clinical trial was determined by the physician. The mean duration of treatment was 11 days (range 10 to 21 days).
Drug administration should begin as soon as possible after suspected or confirmed exposure to Bacillus anthracis spores. This indication is based on a surrogate endpoint, ciprofloxacin serum concentrations achieved in humans, reasonably likely to predict clinical benefit.6 For a discussion of ciprofloxacin serum concentrations in various human populations, see Inhalational Anthrax In Adults and Pediatrics, Additional Information.

Infection

Route of Administration

Dose
(mg/kg)

Frequency

Total Duration

Complicated Urinary Tract or Pyelonephritis

(patients from 1 to 17 years of age)

Intravenous

6 to 10 mg/kg
(maximum 400 mg per dose; not to be exceeded even in patients weighing > 51 kg)

Every 8 hours




10-21 days*

Oral

10 mg/kg to 20 mg/kg
(maximum 750 mg per dose; not to be exceeded even in patients weighing > 51 kg)

Every 12 hours

   

Inhalational Anthrax
(Post-
Exposure)

Intravenous

10 mg/kg
(maximum 400 mg per dose)

Every 12 hours




60 days

Oral

15 mg/kg
(maximum 500 mg per dose)

Every 12 hours

   

Pediatric patients with moderate to severe renal insufficiency were excluded from the clinical trial of complicated urinary tract infection and pyelonephritis. No information is available on dosing adjustments necessary for pediatric patients with moderate to severe renal insufficiency (that is, creatinine clearance of < 50 mL/min/1.73m2).

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