Adults

The typical dosage ranges from 250 mg to 750 mg twice daily, depending on the severity and type of infection. For uncomplicated urinary tract infections, 250 mg twice daily for 3 days is often prescribed.

Elderly

Dosage adjustment may be necessary based on renal function and overall health status. Consult a physician for specific recommendations.

Renal_impairment

Reduced dosage is required. For creatinine clearance between 30-60 mL/min, administer 250-500 mg every 12 hours. For clearance <30 mL/min, administer 250-500 mg every 18-24 hours. Hemodialysis and CAPD patients should receive a dose after dialysis.

Onset

Within 1-2 hours

Excretion

Primarily renal (about 50-70% as unchanged drug) and to a lesser extent, fecal (15-30% as metabolites and unchanged drug).

Half life

Approximately 3-5 hours (in individuals with normal renal function)

Absorption

Rapidly and well absorbed from the gastrointestinal tract; bioavailability is approximately 70-80%. Peak plasma concentrations are reached 1-2 hours after oral administration.

Metabolism

Partially metabolized in the liver to four active metabolites (desethyleneciprofloxacin, sulfociprofloxacin, oxociprofloxacin, and formylciprofloxacin); however, primary excretion is renal.

Caffeine

May decrease caffeine clearance and prolong its half-life, leading to increased caffeine effects.

Warfarin

May enhance the anticoagulant effect of warfarin, increasing the risk of bleeding. Close monitoring of INR (International Normalized Ratio) is recommended.

Cyclosporine

Increased serum creatinine has been observed. Close monitoring of renal function is advised.

Methotrexate

May increase methotrexate plasma concentrations, potentially leading to toxicity. Avoid co-administration if possible.

Theophylline

Ciprofloxacin can increase serum concentrations of theophylline, potentially leading to toxicity. Monitor theophylline levels and adjust its dosage if necessary.

Antacids (aluminum/magnesium), Sucralfate, Didanosine (chewable/buffered tablets)

These agents can significantly reduce the absorption of ciprofloxacin. Administer ciprofloxacin at least 2 hours before or 6 hours after these medications.