1 May 2026Oral drugsSource update: September 2023
Ciprofloxacin oral
Ciprofloxacin guidance for selected bacterial infections including shigellosis, pyelonephritis, plague, and anthrax, with tendon and QT precautions.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
Fluoroquinolone antibacterial.
Indications
- Shigellosis and uncomplicated cutaneous anthrax.
- Uncomplicated acute pyelonephritis, acute prostatitis, and acute cystitis in non-pregnant women in the event of previous treatment failure.
- Plague, alone or in combination with other antibacterials.
- Completion treatment following therapy with parenteral ciprofloxacin.
Forms and strengths
- 250 mg and 500 mg tablets.
- 250 mg/5 ml granules and solvent for oral suspension.
Dose
| Age | Weight | 250 mg/5 ml susp. | 250 mg tablet | 500 mg tablet |
|---|---|---|---|---|
| 1 to < 3 months | 4 to < 6 kg | 1.5 ml x 2 | - | - |
| 3 to < 7 months | 6 to < 8 kg | 2 ml x 2 | - | - |
| 7 months to < 2 years | 8 to < 12 kg | 2.5 ml x 2 | - | - |
| 2 to < 3 years | 12 to < 15 kg | 4 ml x 2 | - | - |
| 3 to < 8 years | 15 to < 26 kg | 5 ml x 2 | 1 tab x 2 | - |
| 8 to < 11 years | 26 to < 36 kg | 8 ml x 2 | - | - |
| ≥ 11 years and adult | ≥ 36 kg | - | 2 tab x 2 | 1 tab x 2 |
Shigellosis, uncomplicated cutaneous anthrax
- Child 1 month and over: 15 mg/kg, maximum 500 mg, 2 times daily.
- Adult: 500 mg 2 times daily.
Uncomplicated acute pyelonephritis, acute prostatitis, acute cystitis
- Adult: 500 mg 2 times daily.
Weight guide for 250 mg/5 ml suspension or tablets
- 1 to < 3 months and 4 to < 6 kg: 1.5 ml 2 times daily.
- 3 to < 7 months and 6 to < 8 kg: 2 ml 2 times daily.
- 7 months to < 2 years and 8 to < 12 kg: 2.5 ml 2 times daily.
- 2 to < 3 years and 12 to < 15 kg: 4 ml 2 times daily.
- 3 to < 8 years and 15 to < 26 kg: 5 ml 2 times daily or 1 tablet of 250 mg 2 times daily.
- 8 to < 11 years and 26 to < 36 kg: 8 ml 2 times daily.
- >= 11 years and adult, >= 36 kg: 2 tablets of 250 mg 2 times daily or 1 tablet of 500 mg 2 times daily.
Plague
- Child 1 month and over: 15 mg/kg 2 to 3 times daily, maximum 750 mg 2 times daily or 500 mg 3 times daily.
- Adult: 750 mg 2 times daily, or 500 mg 3 times daily in pregnant women.
Duration
- Shigellosis and cystitis: 3 days.
- Cutaneous anthrax: 7 to 14 days depending on severity.
- Pyelonephritis and plague: 10 to 14 days.
- Prostatitis: 14 days. If signs and symptoms continue after 14 days, continue the same treatment for a further 14 days.
Contra-indications, adverse effects, precautions
- Do not administer to patients with a history of allergy or serious adverse effects due to a fluoroquinolone, such as tendinitis or tendon rupture.
- Administer with caution to epileptic patients, older patients, and patients with hypertension or heart disorders.
- Reduce the dose by half in patients with renal impairment.
- May cause gastrointestinal disturbances, headache, dizziness, confusion, hallucinations, seizures, allergic reaction, peripheral neuropathy, photosensitivity, joint and muscle pain, tendinitis, QT interval prolongation, hypo or hyperglycaemia, and haemolytic anaemia in patients with G6PD deficiency.
- In the event of allergic reaction, severe neurological disorders, peripheral neuropathy, joint or muscle pain, or tendinitis, stop treatment immediately.
- Avoid combination with drugs that prolong the QT interval, including amiodarone, chloroquine, co-artemether, fluconazole, haloperidol, mefloquine, ondansetron, pentamidine, and quinine.
- Monitor patients taking glibenclamide, NSAIDs, and corticosteroids.
- Do not administer simultaneously with antacids; take ciprofloxacin 2 hours before or 4 hours after antacids.
- Do not administer simultaneously with iron salts, calcium, or zinc sulfate; take 2 hours apart.
- Drink a lot of liquid during treatment.
- Pregnancy: reserved for severe infections when there is no therapeutic alternative.
- Breast-feeding: no contra-indication.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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