Bacterial infections:
Indications for: CIPRO XR
Susceptible infections including UTIs, acute uncomplicated pyelonephritis. For uncomplicated UTIs: reserve for those who have no alternative treatment options.
Adult Dosage:
Swallow whole. ≥18yrs: Uncomplicated UTIs: 500mg once daily for 3 days. Complicated UTIs, acute uncomplicated pyelonephritis: 1000mg once daily for 7–14 days; renal impairment (CrCl <30mL/min): 500mg once daily for 7–14 days. Coincide dose for end of dialysis.
Children Dosage:
<18yrs: not recommended.
CIPRO XR Contraindications:
Concomitant tizanidine.
Boxed Warning:
Serious adverse reactions (including tendinitis and tendon rupture, peripheral neuropathy, CNS effects). Exacerbation of myasthenia gravis.
CIPRO XR Warnings/Precautions:
XR not interchangeable with other forms. Increased risk of disabling and potentially irreversible adverse reactions (including tendinitis/tendon rupture [esp. in patients >60yrs, or those with kidney, heart or lung transplants], peripheral neuropathy, or CNS/psychiatric effects); discontinue immediately if signs/symptoms occur. CNS disorders (eg, cerebral arteriosclerosis, epilepsy) that increase seizure risk. History of myasthenia gravis; avoid. Renal (except XR tabs for uncomplicated UTIs) or hepatic dysfunction: reduce dose. History of QT prolongation, ventricular arrhythmias, proarrhythmic conditions (eg, bradycardia, acute myocardial ischemia), hypokalemia, or hypomagnesemia; avoid. Increased risk of aortic aneurysm and dissection (esp. in elderly); reserve use only if no alternatives in patients with history or risk of. Discontinue at 1st sign of skin rash, jaundice, any other hypersensitivity, hepatitis, or photosensitivity. Monitor blood glucose in diabetic patients; discontinue if hypoglycemia occurs. History of joint-related disorders (esp. children). Maintain adequate hydration, avoid alkaline urine to avoid crystalluria. May mask symptoms of syphilis; test for syphilis before treating gonorrhea, then follow-up after 3mos. Avoid excessive sun or UV light. Elderly. Pregnancy. Nursing mothers: may pump/discard breast milk or avoid (during and for 2 days after the last dose); monitor infant; for inhalation anthrax (post exposure): consider risk/benefit.
CIPRO XR Classification:
Quinolone.
CIPRO XR Interactions:
See Contraindications. Avoid theophylline, duloxetine, zolpidem, drugs that prolong QT interval (eg, Class IA or Class III antiarrhythmics, TCAs, macrolides, antipsychotics). Oral forms: take at least 2hrs before or 6hrs after magnesium- or aluminum-containing antacids, sucralfate, metal cations, multivitamins containing zinc or iron, or didanosine (buffered forms). Increased risk of tendinitis/tendon rupture with corticosteroids. Severe hypoglycemia with oral antidiabetics (eg, glyburide, glimepiride); monitor. Increased seizure risk with concomitant NSAIDs. Potentiates caffeine/xanthine derivatives; monitor and adjust dose as needed. Potentiated by probenecid. Monitor renal function with concomitant cyclosporine. Monitor methotrexate, oral anticoagulants (eg, warfarin), phenytoin, clozapine, ropinirole, sildenafil. Reduced absorption with omeprazole (XR).
Adverse Reactions:
Nausea, diarrhea, abnormal LFTs, vomiting, rash; tendinitis/tendon rupture, peripheral neuropathy, CNS effects, hypersensitivity reactions, hepatotoxicity, C. difficile-associated diarrhea, torsades de pointes, dysglycemia, phototoxicity, aortic aneurysm/dissection, joint-related disorders (children). IV: also inj site reactions, eosinophilia, headache, restlessness.
Generic Drug Availability:
YES
How Supplied:
Tabs—100; Oral Susp—100mL (w. graduated teaspoon); XR Tabs—50; IV premixed, IV conc—contact supplier
