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Last updated: September 2023
Therapeutic action
- Fluoroquinolone antibacterial
Indications
- Shigellosis, uncomplicated cutaneous anthrax
- Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis in non-pregnant women in the event of previous treatment failure
- Plague, alone or in combination with other antibacterials
- Completion treatment following therapy with parenteral ciprofloxacin
Forms and strengths
- 250 mg and 500 mg tablets
- 250 mg/5 ml granules and solvent for oral suspension
Dosage
Shigellosis, uncomplicated cutaneous anthrax
- Child 1 month and over: 15 mg/kg (max. 500 mg) 2 times daily
- Adult: 500 mg 2 times daily
Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis
- Adult: 500 mg 2 times daily
|
Age |
Weight |
250 mg/5 ml susp. |
250 mg tablet |
500 mg tablet |
|---|---|---|---|---|
|
1 to < 3 months |
4 to < 6 kg |
1.5 ml x 2 |
– |
– |
|
3 to < 7 months |
6 to < 8 kg |
2 ml x 2 |
– |
– |
|
7 months to < 2 years |
8 to < 12 kg |
2.5 ml x 2 |
– |
– |
|
2 to < 3 years |
12 to < 15 kg |
4 ml x 2 |
– |
– |
|
3 to < 8 years |
15 to < 26 kg |
5 ml x 2 |
1 tab x 2 |
– |
|
8 to < 11 years |
26 to < 36 kg |
8 ml x 2 |
– |
– |
|
≥ 11 years and adult |
≥ 36 kg |
– |
2 tab x 2 |
1 tab x 2 |
Plague
- Child 1 month and over: 15 mg/kg 2 to 3 times daily (max. 750 mg 2 times daily or 500 mg 3 times daily)
- Adult: 750 mg 2 times daily (500 mg 3 times daily in pregnant women)
Duration
-
Shigellosis, cystitis: 3 days
- Cutaneous anthrax: 7 to 14 days depending on severity
- Pyelonephritis, plague: 10 to 14 days
- Prostatitis: 14 days (if signs and symptoms are ongoing after 14 days, continue the same treatment for a further 14 days)
Contra-indications, adverse effects, precautions
- Do not administer to patients with history of allergy or serious adverse effects due to a fluoroquinolone, e.g. tendinitis, tendon rupture.
- Administer with caution to epileptic patients (risk of seizures), older patients and patients with hypertension and heart disorders.
- Reduce the dose by half in patients with renal impairment.
- May cause: gastrointestinal disturbances, neurological disorders (headache, dizziness, confusion, hallucinations, seizures), allergic reaction, peripheral neuropathy, photosensitivity (protect skin from sun exposure), joint and muscle pain, tendinitis (especially Achilles tendinitis), QT interval prolongation, hypo/hyperglycaemia, haemolytic anaemia in patients with G6PD deficiency. In the event of allergic reaction, severe neurological disorders, peripheral neuropathy, joint or muscle pain or tendinitis, stop treatment immediately.
- Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co-artemether, fluconazole, haloperidol, mefloquine, ondansetron, pentamidine, quinine, etc.).
- Monitor patients taking glibenclamide (risk of hypoglycaemia), NSAIDs (risk of seizure) and corticosteroids (risk of tendinitis).
- Do not administer simultaneously with:
- antacids (aluminium or magnesium hydroxide, etc.): take ciprofloxacin 2 hours before or 4 hours after antacids;
- iron salts, calcium, zinc sulfate: take 2 hours apart.
- Drink a lot of liquid during treatment (risk of crystalluria).
- Pregnancy: reserved for severe infections, when there is no therapeutic alternative.
- Breast-feeding: no contra-indication
Remarks
- Ciprofloxacin is also used:
- as first-line treatment of typhoid fever in some countries, however fluoroquinolone resistance is endemic in Asia and is increasing in several parts of the world;
- as an alternative to first-line treatment for septicaemia (child: 15 to 20 mg/kg (max. 750 mg) 2 times daily; adult: 500 to 750 mg 2 times daily), in combination with other antibacterials.
Storage
–
– Below 25 °C