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Fluoroquinolone Antibiotic Pregnancy: C

Ciprofloxacin (UTI/Prostatitis)

Brand names: Ciproxin

Adult dose

Dose: 500 mg twice daily (UTI); 500 mg twice daily for 28 days (prostatitis)
Route: oral
Frequency: twice daily
Max: 1500 mg/day
MHRA: reserve for serious/complicated UTI only after other antibiotics failed — risk of disabling and potentially irreversible side effects

Paediatric dose

Dose: 10 mg/kg
Route: oral
Frequency: twice daily
Max: 750 mg per dose
Concentration: 250 mg/5 ml suspension mg/ml
Reserved for resistant infections only; not first-line in children; risk of arthropathy

Dose adjustments

Renal

Reduce dose if eGFR <30 ml/min; max 500 mg/day if eGFR <10 ml/min

Hepatic

Use with caution in severe hepatic impairment

Paediatric weight-based calculator

Reserved for resistant infections only; not first-line in children; risk of arthropathy

Clinical pearls

  • MHRA 2019: restrict use — disabling side effects (tendinopathy, neuropathy, CNS) can be irreversible
  • First-line for acute prostatitis and complicated UTI per NICE/PHE guidelines
  • Must be taken 2h before or 6h after dairy products, antacids, iron

Contraindications

  • Tendon disorders related to fluoroquinolones
  • History of QT prolongation
  • Epilepsy
  • Concurrent NSAIDs (seizure risk)

Side effects

  • Tendinopathy/rupture (Achilles)
  • Peripheral neuropathy
  • CNS effects (seizures, psychosis)
  • QT prolongation
  • Clostridium difficile
  • Photosensitivity

Interactions

  • Antacids/iron/calcium (reduced absorption)
  • Warfarin (enhanced)
  • Theophylline (increased toxicity)
  • NSAIDs (seizure risk)

Monitoring

  • Renal function
  • Signs of tendinopathy
  • CNS symptoms

Reference: BNFc; BNF 86; MHRA Drug Safety Update 2019; NICE NG112. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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