Ciprobay Dosage/Direction for Use

Ciprobay: Method of administration: Film-coated tablet: For oral use.
Ciprofloxacin (Ciprobay) film-coated tablets are to be swallowed whole with a small amount of fluid.
Ciprofloxacin (Ciprobay) film-coated tablets can be taken independently of mealtimes.
If they are taken on an empty stomach, the active substance is absorbed more rapidly. In this case, Ciprofloxacin (Ciprobay) film-coated tablets should not be taken concurrently with dairy products or with mineral-fortified drinks alone (e.g. milk, yoghurt, calcium-fortified orange juice) (see Interactions).
If the patient is unable to take Ciprofloxacin (Ciprobay) film-coated tablets because of the severity of the illness or for other reasons (e.g. patients on enteral nutrition), it is recommended to commence the therapy with an intravenous form of ciprofloxacin. After intravenous administration, the treatment can be continued orally.
Solution for infusion: For intravenous use.
Ciprofloxacin (Ciprobay) solution for infusion should be administered by intravenous infusion over a period of 60 minutes. Slow infusion into a large vein will minimize patient discomfort and reduce the risk of venous irritation. The solution for infusion can be infused either directly or after mixing with other compatible solutions for infusion.
Unless compatibility with other solutions for infusion/medicinal products has been confirmed, the solution for infusion must always be administered separately. The visual signs of incompatibility are e.g. precipitation, clouding and discoloration.
Incompatibility appears with all solutions for infusion/medicinal products that are physically or chemically unstable at the pH of the solution (e.g. penicillins, heparin solutions), especially on combination with solutions adjusted to an alkaline pH (pH of Ciprofloxacin (Ciprobay) solutions for infusion: 3.9 - 4.5). Only clear solutions are to be used.
Duration of treatment: The duration of treatment depends on the severity of the illness and on the clinical and bacteriological course. It is essential to continue therapy for at least 3 days after disappearance of the fever or of the clinical symptoms.
Mean duration of treatment: Adults: 1 day for acute uncomplicated gonorrhea and cystitis; up to 7 days for infections of the kidneys, urinary tract and abdominal cavity; over the entire period of the neutropenic phase in patients with weakened body defenses; a maximum of 2 months in osteomyelitis; and 7-14 days in all other infections.
In streptococcal infections, the treatment must last at least ten days because of the risk of late complications.
Infections caused by Chlamydia spp. should also be treated for a minimum of ten days.
Children and adolescents: Cystic Fibrosis: For acute pulmonary exacerbation of cystic fibrosis associated with Pseudomonas aeruginosa infection in pediatric patients (aged 5-17 years), the duration of treatment is 10-14 days.
Complicated Urinary Tract Infections and Pyelonephritis: For complicate urinary tract infections or pyelonephritis due to Escherichia coli, the duration of treatment is 10-21 days.
Dosage regimen: Unless otherwise prescribed, the following daily doses are recommended for: Adults: Film-coated tablet: See Table 1.

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Solution for infusion: See Table 2.

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Children and adolescents: Film-coated tablet: See Table 3.

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Solution for infusion: See Table 4.

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Missed dose: Film-coated tablet: If a dose is missed it should be taken as soon as the patient remembers and then treatment should be continued as prescribed. Double doses should not be taken to compensate for a missed dose.
Additional information on special populations: Children and adolescents: For recommended dosage regimen, see Tables 3 and 4.
Geriatric patients: Elderly patients should receive a dose as low as possible depending on the severity of their illness and the creatinine clearance (see also Patients with renal and hepatic impairment).
Patients with renal and hepatic impairment: Adults: Patients with renal impairment: Film-coated tablet: See Table 5.

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Solution for infusion: See Table 6.

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Patients with renal impairment on hemodialysis: Film-coated tablet: For patients with creatinine clearance between 30 and 60 mL/min/1.73 m² (moderate renal impairment) or serum creatinine concentration between 1.4 and 1.9 mg/100 mL, the maximum daily oral dose of ciprofloxacin should be 1000 mg.
For patients with creatinine clearance less than 30 mL/min/1.73 m² (severe renal impairment) or serum creatinine concentration equal or higher than 2.0 mg/100 mL, the maximum daily oral dose of ciprofloxacin should be 500 mg on dialysis days after dialysis.
Solution for infusion: For patients with creatinine clearance between 30 and 60 mL/min/1.73 m² (moderate renal impairment) or serum creatinine concentration between 1.4 and 1.9 mg/100 mL, the maximum daily intravenous dose of ciprofloxacin should be 800 mg.
For patients with creatinine clearance less than 30 mL/min/1.73 m² (severe renal impairment) or serum creatinine concentration equal or higher than 2.0 mg/100 mL, the maximum daily intravenous dose of ciprofloxacin should be 400 mg on dialysis days after dialysis.
Patients with renal impairment on continuous ambulatory peritoneal dialysis (CAPD): Film-coated tablet: The maximum daily oral dose of ciprofloxacin should be 500 mg (1 x 500 mg Ciprofloxacin (Ciprobay) film-coated tablet or 2 x 250 mg Ciprofloxacin (Ciprobay) film-coated tablets).
Solution for infusion: Addition of Ciprofloxacin (Ciprobay) solution for infusion to the dialysate (intraperitoneal): 50 mg ciprofloxacin / liter dialysate administered 4 times a day every 6 hours.
Patients with hepatic impairment: In patients with hepatic impairment, no dose adjustment is required.
Patients with renal and hepatic impairment: Film-coated tablet: For patients with creatinine clearance between 30 and 60 mL/min/1.73 m² (moderate renal impairment) or serum creatinine concentration between 1.4 and 1.9 mg/100 mL, the maximum daily oral dose of ciprofloxacin should be 1000 mg.
For patients with creatinine clearance less than 30 mL/min/1.73 m² (severe renal impairment) or serum creatinine concentration equal or higher than 2.0 mg/100 mL, the maximum daily oral dose of ciprofloxacin should be 500 mg.
Solution for infusion: For patients with creatinine clearance between 30 and 60 mL/min/1.73 m² (moderate renal impairment) or serum creatinine concentration between 1.4 and 1.9 mg/100 mL, the maximum daily intravenous dose of ciprofloxacin should be 800 mg.
For patients with creatinine clearance less than 30 mL/min/1.73 m² (severe renal impairment) or serum creatinine concentration equal or higher than 2.0 mg/100 mL, the maximum daily intravenous dose of ciprofloxacin should be 400 mg.
Children: Dosing in children with impaired renal and/or hepatic function has not been studied.