Ciprofloxacin Dosing Recommendations for Patients with Renal Impairment

Moderate Renal Impairment (Creatinine Clearance 30–50 mL/min)

For adults with a creatinine clearance of 30–50 mL/min, administer ciprofloxacin 250 mg to 500 mg every 12 hours; the lower dose is appropriate for mild‑to‑moderate infections, while the higher dose is reserved for severe infections. 1

In patients undergoing hemodialysis or peritoneal dialysis, give ciprofloxacin 250 mg to 500 mg once daily after the dialysis session to maintain therapeutic exposure. 1
Administer ciprofloxacin after hemodialysis rather than before to prevent significant drug loss during the procedure and to allow for directly observed therapy. 2
When ciprofloxacin is given immediately before hemodialysis, roughly 40 % of the administered dose is removed by the dialyzer; if the drug is administered after dialysis (once it has distributed into the body), the amount removed is markedly lower. 2