Two medicines, side by side
Ciprofloxacin vs levofloxacin
Ciprofloxacin and levofloxacin are both labeled for bacterial infections and urinary tract infections. Drugs@FDA records approvals of ciprofloxacin since 1987 and of levofloxacin since 1996. Pharmacies paid $0.123 per ciprofloxacin HCl 500 mg tablet and $0.259 per levofloxacin 750 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Ciprofloxacin's other strengths are brand-only: $1.25 per mL (Cipro 5% suspension). How each works, in its label's words: Ciprofloxacin, “Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”; Levofloxacin, “Levofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”
Check it at the source: the ciprofloxacin FDA label on DailyMed (effective March 2, 2026); the levofloxacin FDA label on DailyMed (effective July 10, 2024).
Highlights of the ciprofloxacin record
Ciprofloxacin (Cipro) · label of March 2, 2026
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS
Fluoroquinolones, including CIPRO ® , have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together [see Warnings and Precautions ( 5.1 )], including:
Tendinitis and tendon rupture [see Warnings and Precautions ( 5.2 )].
Peripheral neuropathy [see Warnings and Precautions ( 5.3 )].
Used for
From the label: indicationsCIPRO is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with the following infections caused by designated, susceptible bacteria and in pediatric patients where indicated: • Skin and Skin Structure Infections ( 1.1 ) • Bone and Joint Infections ( 1.2 ) • Complicated Intra-Abdominal Infections ( 1.3 ) • Infectious Diarrhea ( 1.4 ) • Typhoid Fever (Enteric Fever) ( 1.5 ) • […]
On the market
- Earliest approval on file
- October 22, 1987
- Generic labelers
- 54 labelers
- Pharmacy cost
- $0.123 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
Highlights of the levofloxacin record
Levofloxacin (Levaquin) · label of July 10, 2024
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsLevofloxacin is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with infections caused by designated, susceptible bacteria and in pediatric patients where indicated ( 1 , 12.4 ). […]
On the market
- Earliest approval on file
- December 20, 1996
- Generic labelers
- 44 labelers
- Pharmacy cost
- $0.259 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 13
Source: FDA drug labels via openFDA (Ciprofloxacin label of March 2, 2026, Levofloxacin label of July 10, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ciprofloxacin and levofloxacin differ on the record?
How each works, in its label's words: Ciprofloxacin, “Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”; Levofloxacin, “Levofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”
Both are in FDA's class fluoroquinolone antibacterials.
Half-life, in each label's words: Ciprofloxacin, “The serum elimination half-life in subjects with normal renal function is approximately 4 hours.”; Levofloxacin, “The mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single …”
Both labels carry a boxed warning; the records quote them.
Generics: ciprofloxacin since 2004; levofloxacin since 2010 (Drugs@FDA).
| Ciprofloxacin | Levofloxacin | |
|---|---|---|
| Labeled for | Diarrhea, Urinary tract infections, Bacterial infections | Bacterial infections, Urinary tract infections |
| Pharmacologic class | Fluoroquinolone Antibacterial, Quinolone Antimicrobial | Fluoroquinolone Antibacterial |
| How it works (label) | Ciprofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. | Levofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. |
| Half-life (label) | The serum elimination half-life in subjects with normal renal function is approximately 4 hours. | The mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single or multiple doses of levofloxacin given orally or intravenously. |
| Earliest approval on file (Drugs@FDA) | October 22, 1987 | December 20, 1996 |
| First generic approved | March 16, 2004 | December 20, 2010 |
| Generic labelers (NDC) | 54 labelers | 44 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.123 per tablet (Ciprofloxacin HCl 500 mg tablet) | $0.259 per tablet (Levofloxacin 750 mg tablet) |
| 12-month price change | -9% | -11% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 14 | 13 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 96,726 | 59,954 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to ciprofloxacin
- every medicine labeled for the same conditions