Ciprofloxacin

Ciprofloxacin Brand Names

Cetraxal | Ciloxan | Cipro | Cipro XR | OTIPRIO | Proquin XR

What is Ciprofloxacin

Ciprofloxacin is a broad-spectrum anti-infective agent of the fluoroquinolone class. Immediate-release oral and intravenous dosage regimens produce similar AUCs and can be used interchangeably in patients able to tolerate oral therapy.

Disabling and potentially irreversible serious adverse reactions associated with quinolones include tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects.

Other significant adverse events include potential QT prolongation and myasthenia gravis exacerbation.

Ciprofloxacin is FDA-approved for mild to moderate and complicated urinary tract infections (UTIs), pneumonia, skin and skin structure infections, plague, several types of infectious diarrhea, prophylaxis of anthrax, corneal ulcers, bacterial conjunctivitis, acute otitis externa, and bilateral otitis media with effusion in patients undergoing tympanostomy tube placement.

Ciprofloxacin is also FDA-approved for acute sinusitis, acute exacerbations of chronic bronchitis, and uncomplicated UTIs; however, due to the potential for serious adverse events, quinolones should only be used for these infection types when alternative treatment options cannot be used.

Indications

  1. Acinetobacter calcoaceticus
  2. Acinetobacter lwoffii
  3. Aeromonas caviae
  4. Aeromonas hydrophila
  5. anthrax
  6. anthrax prophylaxis
  7. Bacillus anthracis
  8. Bacillus sp.
  9. bacterial conjunctivitis
  10. bacterial infection prophylaxis
  11. bone and joint infections
  12. bronchitis
  13. Brucella melitensis
  14. brucellosis
  15. Burkholderia pseudomallei
  16. Campylobacter coli
  17. Campylobacter fetus
  18. Campylobacter jejuni
  19. campylobacteriosis
  20. cervicitis
  21. chancroid
  22. Chlamydia trachomatis
  23. cholera
  24. Citrobacter diversus
  25. Citrobacter freundii
  26. community-acquired pneumonia
  27. corneal ulcer
  28. Corynebacterium sp.
  29. cystic fibrosis
  30. cystitis
  31. dental infection
  32. dentoalveolar infection
  33. diabetic foot ulcer
  34. Edwardsiella tarda
  35. Eikenella corrodens
  36. endocarditis
  37. Enterobacter cloacae
  38. Enterococcus faecalis
  39. Escherichia coli
  40. febrile neutropenia
  41. Flavobacterium sp.
  42. Francisella tularensis
  43. Gardnerella vaginalis
  44. gastroenteritis
  45. gonorrhea
  46. granuloma inguinale
  47. Haemophilus ducreyi
  48. Haemophilus influenzae (beta-lactamase negative)
  49. Haemophilus influenzae (beta-lactamase positive)
  50. Haemophilus parainfluenzae
  51. Hafnia alvei
  52. Helicobacter pylori
  53. infectious arthritis
  54. infectious diarrhea
  55. intraabdominal infections
  56. Isospora belli
  57. isosporiasis
  58. Klebsiella aerogenes
  59. Klebsiella granulomatis
  60. Klebsiella oxytoca
  61. Klebsiella pneumoniae
  62. Legionella bozemanii
  63. Legionella dumoffii
  64. Legionella gormanii
  65. Legionella jordanis
  66. Legionella longbeachae
  67. Legionella micdadei
  68. Legionella pneumophila
  69. Legionella wadsworthii
  70. Leptospira interrogans
  71. Listeria monocytogenes
  72. lower respiratory tract infections
  73. melioidosis
  74. meningococcal infection prophylaxis
  75. Moraxella catarrhalis
  76. Moraxella sp.
  77. Morganella morganii
  78. Mycobacterium avium
  79. Mycobacterium avium complex infection
  80. Mycobacterium chelonae
  81. Mycobacterium fortuitum
  82. Mycobacterium intracellulare
  83. Mycobacterium tuberculosis
  84. Neisseria gonorrhoeae
  85. Neisseria meningitidis
  86. nosocomial pneumonia
  87. osteomyelitis
  88. otitis externa
  89. otitis media
  90. Pantoea agglomerans
  91. Pasteurella multocida
  92. periodontitis
  93. peritonitis
  94. plague
  95. plague prophylaxis
  96. Plasmodium falciparum
  97. pneumonia
  98. prostatitis
  99. Proteus mirabilis
  100. Proteus vulgaris
  101. Providencia rettgeri
  102. Providencia stuartii
  103. Pseudomonas aeruginosa
  104. pyelonephritis
  105. Rickettsia conorii
  106. Salmonella enteritidis
  107. Salmonella sp.
  108. Salmonella typhi
  109. salmonellosis
  110. sepsis
  111. Serratia marcescens
  112. Shigella flexneri
  113. Shigella sonnei
  114. shigellosis
  115. sinusitis
  116. skin and skin structure infections
  117. Staphylococcus aureus (MSSA)
  118. Staphylococcus epidermidis
  119. Staphylococcus haemolyticus
  120. Staphylococcus hominis
  121. Staphylococcus saprophyticus
  122. Stenotrophomonas maltophilia
  123. Streptococcus agalactiae (group B streptococci)
  124. Streptococcus bovis
  125. Streptococcus dysgalactiae
  126. Streptococcus pneumoniae
  127. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  128. surgical infection prophylaxis
  129. traveler’s diarrhea
  130. tularemia
  131. tularemia prophylaxis
  132. typhoid fever
  133. urethritis
  134. urinary tract infection (UTI)
  135. Vibrio cholerae
  136. Vibrio parahaemolyticus
  137. Vibrio vulnificus
  138. Viridans streptococci
  139. Yersinia enterocolitica
  140. Yersinia pestis

