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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Ciprofloxacin - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Ciprofloxacin">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2024/08/15">
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<meta name="citation_keywords" content="ciprofloxacin">
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<meta name="citation_keywords" content="Ciprofloxacine">
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<meta name="citation_keywords" content="Ciprobay">
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<meta name="citation_keywords" content="Ciproxan">
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<meta name="citation_keywords" content="Cipro">
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<meta name="citation_keywords" content="Ciprofloxacina">
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<meta name="citation_keywords" content="Ciprofloxacino">
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<meta name="citation_keywords" content="Ciprofloxacinum">
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<meta name="citation_keywords" content="Ciprocinol">
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<meta name="citation_keywords" content="Cipromycin">
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<meta name="citation_keywords" content="Ciproquinol">
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<meta name="citation_keywords" content="Bacquinor">
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<meta name="citation_keywords" content="Bernoflox">
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<meta name="citation_keywords" content="Ciproxina">
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<meta name="citation_keywords" content="Septicide">
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<meta name="citation_keywords" content="Cifloxin">
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<meta name="citation_keywords" content="Ciprodar">
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<meta name="citation_keywords" content="Ciproflox">
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<meta name="citation_keywords" content="Ciproxine">
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<meta name="citation_keywords" content="Proflaxin">
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<meta name="citation_keywords" content="Superocin">
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<meta name="citation_keywords" content="Cetraxal">
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<meta name="citation_keywords" content="Ciprogis">
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<meta name="citation_keywords" content="Ciprolin">
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<meta name="citation_keywords" content="Ciprolon">
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<meta name="citation_keywords" content="Ciprowin">
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<meta name="citation_keywords" content="Citopcin">
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<meta name="citation_keywords" content="Corsacin">
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<meta name="citation_keywords" content="Fimoflox">
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<meta name="citation_keywords" content="Quinolid">
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<meta name="citation_keywords" content="Spitacin">
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<meta name="citation_keywords" content="Zumaflox">
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<meta name="citation_keywords" content="Ciprecu">
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<meta name="citation_keywords" content="Ipiflox">
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<meta name="citation_keywords" content="Otiprio">
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<meta name="citation_keywords" content="Probiox">
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<meta name="citation_keywords" content="Proflox">
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<meta name="citation_keywords" content="Quintor">
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<meta name="citation_keywords" content="Roxytal">
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<meta name="citation_keywords" content="Cipro IV">
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<meta name="citation_keywords" content="Baflox">
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<meta name="citation_keywords" content="Ciplus">
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<meta name="citation_keywords" content="Ciriax">
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<meta name="citation_keywords" content="Cixan">
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<meta name="citation_keywords" content="Cycin">
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<meta name="citation_keywords" content="Sophixin Ofteno">
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<meta name="citation_keywords" content="85721-33-1">
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<meta name="citation_keywords" content="Ciprobay Uro">
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<meta name="citation_keywords" content="Alcon Cilox">
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<meta name="citation_keywords" content="Cipro XR">
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<meta name="citation_keywords" content="Cyprobay">
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<meta name="citation_keywords" content="Bi-Cipro">
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<meta name="citation_keywords" content="AuriPro">
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<meta name="citation_keywords" content="Linhaliq">
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<meta name="citation_keywords" content="Proksi 250">
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<meta name="citation_keywords" content="Ciprofloxacine [INN-French]">
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<meta name="citation_keywords" content="Ciprofloxacinum [INN-Latin]">
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<meta name="citation_keywords" content="Ciprofloxacino [INN-Spanish]">
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<meta name="citation_keywords" content="CCRIS 5241">
