VitalsCentral

Ciprofloxacin

Cipro

FDA ApprovedAnti-InfectivesFluoroquinolones
Half-life: Approximately 4 hoursPregnancy: Category C

Overview

Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic used to treat a variety of bacterial infections including urinary tract, respiratory, gastrointestinal, and skin infections.

Indications

  • Urinary tract infections
  • Respiratory tract infections
  • Gastrointestinal infections
  • Skin and soft tissue infections
  • Anthrax post-exposure prophylaxis

Contraindications

  • Hypersensitivity to fluoroquinolones
  • Concurrent tizanidine use

Classification

Anti-InfectivesFluoroquinolonesImmune System

Mechanism of Action

Inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication, transcription, and repair and producing bactericidal activity.

Pharmacodynamics

Exhibits concentration-dependent bactericidal killing with a post-antibiotic effect against many gram-negative and some gram-positive organisms.

Pharmacokinetics

Absorption
Well absorbed orally with bioavailability around 70%.
Distribution
Widely distributed into tissues and body fluids; moderate protein binding.
Metabolism
Partially metabolized in the liver to less active metabolites.
Excretion
Excreted mainly in urine as unchanged drug and metabolites.
Half-life
Approximately 4 hours
Bioavailability
Approximately 70%
Protein Binding
Approximately 20-40%

Dosage

Typical dosage: 250-750 mg every 12 hours depending on infection

Available Forms

  • Tablet
  • Extended-release tablet
  • Oral suspension
  • Injection
  • Ophthalmic solution

Side Effects

Common

  • Nausea
  • Diarrhea
  • Headache
  • Dizziness

Serious

  • Tendon rupture
  • Peripheral neuropathy
  • QT prolongation
  • Clostridioides difficile colitis

Rare

  • Aortic aneurysm or dissection
  • Seizures

Drug Interactions

Tizanidinemajor

Ciprofloxacin markedly inhibits tizanidine metabolism, causing severe hypotension and sedation; the combination is contraindicated.

Warfarinmajor

May potentiate warfarin, increasing INR and bleeding risk.

Warnings

⚠️BLACK BOX WARNING

Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially irreversible serious adverse reactions including tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects, and can exacerbate muscle weakness in myasthenia gravis. Reserve use for infections with no alternative treatment options.

Pregnancy

Category C

Toxicity

Overdose may cause renal toxicity and crystalluria.

Overdose

Provide supportive care and adequate hydration; monitor renal function. Only a small amount is removed by hemodialysis.

References

Looking for patient-friendly information? Visit RemedyDoor for easy-to-read guides about this medication.