Adults

Typical oral dosage ranges from 250 mg to 750 mg twice daily, depending on the type and severity of infection. For most severe infections or difficult-to-treat pathogens, 750 mg twice daily may be used. Duration varies from 5 to 14 days, or longer for bone/joint infections.

Elderly

No specific dosage adjustment is required based on age alone, but renal function should be assessed.

Renal_impairment

Dosage reduction is necessary in patients with creatinine clearance less than 50 mL/min. For CrCl 30-60 mL/min, maximum dose 500 mg twice daily. For CrCl <30 mL/min, maximum dose 500 mg once daily or 250 mg twice daily.

Onset

Within 1-2 hours for therapeutic effect.

Excretion

Primarily excreted renally by glomerular filtration and tubular secretion (50-70% as unchanged drug). Also excreted via feces (15-30%).

Half life

Approximately 3-5 hours.

Absorption

Rapidly and well absorbed from the gastrointestinal tract, with bioavailability of about 70-80%. Peak plasma concentrations are achieved 1-2 hours after oral administration.

Metabolism

Undergoes limited hepatic metabolism (10-20%) to four active metabolites (desethyleneciprofloxacin, sulfociprofloxacin, oxociprofloxacin, and N-formylciprofloxacin), which have less antimicrobial activity than the parent drug.

Warfarin

May enhance the anticoagulant effect of warfarin, requiring INR monitoring.

Tizanidine

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

Theophylline

May increase plasma concentrations of theophylline, leading to toxicity. Monitor theophylline levels.

Corticosteroids

Increased risk of tendinitis and tendon rupture.

NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

Concurrent use may increase the risk of CNS stimulation and convulsive seizures.

Antacids/Mineral supplements (containing aluminum, magnesium, calcium, iron, zinc)

Reduce ciprofloxacin absorption. Administer Ciprocin at least 2 hours before or 6 hours after these products.