Ciprofloxacin (Cipro)

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

PO ~$0.20/day
IV ~$6.00/day

General Information

Common Usage

Pseudomonal and other gram negative infections of urinary tract, bone/joint, abdomen and other sites.

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

  • QTc prolongation

  • Dysglycemia

  • Tendinopathy and rupture

  • GI upset

  • Rash

  • Retinal detachment

  • CNS toxicity including confusion, psychosis

  • Weakness exacerbation in myasthenia gravis

Major Interactions

CYP1A2 inhibitor - Multiple interactions possible.

QTc prolongation - Increased risk with other agents that prolong QTc.

Divalent & trivalent cations including Al, Ca, Fe, Mg (antacids, dairy products, iron supplements, some enteral feeds) - Decreased absorption.

Cyclosporine - Increased levels of cyclosporine.

Warfarin - Increased INR.

Methadone - Lowered seizure threshold.

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Therapeutic