Type of Medication: Antibiotic

Indications: Treatment of Pseudomonas aeruginosa respiratory infections. Part of Pseudomonas aeruginosa eradication protocol. Treatment of community acquired pneumonia. Relatively poor activity against S. pneumoniae. Used in combination with other antibiotic in NTM.

Side Effects: Nausea, vomiting, dyspesia, abdo pain, diarrhoea, headaches, dizziness, UV hypersensitivity, transient disturbance in LFTs, increase in urea and creatinine,drowsiness (caution driving),convulsions, confusion, hypersensitivity reactions,eosinophilia, leucopenia, thrombocytopenia, disturbance in taste, vision, hearing,arthralgia, myalgia, tachycardia, tendon inflammation and damage.

Photosensitising so warn patient re sunlight. High strength sunblock should be used in summer or on holidays for 4 weeks after course finished.

Tendon damage (including rupture) has been reported rarely in patients receiving quinolones. Tendon rupture may occur within 48 hours of starting treatment; cases have also been reported several months after stopping. Quinolones are contra‐indicated in patients with a history of tendon disorders related to quinolone use; patients over 60 years of age are more prone to tendon damage; the risk of tendon damage is increased by the concomitant use of corticosteroids; if tendinitis is suspected, the quinolone should be discontinued immediately.

Milk will reduce absorption. Avoid milk for at least 30 mins before and after taking ciprofloxacin.

Prolonged QT interval

If GFR <10mL/min Reduce to 50% of normal dose (100% of dose may be used for short periods in exceptional circumstances – seek advice from a pharmacist).

Route of administration: Adult (Intravenous)

Dose:400 mg bd

Administration: Infuse over 60 minutes

Route of administration: Adult (Oral)

Dose:750 bd

Administration: Treat for 2 weeks for acute pseudomonal infection. Treat for 3 months for eradication of P.aeruginosa in combination with nebulised colistin. Available as 100 mg, 250 mg, 500 mg and 750 mg tablets or 250 mg/5ml suspension.

Route of administration: Paediatric (Intravenous)

Dose:10 mg/kg tds (maximum total daily dose 1200 mg).

Administration: Infuse over 60 minutes

Route of administration: Paediatric (Oral)

Dose: <1 month: 15 mg/kg bd (licenced aged 5-17 years). 1 month: 20 mg/kg bd, Max dose 750 mg bd.

Examples of some Drug Interactions

Interacting drug: Antacids

reduce absorption of ciprofloxacin

Interacting drug: Calcium salts

reduced absorption of ciprofloxacin

Interacting drug: Cyclosporin

increase risk of nephrotoxicity

Interacting drug: Ferrous sulphate

absorption of ciprofloxacin reduced

Interacting drug: Magnesiom salts

Reduced absorption of ciprofloxacin

Interacting drug: NSAID

increased risk of convulsions

Interacting drug: Probenecid

reduces excretion of ciprofloxacin

Interacting drug: Theophylline

increases theophylline level, increases risk of convulsions

Interacting drug: Warfarin

increase INR