Levofloxacin

💊 What is Levofloxacin used for?

• •Pneumonia, both nosocomial (hospital-acquired) and community-acquired
• •Complicated and uncomplicated skin and skin structure infections
• •Chronic bacterial prostatitis (long-term prostate infection)
• •Inhalational anthrax, after exposure, in adults and pediatric patients
• •Plague in adults and pediatric patients
• •Complicated and uncomplicated urinary tract infections
• •Acute pyelonephritis (kidney infection)
• •Acute bacterial exacerbation of chronic bronchitis
• •Acute bacterial sinusitis

How it works

How it is usually taken

• •The label describes levofloxacin as a tablet taken by mouth. It is usually taken once every 24 hours, and the schedule and length of treatment depend on the type of infection. The label says it should be used only for infections that are proven or strongly suspected to be caused by bacteria. Taking it within two hours of certain antacids, minerals, or other products can reduce how much medicine the body absorbs (see the interactions section). The label also says that adequate fluid intake (hydration) should be maintained during treatment. Follow the instructions from your prescriber or pharmacist.

Comes as

• •250 mg tablets (white, film-coated)
• •500 mg tablets (orange, film-coated)
• •750 mg tablets (yellow, film-coated)

⚠️ Levofloxacin side effects

🛑 Who should not take Levofloxacin, and who should be careful

The label says not to take it if

• 🚨The label says not to take levofloxacin if you have had a known allergic reaction (hypersensitivity) to levofloxacin or other quinolone antibacterials.
• 🚨The label says to avoid levofloxacin if you have a known history of myasthenia gravis.
• 🚨The label says to avoid levofloxacin if you have a history of tendon disorders or tendon rupture.
• 🚨The label says to avoid fluoroquinolones in anyone who has had a serious adverse reaction to them.
• 🚨The label says levofloxacin should not be used for uncomplicated urinary tract infections, acute bacterial exacerbation of chronic bronchitis, or acute bacterial sinusitis when other treatment options are available.

Tell your doctor before taking it if

• •Tell your prescriber if you have ever had a severe allergic reaction to levofloxacin or another quinolone antibiotic.
• •Tell your prescriber if you have a history of mental health problems, including depression, or a history of seizures.
• •Tell your prescriber if you have myasthenia gravis.
• •Tell your prescriber if you have a history of tendon problems, rheumatoid arthritis, or kidney, heart, or lung transplant.
• •Tell your prescriber if you are over 60 or take corticosteroid medicines, since the label says these raise the risk of tendon problems.
• •Tell your prescriber about kidney problems, since the label says doses may need adjusting when kidney function is reduced.
• •Tell your prescriber about a history of an irregular heartbeat (QT interval prolongation), low potassium (hypokalemia), or diabetes.
• •The label says it is not known if levofloxacin is safe and effective in children under 6 months of age. It is used in children only in certain situations, and the label says it should be given to pediatric patients weighing 30 kg or more.

🔀 Levofloxacin with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Antacids containing magnesium or aluminum, sucralfate, iron, multivitamins with zinc, and didanosine can reduce absorption of levofloxacin. The label says to take these at least two hours before or two hours after levofloxacin.
• •Warfarin: levofloxacin may increase the effect of warfarin. The label says blood tests (prothrombin time or INR) should be closely monitored, and you should be watched for bleeding.
• •Antidiabetic medicines: the label says blood glucose should be carefully monitored when these are used together with levofloxacin.
• •Other drugs that prolong the QT interval: the label says to avoid use with these.
• •Corticosteroids: the label lists these as increasing the risk of tendon problems.

Alcohol and food

The label does not give guidance about alcohol. The label does say that antacids, sucralfate, iron, zinc-containing multivitamins, and didanosine can reduce how well levofloxacin is absorbed, so they should be taken at least two hours apart from the medicine. Follow the instructions from your prescriber or pharmacist.

🤰 Levofloxacin in pregnancy and breastfeeding

Pregnancy

The label says published information has not identified a drug-associated risk of major birth defects, miscarriage, or other adverse outcomes in pregnancies where levofloxacin was used. Animal studies in rats and rabbits did not show birth defects at the doses tested, but fetal toxicity was seen in one rat study at high doses. The label says the background risk for the indicated population is unknown. Talk with your prescriber or pharmacist about any questions regarding pregnancy.

Breastfeeding

The label does not say.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store levofloxacin tablets at 20 to 25 degrees C (68 to 77 degrees F), which it describes as controlled room temperature. Keep this and all medicines out of reach of children. The label notes that some unit dose packages are not child resistant and are intended for institutional use only.

If a dose is missed

The label does not say.

If too much is taken

The label gives overdose guidance mainly for medical staff. It says the stomach should be emptied, the person should be observed, and appropriate hydration should be maintained. Levofloxacin is not efficiently removed by hemodialysis or peritoneal dialysis. If you think someone has taken too much levofloxacin, get medical help right away.

🗒️ Questions to ask about Levofloxacin

• Is levofloxacin the right choice for my infection, given the warnings about serious side effects?
• Do I have any risk factors for tendon problems, such as being over 60 or taking corticosteroids?
• Should I be concerned about my history of depression, seizures, or myasthenia gravis?
• Which of my other medicines or supplements could interfere with how levofloxacin is absorbed?
• If I take warfarin or a diabetes medicine, how will my blood tests or blood sugar be monitored?
• How long will I need to take levofloxacin, and what should I do if I have side effects?

❓ Levofloxacin: frequently asked questions