Ciprofloxacin

Fluoroquinolone·Infectious Diseases - Fluoroquinolones

Complicated UTIs, Pseudomonas aeruginosa infections, severe Gram-negative osteomyelitis, prostatitis

Authority requiredPBSFLUOROQUINOLONECiproxin250 mg tablet+2

Max Dose

1500 mg/day

Half-life

4 h

Tendon Rupture

CRITICAL

Aortic Dissect

RISK

Rapid Summary

Overview

Highly potent fluoroquinolone. Exceptional tissue penetration and Gram-negative coverage (including Pseudomonas). Oral absorption is functionally equivalent to IV.

Maximum Dose

Max 1500 mg/day (For severe Pseudomonas infections).

Clinical Focus

Carries 'Black Box' warnings for tendon rupture, aortic aneurysm dissection, and permanent peripheral neuropathy. Do not use for simple infections.

Bottom Line

Ciprofloxacin is a powerful fluoroquinolone for gram-negative and pseudomonal infections, but carries serious risks of tendon rupture, QTc prolongation, and is restricted due to resistance concerns.

Formulation & Access

Brand Names

Ciproxin

Oral Routes

Tablets (250 mg, 500 mg, 750 mg).

Parenteral

Pre-mixed infusion bags for IV use.

Prescribing & PBS

Authority Required (PBS) to prevent resistance.

Indications & Use

Primary

PBSTGA

Complicated UTIs, Pseudomonas aeruginosa infections, severe Gram-negative osteomyelitis, prostatitis.

Clinical Place

Reserved exclusively for resistant Gram-negative infections or when an oral anti-pseudomonal agent is required for discharge.

Quick reference

Class & Role

Fluoroquinolone — Highly potent fluoroquinolone.

Route / Formulation

Tablets (250 mg, 500 mg, 750 mg). (Ciproxin)

Usual Dose & Max

PO 500 mg BD. Max 1500 mg/day (For severe Pseudomonas infections).

Key Indication Doses

Severe UTI / Pyelonephritis: PO 500 mg BD. Pseudomonas / Osteomyelitis: PO 750 mg BD OR IV 400 mg q8h. Renal Impairment: Reduce dose by 50% if eGFR < 30.

Best Uses

Ciprofloxacin is a powerful fluoroquinolone for gram-negative and pseudomonal infections, but carries serious risks of tendon rupture, QTc prolongation, and is restricted due to resistance concerns.

Avoid / Cautions

History of tendon disorders, known aortic aneurysm, Myasthenia Gravis, prolonged QTc.

Key Risks

Musculoskeletal: Achilles tendon rupture (can occur suddenly and bilaterally). Exacerbates Myasthenia Gravis. Cardiovascular: Aortic aneurysm dissection/rupture (degrades collagen). HIGH — QTc prolongation. Neurological: Irreversible peripheral neuropathy, seizures (lowers threshold), severe insomnia/anxiety. Gastrointestinal: C. difficile infection.

Key Interactions

Dairy, Calcium, Iron, Antacids. Multi-valent cations bind ciprofloxacin in the gut, dropping absorption to zero. Separate by 2-4 hours. NSAIDs (massively increases risk of seizures). Corticosteroids (exponentially increases risk of tendon rupture).

Monitoring

Warn the patient to stop the drug instantly if they feel any pain or snapping in their Achilles tendon or sudden severe chest/back pain. Check eGFR to guide dosing.

Clinical Pearl

Ciprofloxacin PO is virtually 100% bioavailable. If a patient is stable with a functioning gut, there is zero clinical reason to use IV Ciprofloxacin. Switch to PO to save their veins and reduce infection risk.

Access

Authority requiredCiproxin250 mg tablet

Brand: Ciproxin
PBS status: Authority required
Formulation: Tablets (250 mg, 500 mg, 750 mg)

Ciprofloxacin

Fluoroquinolone·Infectious Diseases - Fluoroquinolones

Complicated UTIs, Pseudomonas aeruginosa infections, severe Gram-negative osteomyelitis, prostatitis

Authority requiredPBSFLUOROQUINOLONECiproxin250 mg tablet+2

Max Dose

1500 mg/day

Half-life

4 h

Tendon Rupture

CRITICAL

Aortic Dissect

RISK

Rapid Summary

Overview

Highly potent fluoroquinolone. Exceptional tissue penetration and Gram-negative coverage (including Pseudomonas). Oral absorption is functionally equivalent to IV.

Maximum Dose

Max 1500 mg/day (For severe Pseudomonas infections).

Clinical Focus

Carries 'Black Box' warnings for tendon rupture, aortic aneurysm dissection, and permanent peripheral neuropathy. Do not use for simple infections.

Bottom Line

Ciprofloxacin is a powerful fluoroquinolone for gram-negative and pseudomonal infections, but carries serious risks of tendon rupture, QTc prolongation, and is restricted due to resistance concerns.

Formulation & Access

Brand Names

Ciproxin

Oral Routes

Tablets (250 mg, 500 mg, 750 mg).

Parenteral

Pre-mixed infusion bags for IV use.

Prescribing & PBS

Authority Required (PBS) to prevent resistance.

Indications & Use

Primary

PBSTGA

Complicated UTIs, Pseudomonas aeruginosa infections, severe Gram-negative osteomyelitis, prostatitis.

Clinical Place

Reserved exclusively for resistant Gram-negative infections or when an oral anti-pseudomonal agent is required for discharge.

Quick reference

Class & Role

Fluoroquinolone — Highly potent fluoroquinolone.

Route / Formulation

Tablets (250 mg, 500 mg, 750 mg). (Ciproxin)

Usual Dose & Max

PO 500 mg BD. Max 1500 mg/day (For severe Pseudomonas infections).

Key Indication Doses

Severe UTI / Pyelonephritis: PO 500 mg BD. Pseudomonas / Osteomyelitis: PO 750 mg BD OR IV 400 mg q8h. Renal Impairment: Reduce dose by 50% if eGFR < 30.

Best Uses

Ciprofloxacin is a powerful fluoroquinolone for gram-negative and pseudomonal infections, but carries serious risks of tendon rupture, QTc prolongation, and is restricted due to resistance concerns.

Avoid / Cautions

History of tendon disorders, known aortic aneurysm, Myasthenia Gravis, prolonged QTc.

Key Risks

Key Interactions

Monitoring

Warn the patient to stop the drug instantly if they feel any pain or snapping in their Achilles tendon or sudden severe chest/back pain. Check eGFR to guide dosing.

Clinical Pearl

Access

Authority requiredCiproxin250 mg tablet

Brand: Ciproxin
PBS status: Authority required
Formulation: Tablets (250 mg, 500 mg, 750 mg)