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ciprofloxacin

ciprofloxacin

Brand names: Cipro

Form	Strength
SOLUTION, INTRAVENOUS	200 mg/100 mL; 400 mg/200 mL
TABLET, ORAL	250 mg; 500 mg

Display Quinolones, Antituberculosis Agents Class: 081218, 081604

Medication comments:

Per policy, these drugs are subject to renal dosing adjustments by pharmacy.
Generic + Route (Brand) • Indications	Usual Adult Dose Comments	Renal Dosage Adjustments
ciprofloxacin IV (Cipro^©)	200-400 mg q8-12h q8h for pseudomonas	CrCl ≥ 30: No adjustment necessary CrCl <30: 200-400 mg q24h HD/PD: 200-400 mg q24h
ciprofloxacin PO (Cipro^©)	250-750 mg q12h	CrCl > 50: No adjustment necessary CrCl 30-50: 250-500 mg q12h CrCl <30: 500 mg q24h HD/PD: 250-500 mg q24h

Per policy, these drugs may be converted from IV to PO in patients who meet criteria.
Generic (Brand)	Population	IV Dose	PO Dose	Notes
ciprofloxacin (Cipro)	adult	200 mg IV q12h	250 mg PO q12h	Avoid concurrent divalent and trivalent cation administration 2 hours before or 6 hours after. Avoid administration with tube feeds.
		200 mg IV q24h	250 mg PO q24h
		400 mg IV q8h	750 mg PO q12h
		400 mg IV q12h	500 mg PO q12h
		400 mg IV q24h	500 mg PO q24h
	pediatric	10-15 mg/kg q8-12h (max: 400 mg/dose or 40 mg/kg/day)	10-15 mg/kg q8-12h (max: 750 mg/dose or 40 mg/kg/day)

Enteral Drug Administration notes.
Generic (Brand)	Comments and Considerations	Recommendations for Administration with Enteral Nutrition
ciprofloxacin (Cipro)	Binds to divalent ions (absorption reduced by 50%)	Recommend changing to IV for severe infections. For mild/moderate infections suggest 750 mg BID. Use crushed tablets (suspension may NOT be used with any feeding tube). Consider holding continuous EN for 1-2 hours before and after

2023 American Geriatrics Society Beers Criteria^® for potentially inappropriate medication use in older adults.
Medication:	ciprofloxacin (Cipro)
Criteria 5: medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults. (Table 6)
CrCl (mL/min) at which action is required	<30
Rationale	Increased risk of CNS effects (e.g., seizures, confusion) and tendon ruPture.
Recommendation	Dosages used to treat common infections typically require reduction when CrCl <30 mL/min.
Quality of evidence: Moderate, Strength of Recommendation: Strong

Last updated: Sep. 18, 2025

Renal Adjustment Policy ciprofloxacin subject to adjustments by pharmacy.
IV to PO Conversion Policy Policy
Black Box Warnings Tendinitis; tendon rupture

UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.