Adults

Typically 250-750 mg orally twice daily, depending on the type and severity of infection.

Elderly

Dosage adjustment may be required based on renal function.

Renal_impairment

Dosage adjustment is necessary; e.g., for CrCl 30-60 mL/min, reduce dose by 50% or extend dosing interval; for CrCl <30 mL/min, further reduction.

Onset

Onset of antibacterial action typically within 1-2 hours.

Excretion

Primarily excreted unchanged in the urine (50-70%) and to a lesser extent in feces (15-30%).

Half life

Approximately 3-5 hours in adults with normal renal function.

Absorption

Rapidly and well absorbed from the gastrointestinal tract, reaching peak plasma concentrations within 1-2 hours after oral administration. Bioavailability is approximately 70-80%.

Metabolism

Partially metabolized in the liver (10-20%) to several less active metabolites.

NSAIDs

Concomitant use with fluoroquinolones may increase the risk of CNS stimulation and convulsive seizures.

Warfarin

Ciprofloxacin may enhance the anticoagulant effect of warfarin. Monitor INR closely.

Tizanidine

Concomitant use is contraindicated due to increased tizanidine plasma concentrations, leading to hypotension and sedation.

Theophylline

Ciprofloxacin may increase plasma levels of theophylline, leading to toxicity. Monitor theophylline levels.

Corticosteroids

Increased risk of tendon rupture.

Antacids, Sucralfate, Mineral Supplements (containing Mg, Al, Ca, Fe, Zn)

Reduce oral absorption of ciprofloxacin. Administer ciprofloxacin 2 hours before or 6 hours after these agents.