Q-BID ( TABLET ) ( 250 mg )

• Gastroenteritis-including cholera, shigellosis, travellers’ diarrhoea, campylobacter and salmonella enteritis
• Typhoid
• Gonorrhoea
• Chancroid
• Legionnaires’ disease
• Meningitis (including meningococcal meningitis prophylaxis)
• Respiratory-tract infectionsincluding pseudomonal infections in cystic fibrosis, but not pneumococcal pneumonia
• Urinary-tract infections
• Bone and joint infections
• Septicaemia
• Anthrax
• Skin infections
• Prophylaxis in surgery.
• Bacterial infections of eye.

Source : IAP Pediatric Drug Formulary
Neonates 10mg/kg 12 hraly orally or IV; children 15-30 mg/kg/24 hrin 2 divided doses oral or IV (Maximum single dose IV 400mg and oral 750mg).

Dose adjustment in renal or liver failur: In severe impairment (creatinine clearance <20ml/ minute/1.73sqm) total daily dosage may be reduced by half, although monitoring serum levels provides the most relibale basis for dose adjustment. No adjustment in impaired hepatic function.

• Corneal ulcers - apply throughout the day and night.
• First day - 2 drops every 15 min for 6hr followed by 2 drops every 30min for the rest of the day.
• 2nd day -2 drops every hour and from 3rd to 14th day - drops 4th hrly.
• Superficial infections of eye - 1-2 drops 4 times daily till 48 hrs after the eye is clinically normal (use for max. of 21 days)

Source : NFI National Formulary of India

• Oral Adult- Urinary tract infection, respiratory tract infection: 250 to 500 mg, twice daily. Severe respiratory tract infections: up to 750 mg twice daily (however in acute uncomplicated cystitis in women 100 mg twice daily for three days).
• Chronic prostatitis: 500 mg twice daily for28 days.
• Gonorrhoea: 500 mg as a single dose.
• Child- Not recommended.

Intravenous infusion (30 to 60 min)

• Adult- Urinary tract infection, ENT infection, skin, soft tissue and bone infection, joint infection, gastrointestinal tract infection, severe systemic infection, gonorrhea, surgical prophylaxis and septicaemia; 100 to 200 mg twice daily by slow intravenous injection or infusion."
• Adult and child above 12 years- Instill 2 to3 drops in affected eye 3 to 4 times dailyto start with thereafter reduce slowly asinfection subsides. Apply about 0.5 cm ribbonof ointment in lower conjuctival sac for 3 to 4times daily. Reduce as infection subsides.

• History of tendon disorders related to quinolone use
• Exposure to strong sunlight, hypersensitivity to quinolones derivatives
• Tizanidine therapy.
• Epilepsy and hypersensitivity to quinolones.

• History of epilepsy or conditions that predispose to seizures, G-6-PD deficiency, myasthenia gravis (risk of exacerbation), pregnancy, lactation, children or adolescents (see below)
• Avoid exposure to excessive sunlight (discontinue if photosensitivity occurs)
• Rarely, tendon damage-discontinue at first sign of pain or inflammation and rest affected limb
• Hepatic impairment
• Renal failure
• Avoid excessive alkalinity of urine and ensure adequate fluid intake as there is risk of crystalluria
• Interactions
• Cerebral arteriosclerosis, anxiety, paranoia, erythema, blistering.
• Use In Children. Ciprofloxacin causes arthropathy in the weight-bearing joints of immature animals and is therefore generally not recommended in children and growing adolescents. However, the significance of this effect in humans is uncertain and in some specific circumstances short-term use of ciprofloxacin in children may be justified.
• Ciprofloxacin is used for pseudomonal infections in cystic fibrosis (for children over 5 years) and for treatment and prophylaxis of anthrax.
• May impair ability to perform skilled tasks, for example operating machinery, driving.
• It should be used with caution in patients with a history of epilepsy or conditions that predispose to seizures
• In G-6-PD deficiency
• Myasthenia gravis
• In renal impairment
• Pregnancy, during lactation, and in children or adolescents. Exposure to excessive sunlight should be avoided. Avoid excessive alkalinity of urine and ensure adequate fluid intake
• Interactions
• Paediatric use.

• Nausea, vomiting, dyspepsia, abdominal pain, flatulence, diarrhoea (rarely, antibiotic-associated colitis), dysphagia, tremor, hyperglycaemia, headache, dizziness, sleep disorders, rash (rarely, erythema multiforme (Stevens-Johnson syndrome) and toxic epidermal necrolysis) and pruritus
• Vasculitis, erythema nodosum, petechiae, haemorrhagic bullae
• Less frequently anorexia, increase in blood urea and creatinine; drowsiness, restlessness, asthenia, depression, confusion, hallucinations, convulsions, paraesthesia; photosensitivity, hypersensitivity reactions including fever, urticaria, angioedema, arthralgia, myalgia and anaphylaxis
• Blood disorders (including eosinophilia, leukopenia, thrombocytopenia), altered prothrombin time
• Disturbances in vision, taste, hearing and smell, tinnitus
• Tenosynovitis
• Tachycardia, oedema, syncope, hot flushes and sweating
• If psychiatric, neurological or hypersensitivity reactions (including severe rash) occur discontinue
• Arthralgia.
• Other side-effects that have been reported include haemolytic anaemia, renal failure, interstitial nephritis, and hepatic dysfunction (including hepatitis and cholestatic jaundice). The drug should be discontinued if psychiatric, neurological or hypersensitivity reactions (including severe rash) occur. Ophthalmic solution:local burning, discomfort, corneal ulcers, lid oedema, corneal infiltration. Ointment: discomfort, keratopathy, blurred vision, corneal staining, epitheliopathy, photophobia.

Eye drops and Tablet: Store protected from light.

• Injection: Store protected from light at a temperature not exceeding 30⁰C.
• Ointment: Store protected from light at a temperature not exceeding 300C.
• Drops: Store protected from light.

The container should not be allowed to freeze.