Side Effects

  1. abdominal pain
  2. abnormal dreams
  3. acute generalized exanthematous pustulosis (AGEP)
  4. agitation
  5. agranulocytosis
  6. anaphylactic shock
  7. anaphylactoid reactions
  8. anemia
  9. angina
  10. angioedema
  11. anorexia
  12. anosmia
  13. anxiety
  14. aortic dissection
  15. aplastic anemia
  16. arthralgia
  17. arthropathy
  18. asthenia
  19. ataxia
  20. azotemia
  21. back pain
  22. bleeding
  23. blurred vision
  24. bone pain
  25. bradycardia
  26. bronchospasm
  27. bullous rash
  28. candidiasis
  29. cardiac arrest
  30. cholestasis
  31. colitis
  32. coma
  33. confusion
  34. conjunctival hyperemia
  35. constipation
  36. corneal deposits
  37. crystalluria
  38. cylindruria
  39. delirium
  40. depression
  41. diaphoresis
  42. diarrhea
  43. diplopia
  44. dizziness
  45. drowsiness
  46. dysesthesia
  47. dysgeusia
  48. dysmenorrhea
  49. dyspepsia
  50. dyspnea
  51. elevated hepatic enzymes
  52. eosinophilia
  53. erythema multiforme
  54. erythema nodosum
  55. exfoliative dermatitis
  56. fever
  57. flatulence
  58. flushing
  59. GI bleeding
  60. gynecomastia
  61. hallucinations
  62. headache
  63. hearing loss
  64. hematuria
  65. hemolytic anemia
  66. hemoptysis
  67. hemorrhagic cystitis
  68. hepatic failure
  69. hepatic necrosis
  70. hepatitis
  71. hyperbilirubinemia
  72. hypercalcemia
  73. hypercholesterolemia
  74. hyperesthesia
  75. hyperglycemia
  76. hyperkalemia
  77. hypertension
  78. hypertonia
  79. hypertriglyceridemia
  80. hyperuricemia
  81. hypoalbuminemia
  82. hypoesthesia
  83. hypoglycemia
  84. hypokalemia
  85. hypotension
  86. ileus
  87. increased intracranial pressure
  88. increased urinary frequency
  89. injection site reaction
  90. insomnia
  91. interstitial nephritis
  92. irritability
  93. jaundice
  94. keratitis
  95. keratoconjunctivitis
  96. laryngeal edema
  97. leukocytosis
  98. leukopenia
  99. maculopapular rash
  100. malaise
  101. mania
  102. memory impairment
  103. methemoglobinemia
  104. migraine
  105. myalgia
  106. myasthenia
  107. myasthenia gravis
  108. myocardial infarction
  109. myoclonia
  110. nausea
  111. neurotoxicity
  112. nightmares
  113. nystagmus
  114. ocular irritation
  115. ocular pain
  116. ocular pruritus
  117. oral ulceration
  118. pancreatitis
  119. pancytopenia
  120. paranoia
  121. paresthesias
  122. peripheral neuropathy
  123. peripheral vasodilation
  124. petechiae
  125. pharyngitis
  126. phlebitis
  127. phobia
  128. photophobia
  129. photopsia
  130. photosensitivity
  131. pneumonitis
  132. pruritus
  133. pseudomembranous colitis
  134. pseudotumor cerebri
  135. psychosis
  136. purpura
  137. QT prolongation
  138. rash
  139. renal failure (unspecified)
  140. respiratory arrest
  141. restlessness
  142. rhinorrhea
  143. seizures
  144. serum sickness
  145. sinus tachycardia
  146. Stevens-Johnson syndrome
  147. suicidal ideation
  148. superinfection
  149. syncope
  150. tendinitis
  151. tendon rupture
  152. thrombocytopenia
  153. thrombotic thrombocytopenic purpura (TTP)
  154. tinnitus
  155. torsade de pointes
  156. toxic epidermal necrolysis
  157. tremor
  158. urticaria
  159. vaginitis
  160. vasculitis
  161. vertigo
  162. vesicular rash
  163. visual impairment
  164. vomiting
  165. weakness
  166. xerophthalmia
  167. xerosis
  168. xerostomia

