What is the dose of ciprofloxacin (Cipro)?

From the Guidelines

The recommended dose of ciprofloxacin for adults is 400 mg every 8 hours intravenously or 750 mg every 12 hours orally, as stated in the most recent guidelines 1.

Dosing Considerations

When considering the dose of ciprofloxacin, it's essential to take into account the type of infection being treated, patient factors such as kidney function, and the administration route.

• For urinary tract infections, a dose of 250-500 mg twice daily for 3-7 days may be appropriate, as suggested by previous guidelines 1.
• However, the most recent guidelines 1 provide a clear recommendation for the dose of ciprofloxacin in adults, which should be prioritized.

Administration and Absorption

Ciprofloxacin should be taken with plenty of water, and absorption can be reduced when taken with dairy products, antacids, or supplements containing calcium, magnesium, aluminum, iron, or zinc.

Special Considerations

Dosage adjustments are necessary for patients with kidney impairment, and a healthcare provider should always determine the specific dose based on individual patient factors and the specific infection being treated.

Evidence-Based Recommendation

The recommendation is based on the most recent guidelines from 2021 1, which provide a clear and evidence-based dosing regimen for ciprofloxacin in adults. This guideline should be prioritized over previous guidelines 1 and other evidence 1, as it is the most recent and highest quality study.

From the FDA Drug Label

ADULT DOSAGE GUIDELINES InfectionSeverityDoseFrequencyUsual Durations†

• used in conjunction with metronidazole † Generally ciprofloxacin should be continued for at least 2 days after the signs and symptoms of infection have disappeared, except for inhalational anthrax (post-exposure). ** Drug administration should begin as soon as possible after suspected or confirmed exposure This indication is based on a surrogate endpoint, ciprofloxacin serum concentrations achieved in humans, reasonably likely to predict clinical benefit. 12 h 7 to 14 Days Chronic Bacterial Prostatits Mild/Moderate 500 mg q 12 h 28 Days Lower Respiratory Tract Mild/Moderate 500 mg q 12 h 7 to 14 days Severe/Complicated 750 mg q 12 h 7 to 14 days Acute Sinusitis Mild/Moderate 500 mg q 12 h 10 days Skin and Skin Structure Mild/Moderate 500 mg q 12 h 7 to 14 Days Severe/Complicated 750 mg q 12 h 7 to 14 Days Bone and Joint Mild/Moderate 500 mg q 12 h ≥4 to 6 weeks Severe/Complicated 750 mg q 12 h ≥4 to 6 weeks Intra-Abdominal* Complicated 500 mg q 12 h 7 to 14 Days Infectious Diarrhea Mild/Moderate/Severe 500 mg q 12 h 5 to 7 Days Typhoid Fever Mild/Moderate 500 mg q 12 h 10 Days Urethral and Cervical Gonococcal Infections Uncomplicated 250 mg single dose single dose Inhalational anthrax (post-exposure)** 500 mg q 12 h 60 Days

The dose of ciprofloxacin varies depending on the infection type and severity. The recommended doses are:

• Mild/Moderate infections: 500 mg every 12 hours
• Severe/Complicated infections: 750 mg every 12 hours
• Uncomplicated gonococcal infections: 250 mg single dose
• Inhalational anthrax (post-exposure): 500 mg every 12 hours for 60 days 2

From the Research

Dose of Ciprofloxacin

• The dose of ciprofloxacin varies depending on the type of infection being treated.
• For severe pyelonephritis or complicated urinary tract infections, a dose of 500 mg twice daily has been shown to be effective 3.
• A study comparing oral and intravenous ciprofloxacin found that the oral dose of 500 mg twice daily was as effective as the intravenous dose of 200 mg twice daily in the initial empirical management of hospitalized patients with serious forms of UTI 3.
• For acute uncomplicated pyelonephritis, a 7-day regimen of ciprofloxacin 500 mg twice daily has been compared to a 14-day regimen of trimethoprim-sulfamethoxazole, with the ciprofloxacin regimen showing greater bacteriologic and clinical cure rates 4.
• An extended-release formulation of ciprofloxacin, given at a dose of 1,000 mg once daily, has been shown to be as effective as the standard formulation of 500 mg twice daily for the treatment of complicated urinary tract infections and acute uncomplicated pyelonephritis 5, 6.
• A study comparing finafloxacin to ciprofloxacin for the treatment of complicated urinary tract infections found that a 5-day regimen of finafloxacin 800 mg once daily had similar results to a 10-day regimen of finafloxacin, and was more effective than a 10-day regimen of ciprofloxacin 400 mg/500 mg twice daily 7.