Cipronat Dosage/Direction for Use

Dosing regimen is determined individually depending on infection localization and severity and also on infection agent sensitivity. Drug solution can be administered undiluted or mixed with other infusion solutions.
Before starting Cipronat therapy the possibility of patient's hypersensitivity should be ruled out by skin test.
In adults, Cipronat is administered by intravenous drop infusion; the doses are between 200 mg and 400 mg (100-200 mL) depending on infection severity, two times a day, with average therapy duration of 7 to 10 days. In patients with chronic bronchitis in the acute stage the drug dose is 200 mg (100 mL) once daily, for 7-10 days. In patients with acute sinusitis the drug dose is 200 mg (100 mL) once daily, for 10 days. In patients with community-acquired pneumonia, the drug dose is 200 mg (100 ml) 1-2 times daily for 7-14 days. In patients with noncomplicated urinary infections the drug dose is 200 mg in a single dose or 100 mg for 3 days; for complicated urinary infections: 200 mg once daily for 7-10 days. For treatment of skin and soft tissue infections the recommended dose is 100 mg once daily for 5-7 days. For treatment of noncomplicated gonorrhea 100 mg should be administered twice daily for 1 day. The infusion time for Cipronat is 60 minutes.
In patients with severe infections, at recurring infections in patients with cystic fibrosis, abdominal, bone and joint infections caused by Pseudomonas or staphylococci, peritonitis, septicemia and acute pneumonias caused by Streptococcus pneumoniae the dose should be increased to 400 mg three times a day. The maximal daily dose is 1200 mg.
Dosing regimen in elderly patients: Elderly patients require lower Cipronat doses basing on the disease severity and creatinine clearance.
Dosing regimen for adult patients with renal or hepatic impairments: Renal function impairments: For patients with creatinine clearance from 31 to 60 mL/min/1.73 m² or blood plasma creatinine concentration from 1.4 to 1.9 mg/100 mL the maximal Cipronat dose for
intravenous administration is 800 mg per day.
For patients with creatinine clearance 30 mL/min/1.73 m² or lower, or blood plasma creatinine concentration 2/100 mL or higher the maximal Cipronat dose for intravenous administration is 400 mg per day.
Renal function impairments + hemodialysis: The maximal Cipronat dose for intravenous administration is 400 mg per day; at hemodialysis days Cipronat should be administered after hemodialysis.
Renal function impairments + outpatient peritoneal dialysis: Cipronat solution for infusions is added to dialysate (peritoneal administration): 50 mg Cipronat per 1 liter of dialysate is administered 4 times daily at 6-hour intervals.
Hepatic function impairments: Dose adjustment is not required.
The therapy duration depends on the infection severity, clinical course and bacteriological test results.
The drug therapy should be continued for at least three days after the body temperature normalizes or clinical symptoms resolve. The therapy duration for patients with acute noncomplicated gonorrhea and cystitis is 1 day. For patients with urinary and abdominal infections, the therapy duration is 7 days.
For patients with other infections the therapy duration is usually 7 to 10 days. In patients with impaired immunity, the therapy is continued throughout the entire neutropenia period.
In patients with infections caused by streptococci and chlamydia the minimal treatment duration is 10 days.