Ciprofloxacin

General Toxicity Notes
Most agents in this group are malabsorbed in the presence of compounds that contain metals such as magnesium, calcium, aluminum, and iron. Poorly absorbed with antacids, sucralfate, and phosphate binders.
Excreted Unchanged %
50-70
Half-Life (Normalesrd) Hours
3-6/6-9
Plasma Protein Binding %
20-40
Volume Of Distribution L/Kg
2.5
Dose For Normal Renal Function
500-750 mg (400 mg if IV) q12h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100%[A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
50-75%[A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50%[A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: 250 mg q12h (200 mg if IV)
Supplement For Dialysis [Recommendation Level]: Pd
PD: 250 mg q8h (200 mg if IV)
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 400 mg q24h, [A]
References
Aronoff GE, Kenner CH, Sloan RS, Pottratz ST. Multiple-dose ciprofloxacin kinetics in normal subjects. Clin Pharmacol Ther. 1984; 36: 384-8. [PMID: 6467798] / Davies SP, Azadian BS, Kox WJ, Brown EA. Pharmacokinetics of ciprofloxacin and vancomycin in patients with acute renal failure treated by continuous haemodialysis. Nephrol Dial Transplant. 1992; 7: 848-54. [PMID: 1325620] / Eliopoulos GM. New quinolones: pharmacology, pharmacokinetics, and dosing in patients with renal insufficiency. Rev Infect Dis. 1988; 10 Suppl 1: S102-5. [PMID: 3279486] / Fillastre JP, Leroy A, Moulin B, Dhib M, Borsa-Lebas F, Humbert G. Pharmaco-kinetics of quinolones in renal insufficiency. J Antimicrob Chemother. 1990; 26 Suppl B: 51-60. [PMID: 2124213] / Fish DN, Bainbridge JL, Peloquin CA. Variable disposition of ciprofloxacin in critically ill patients undergoing continuous arteriovenous hemodiafiltration. Pharmacotherapy. 1995; 15: 236-45. [PMID: 7624271] / Forrest A, Weir M, Plaisance KI, Drusano GL, Leslie J, Standiford HC. Relationships between renal function and disposition of oral ciprofloxacin. Antimicrob Agents Chemother. 1988; 32: 1537-40. [PMID: 3190182] / Golper TA, Hartstein AI, Morthland VH, Christensen JM. Effects of antacids and dialysate dwell times on multiple-dose pharmacokinetics of oral ciprofloxacin in patients on continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 1987; 31: 1787-90. [PMID: 3435126] / H&#246; ffken G, Lode H, Prinzing C, Borner K, Koeppe P. Pharmacokinetics of ciprofloxacin after oral and parenteral administration. Antimicrob Agents Chemother. 1985; 27: 375-9. [PMID: 3158275] / Malone RS, Fish DN, Abraham E, Teitelbaum I. Pharmacokinetics of levofloxacin and ciprofloxacin during continuous renal replacement therapy in critically ill patients. Antimicrob Agents Chemother. 2001; 45: 2949-54. [PMID: 11557500] / Shah A, Lettieri J, Blum R, Millikin S, Sica D, Heller AH. Pharmacokinetics of intravenous ciprofloxacin in normal and renally impaired subjects. J Antimicrob Chemother. 1996; 38: 103-16. [PMID: 8858462] / Wallis SC, Mullany DV, Lipman J, Rickard CM, Daley PJ. Pharmacokinetics of ciprofloxacin in ICU patients on continuous veno-venous haemodiafiltration. Intensive Care Med. 2001; 27: 665-72. [PMID: 11398692] / Wolfson JS, Hooper DC. Pharmacokinetics of quinolones: newer aspects. Eur J Clin Microbiol Infect Dis. 1991; 10: 267-74. [PMID: 1864287]