Ciprofloxacin 0.3% E/E prep
Indications
Ciprofloxacin 0.3% E/E prep is used for:
Otitis media, Superficial ophthalmic infections, Otitis externa
Adult Dose
Bacterial Conjunctivitis
Solution: 1-2 drops instilled into conjunctival sac(s) q2hr with patient awake on days 1-2, then 1-2 drops q4hr with patient awake on days 3-7
Ointment: 0.5-in. (1.25-cm) ribbon applied into conjunctival sac q8hr on days 1-2, then 0.5-in. (1.25-cm) ribbon q12hr on days 3-7
Corneal Ulcers (Keratitis)
Solution: 2 drops q15min for 6 hours, then 2 drops q30min for remainder of day 1, then 2 drops q1hr on day 2, and finally 2 drops q4hr on days 3-14
Ointment: Not indicated for keratitis
Child Dose
Bacterial Conjunctivitis
<1 year: Safety and efficacy not established
>1 year (solution): 1-2 drops instilled into conjunctival sac(s) q2hr with patient awake on days 1-2, then 1-2 drops q4hr with patient awake on days 3-7
>2 years (ointment): 0.5-in. (1.25-cm) ribbon applied into conjunctival sac q8hr on days 1-2, then 0.5-in. (1.25-cm) ribbon q12hr on days 3-7
Renal Dose
Administration
Contra Indications
Ciprofloxacin is contraindicated in patients who have hypersensitivity to Ciprofloxacin or other quinolones.
Precautions
Prolonged use of Ciprofloxacin may result in overgrowth of nonsusceptible organisms including fungi. Ciprofloxacin should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity reaction. Not for injection into the eye.
Lactation: Drug is distributed into milk; use with caution
Pregnancy-Lactation
Interactions
May increase plasma concentrations of CYP1A2 substrates (e.g. clozapine, ropinirole, theophylline). Enhances effect of oral anticoagulants (e.g. warfarin) and glibenclamide. Increased toxicity of methotrexate. Plasma concentrations may be increased by probenecid. Reduced absorption w/ oral multivitamins and mineral supplements containing divalent or trivalent cations (e.g. Fe, Zn, Ca) and antacids containing Al, Ca or Mg. Concomitant use w/ class IA antiarrhythmics (e.g. quinidine, procainamide), class III antiarrhythmics (e.g. amiodarone, sotalol), TCAs, macrolides and antipsychotics may result in additive effects on QT interval prolongation. Concurrent use w/ corticosteroids may increase risk of severe tendon disorders. Increased risk of CNS stimulation w/ NSAIDs. Altered serum concentrations of phenytoin.
Potentially Fatal: Marked elevation in serum levels of tizanidine which is associated w/ potentiated hypotensive and sedative effect.
Adverse Effects
Side effects of Ciprofloxacin 0.3% E/E prep :
>10%
Burning,Ciprofloxacin precipitate in superficial portion of corneal defect,Stinging
1-10%
Conjunctival hyperemia,Crystals or scales on eyelashes,Foreign-body sensation,Itching,Keratopathy or keratitis,Lid margin crusting,Unpleasant taste after instillation
<1%
Corneal infiltrates,Corneal staining,Decrease in vision,Lid edema,Ocular discomfort,Photophobia,Sensitivity reactions,Tearing
Mechanism of Action
Ciprofloxacin promotes breakage of double-stranded DNA in susceptible organisms and inhibits DNA gyrase, which is essential in reproduction of bacterial DNA.