Parenteral Manual

Ciprofloxacin

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Alternate Name(s): 
CIPRO®
Classification: 
Quinolone Antibiotic
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Broad spectrum antibiotic, covering Staph species and gram negatives including Pseudomonas species
  • Does not provide adequate coverage for most Strep species or anaerobes
Reconstitution and Stability: 
  • Available as 2 mg/mL in D5W injection
  • Clear, colorless to slightly yellow solution
  • Diluted solutions (0.5-2 mg/mL) in D5W or NS stable 9 days refrigerated or 30 hours at  room temperature
  • Protect from light
Compatibility: 

- Solutions Compatible:  D5W, D10W, NS, ringer's solution, ringer's lactate

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: KCl, diphenhydramine, calcium gluconate, TPN (amino acids/dextrose - dependent on electrolytes, TPN must not contain phosphates-contact Pharmacy)

Incompatible: azithromycin, clindamycin, cloxacillin, dexamethasone, furosemide, heparin, methylprednisolone, potassium phosphate, sodium phosphate

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

NO
IV Intermittent Infusion YES 
Usual dilution: 1-2 mg/mL
Infusion time: over 60 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:       

  • 20 mg/kg/day IV ÷ Q 12 hours (Maximum: 800 mg/day)
  • Severe infection: 30 mg/kg/day IV ÷ Q 8 hours (Maximum: 1200 mg/day)
  • Cystic Fibrosis: 30 mg/kg/day IV ÷ Q 8 hours (Maximum: 1200 mg/day)

Adult:

  • 200-400 mg IV Q 8 - 12 H depending on severity of infection

Dosing in Renal Impairment:

  •   CrCl <30 mL/minute, increase dosing interval to Q 18-24 hours
Potential hazards of parenteral administration: 
  • Avoid in patients with known sensitivity to ciprofloxacin or other quinolones
  • Venous irritation at injection site (burning, pain, erythema and swelling).  More common when infusion time is < 60 minutes.
  • CNS stimulation leading to tremor, restlessness, headache, confusion and seizures
Notes: 
  • Use in pediatrics not routinely recommended.   Can cause arthropathies with erosion of cartilage in weight bearing joints of immature animals; from limited study the incidence of these effects in children appears to be low, but ciprofloxacin should only be considered for use in the pediatric population when benefits outweigh potential risks.
  • Ciprofloxacin increases serum levels of theophylline, warfarin and cyclosporine
  • Use with caution in patients with seizure disorders
  • Monitor renal, hepatic and hematopoietic function

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