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • aneurysm
  • aortic dissection
  • apheresis
  • arteriosclerosis
  • atrial fibrillation
  • AV block
  • bradycardia
  • breast-feeding
  • cardiomyopathy
  • celiac disease
  • cerebrovascular disease
  • children
  • colitis
  • contact lenses
  • corticosteroid therapy
  • dehydration
  • diabetes mellitus
  • dialysis
  • diarrhea
  • driving or operating machinery
  • females
  • fever
  • geriatric
  • GI disease
  • heart failure
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • human immunodeficiency virus (HIV) infection
  • hyperparathyroidism
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • infants
  • inflammatory bowel disease
  • jaundice
  • long QT syndrome
  • myasthenia gravis
  • myocardial infarction
  • neonates
  • neurotoxicity
  • organ transplant
  • peripheral neuropathy
  • pheochromocytoma
  • pregnancy
  • pseudomembranous colitis
  • psychiatric event
  • QT prolongation
  • quinolone hypersensitivity
  • renal disease
  • renal failure
  • renal impairment
  • rheumatoid arthritis
  • seizure disorder
  • sexually transmitted disease
  • sickle cell disease
  • sleep deprivation
  • stroke
  • sunlight (UV) exposure
  • systemic lupus erythematosus (SLE)
  • tendinitis
  • tendinopathy
  • tendon pain
  • tendon rupture
  • torsade de pointes
  • ulcerative colitis