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<meta name="citation_keywords" content="HSDB 6987">
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<meta name="citation_keywords" content="Linhaliq [Liposomal Formulation]">
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<meta name="citation_keywords" content="BRN 3568352">
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<meta name="citation_keywords" content="Ciprofloxacin [USAN:USP:INN:BAN]">
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<meta name="citation_keywords" content="1-Cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic acid">
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<meta name="citation_keywords" content="CIPROFLOXACIN EXTENDED RELEASE">
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<meta name="citation_keywords" content="CIPRO IN DEXTROSE 5% IN PLASTIC CONTAINER">
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<meta name="citation_keywords" content="1-Cyclopropyl-6-fluoro-4-oxo-7-(1-piperazinyl)-1,4-dihydro-3-quinolinecarboxylic acid">
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<meta name="citation_keywords" content="3-Quinolinecarboxylic acid, 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-">
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<meta name="citation_keywords" content="CIPRO IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER">
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<meta name="citation_keywords" content="3-Quinolinecarboxylic acid, 1,4-dihydro-1-cyclopropyl-6-fluoro-4-oxo-7-(1-piperazinyl)-">
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<meta name="DC.Title" content="Ciprofloxacin">
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<meta name="DC.Publisher" content="National Institute of Child Health and Human Development">
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<meta name="DC.Date" content="2024/08/15">
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<meta name="description" content="Amounts of ciprofloxacin in breastmilk are low. Fluoroquinolones such as ciprofloxacin have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, studies indicate little risk.[1] The calcium in milk might decrease absorption of the small amounts of fluoroquinolones in milk,[2] but insufficient data exist to prove or disprove this assertion. Use of ciprofloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Avoiding breastfeeding for 3 to 4 hours after a dose should decrease the exposure of the infant to ciprofloxacin in breastmilk.">
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<meta name="og:description" content="Amounts of ciprofloxacin in breastmilk are low. Fluoroquinolones such as ciprofloxacin have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, studies indicate little risk.[1] The calcium in milk might decrease absorption of the small amounts of fluoroquinolones in milk,[2] but insufficient data exist to prove or disprove this assertion. Use of ciprofloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Avoiding breastfeeding for 3 to 4 hours after a dose should decrease the exposure of the infant to ciprofloxacin in breastmilk.">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501583_"><span class="title" itemprop="name">Ciprofloxacin</span></h1><p class="fm-aai"><a href="#_NBK501583_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 3 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 85721-33-1</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/135014474" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135014474" alt="image 135014474 in the ncbi pubchem database" /></a><div id="LM69.Drug_Levels_and_Effects"><h2 id="_LM69_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM69.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Amounts of ciprofloxacin in breastmilk are low. Fluoroquinolones such as ciprofloxacin have traditionally not been used in infants because of concern about adverse effects on the infants' developing joints. However, studies indicate little risk.[<a class="bibr" href="#LM69.REF.1" rid="LM69.REF.1">1</a>] The calcium in milk might decrease absorption of the small amounts of fluoroquinolones in milk,[<a class="bibr" href="#LM69.REF.2" rid="LM69.REF.2">2</a>] but insufficient data exist to prove or disprove this assertion. Use of ciprofloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Avoiding breastfeeding for 3 to 4 hours after a dose should decrease the exposure of the infant to ciprofloxacin in breastmilk.</p><p>Maternal use of an ear drop or eye drop that contains ciprofloxacin presents negligible risk for the nursing infant. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.</p></div><div id="LM69.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Ten lactating women (time postpartum not stated) were given ciprofloxacin 750 mg orally every 12 hours for 3 doses. Milk ciprofloxacin was measured after the third dose. The highest levels averaging 3.79 mg/L occurred 2 hours after the dose. Average milk levels then fell as follows: 2.26 mg/L at 4 hours; 0.86 mg/L at 6 hours, 0.51 mg/L at 9 hours; 0.2 mg/L at 12 hours; and 0.02 mg/L at 24 hours after the dose.[<a class="bibr" href="#LM69.REF.3" rid="LM69.REF.3">3</a>] Using the peak milk level data from this study, an exclusively breastfed infant would receive an estimated maximum of 0.57 mg/kg daily with this maternal dosage regimen. This dosage is much lower than the 10 to 40 mg/kg daily used in treating newborn infants.[<a class="bibr" href="#LM69.REF.1" rid="LM69.REF.1">1</a>]</p><p>One mother who was recovering from acute renal failure was given a single dose of ciprofloxacin 500 mg orally with a prenatal vitamin and ferrous sulfate which would be expected to decrease ciprofloxacin bioavailability. Milk levels were 3.5 mg/L at 4, 8 and 12 hours after the dose and 2.3 mg/L 16 hours after the dose.[<a class="bibr" href="#LM69.REF.4" rid="LM69.REF.4">4</a>] Levels were probably elevated and elimination prolonged by the woman's impaired renal function.</p><p>A woman took ciprofloxacin 500 mg daily orally for 10 days. At 10 hours and 40 minutes after the last dose, ciprofloxacin was 0.98 mg/L in breastmilk.[<a class="bibr" href="#LM69.REF.5" rid="LM69.REF.5">5</a>]</p><p><i>Infant Levels.</i> A woman took ciprofloxacin 500 mg daily orally for 10 days. Her infant, who breastfed once 8 hours after the dose, had no detectable ciprofloxacin (<30 mcg/L) in her serum 2.7 hours after nursing.