【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，腎功能不佳之老年人 (CrCl<30mL/min) 使用時須降低藥品劑量。

Fluoroquinolone類抗生素 Urinary tract infection, acute uncomplicated cystitis in females, chronic bacterial prostatitis, bone and joint infections, complicated intra-abdominal infections (in combination with metronidazole), infectious diarrhea, typhoid fever, hospital-acquired pneumonia

Antibiotic, Fluoroquinolone
Inhibits DNA-gyrase in susceptible organisms; inhibits relaxation of supercoiled DNA and promotes breakage of double-stranded DNA

Absorption:
1. Bioavailability: approximately 70%
2. Time to peak concentration: 1-2 h
Distribution:
Protein binding: 20-40%
Metabolism:
1. Partially hepatic; forms 4 metabolites
2. Dialyzable: yes, <10% removed
Excretion:
Urine (35% to 70% as unchanged drug); feces (15% to 35%; <1% as unchanged drug)

1. Hypersensitivity to ciprofloxacin, any component of the formulation, or other quinolones
2. Concurrent administration of tizanidine

1. Ciprofloxacin is recommended for prophylaxis and treatment of pregnant women exposed to anthrax.
2. Alternative antibiotics are recommended in pregnant women for indications such as chancroid, meningococcal disease, or perianal disease and pouchitis in women with inflammatory bowel disease.

In general, quinolone antibiotics should be avoided in breastfeeding women if alternative agents are available.

Musculoskeletal and neurological signs and symptoms, skin rash, abdominal pain, diarrhea, nausea, vomiting, vulvovaginal candidiasis, dizziness, headache, insomnia, nervousness, asthma, fever

Anthrax:
500 mg Q12H for 42 to 60 days
Intra-abdominal infection:
1. Acute Cholecystitis: 500 mg Q12H, continue for 1 day after gallbladder removal
2. Other intra-abdominal infections (eg, perforated appendix, diverticulitis, intra-abdominal abscess): 500 mg Q12H in combination with metronidazole, total duration 4-5 days
Osteomyelitis:
500 to 750 mg Q12H; when treating P. aeruginosa, 750 mg Q12H for ≥6 weeks
Plague (Yersinia pestis) infection:
1. Postexposure prophylaxis: 500 mg twice daily for 7 days
2. Treatment: 500 to 750 mg Q12H, duration 10-14 days
Pneumonia (empiric therapy or for P. aeruginosa):
750 mg Q12H, typically 7 days
GI infection (Salmonella species):
1. Typhoid fever: 500 mg Q12H for 7 to 10 days
2. Nontyphoidal severe illness: 500 mg twice daily for 3 to 14 days (7 to 14 days in patients with HIV with a CD4 count ≥200 cells/mm3)
Septic arthritis:
500 to 750 mg twice daily for 3-4 weeks
Urinary tract infection:
250 to 500 mg Q12H

In pediatric patients, ciprofloxacin is not routinely first-line therapy, but after assessment of risks and benefits, can be considered a reasonable alternative.

1. CrCl 31-60 mL/min/1.73m2: Maximum 1000 mg/day
2. CrCl <30mL/min/1.73m2: Maximum 500 mg/day

There are no dosage adjustments provided in manufacturer's labeling. Use with caution in severe impairment.

Do not store above 25 °C.