Interactions

  • Abarelix
  • Abemaciclib
  • Acalabrutinib
  • Acarbose
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetazolamide
  • Acetohexamide
  • Ado-Trastuzumab emtansine
  • Albiglutide
  • Alfentanil
  • Alfuzosin
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Almotriptan
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alosetron
  • Alpha-glucosidase Inhibitors
  • Alprazolam
  • Aluminum Hydroxide
  • Aluminum Hydroxide; Magnesium Carbonate
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anagrelide
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  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether; Lumefantrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atomoxetine
  • Atorvastatin
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  • Avanafil
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  • Bacillus Calmette-Guerin Vaccine, BCG
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  • Canagliflozin
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  • Carbonic anhydrase inhibitors
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  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Pseudoephedrine
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  • enteral feedings
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  • Everolimus
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  • Fentanyl
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  • Fluoxetine
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  • Fluphenazine
  • Flurazepam
  • Flurbiprofen
  • Flutamide
  • Fluvoxamine
  • food
  • Fosamprenavir
  • Foscarnet
  • Fosphenytoin
  • Gemtuzumab Ozogamicin
  • Gilteritinib
  • Glasdegib
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Goserelin
  • Granisetron
  • Green Tea
  • Guaifenesin; Hydrocodone
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  • Guanfacine
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  • Halogenated Anesthetics
  • Haloperidol
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  • Hetastarch; Dextrose; Electrolytes
  • Histrelin
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  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrocodone
  • Hydrocodone; Ibuprofen
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  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydrocortisone
  • Hydroxychloroquine
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  • Hydroxyzine
  • Ibrutinib
  • Ibuprofen
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  • Insulin Aspart
  • Insulin Aspart; Insulin Aspart Protamine
  • Insulin Degludec
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  • Insulin Glargine
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  • Ivabradine
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  • Ketoconazole
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  • Lapatinib
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  • Lente Insulin
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  • Linagliptin
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  • Lithium
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  • Lofexidine
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  • Magnesium Citrate
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  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
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  • Methadone
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  • Pentamidine
  • Pentoxifylline
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Pexidartinib
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pioglitazone
  • Pirfenidone
  • Piroxicam
  • Pitolisant
  • Polycarbophil
  • Polysaccharide-Iron Complex
  • Pomalidomide
  • Porfimer
  • Posaconazole
  • Pramlintide
  • Prednisolone
  • Prednisone
  • Primaquine
  • Probenecid
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Quinapril
  • Quinidine
  • Quinine
  • Ramelteon
  • Ranolazine
  • Rasagiline
  • Regular Insulin
  • Regular Insulin; Isophane Insulin (NPH)
  • Repaglinide
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifampin
  • Rilpivirine
  • Riluzole
  • Rimegepant
  • Risperidone
  • Rofecoxib
  • Romidepsin
  • Ropinirole
  • Ropivacaine
  • Rosiglitazone
  • Saquinavir
  • Saxagliptin
  • Segesterone Acetate; Ethinyl Estradiol
  • Selpercatinib
  • Selumetinib
  • Semaglutide
  • Sertraline
  • Sevelamer
  • Sevoflurane
  • SGLT2 Inhibitors
  • Short-acting beta-agonists
  • Sildenafil
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sitagliptin
  • Sodium Bicarbonate
  • Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Sofosbuvir; Velpatasvir
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Solifenacin
  • Sonidegib
  • Sorafenib
  • Sotalol
  • St. John’s Wort, Hypericum perforatum
  • Sucralfate
  • Sufentanil
  • Sulfonylureas
  • Sulindac
  • Sunitinib
  • Suvorexant
  • Tacrine
  • Tacrolimus
  • Tamoxifen
  • Tasimelteon
  • Tazarotene
  • Tazemetostat
  • Telavancin
  • Telithromycin
  • Terbinafine
  • Teriflunomide
  • Tetrabenazine
  • Tezacaftor; Ivacaftor
  • Theophylline, Aminophylline
  • Thiabendazole
  • Thiazolidinediones
  • Thioridazine
  • Tizanidine
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Tolterodine
  • Tolvaptan
  • Toremifene
  • Trazodone
  • Tretinoin, ATRA
  • Triamcinolone
  • Triamterene
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Ubrogepant
  • Ultralente Insulin
  • Ursodeoxycholic Acid, Ursodiol
  • Valdecoxib
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venetoclax
  • Venlafaxine
  • Verteporfin
  • Vinorelbine
  • Voriconazole
  • Vorinostat
  • Warfarin
  • Zanubrutinib
  • Zileuton
  • Zinc
  • Zinc Salts
  • Ziprasidone
  • Zolpidem
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