[<a class="bibr" href="#LM69.REF.5" rid="LM69.REF.5">5</a>]</p></div><div id="LM69.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>A case of pseudomembranous colitis in a 2-month-old breastfed infant with a history of necrotizing enterocolitis was probably caused by maternal self-treatment with ciprofloxacin.[<a class="bibr" href="#LM69.REF.6" rid="LM69.REF.6">6</a>]</p><p>Ciprofloxacin was used as part of multi-drug regimens to treat three pregnant women with multidrug-resistant tuberculosis throughout pregnancy and postpartum. Their three infants were breastfed (extent and duration not stated). At age 1.25, 1.8 and 3.9 years, the children were developing normally except for one who had failure to thrive, possibly due to tuberculosis contracted after birth.[<a class="bibr" href="#LM69.REF.7" rid="LM69.REF.7">7</a>]</p></div><div id="LM69.Effects_on_Lactation_and_Breastmilk"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM69.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p>(Urinary Tract) <a href="/books/n/lactmed/LM157/?report=reader">Levofloxacin</a>, <a href="/books/n/lactmed/LM202/?report=reader">Nitrofurantoin</a>, <a href="/books/n/lactmed/LM414/?report=reader">Trimethoprim</a>; (Ophthalmic) <a href="/books/n/lactmed/LM157/?report=reader">Levofloxacin</a>, <a href="/books/n/lactmed/LM204/?report=reader">Ofloxacin</a></p></div><div id="LM69.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM69.REF.1">Kaguelidou
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F, Turner
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MA, Choonara
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I, et al.
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Ciprofloxacin use in neonates: A systematic review of the literature.
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Pediatr Infect Dis J
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2011;30:e29-37.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/21048525" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21048525</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM69.REF.2">Fleiss
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PM. The effect of maternal medications on breast-feeding infants.
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J Hum Lact
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1992;8:7.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/1558663" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1558663</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM69.REF.3">Giamarellou
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H, Kolokythas
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E, Petrikkos
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G, et al.
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Pharmacokinetics of three newer quinolones in pregnant and lactating women.
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Am J Med
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1989;87 (Suppl 5A):49S-51S.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/2589384" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2589384</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM69.REF.4">Cover
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DL, Mueller
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BA. Ciprofloxacin penetration into human breast milk: A case report.
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DICP
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1990;24:703-4.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/2375140" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2375140</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM69.REF.5">Gardner
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DK, Gabbe
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SG, Harter
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C. Simultaneous concentrations of ciprofloxacin in breast milk and in serum in mother and breast-fed infant.
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Clin Pharm
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1992;11:352-4.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/1563233" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1563233</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="LM69.REF.6">Harmon
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T, Burkhart
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G, Applebaum
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H. Perforated pseudomembranous colitis in the breast-fed infant.
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J Pediatr Surg
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1992;27:744-6.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/1501036" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1501036</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="LM69.REF.7">Drobac
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PC, del Castillo
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H, Sweetland
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A, et al.
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Treatment of multidrug-resistant tuberculosis during pregnancy: Long-term follow-up of 6 children with intrauterine exposure to second-line agents.
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Clin Infect Dis
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2005;40:1689-92.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/15889370" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15889370</span></a>]</div></dd></dl></dl></div></div><div id="LM69.Substance_Identification"><h2 id="_LM69_Substance_Identification_">Substance Identification</h2><div id="LM69.Substance_Name"><h3>Substance Name</h3><p>Ciprofloxacin</p></div><div id="LM69.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>85721-33-1</p></div><div id="LM69.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Anti-Infective Agents</p><p>Antibacterial Agents</p><p>Quinolones</p><p>Fluoroquinolones</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501583_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">August 15, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Ciprofloxacin. [Updated 2024 Aug 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/cipaglucosidase/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM621/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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