What it's for (Indications)
- Levofloxacin is indicated for the treatment of various bacterial infections.
- These include infections of the urinary tract (complicated, uncomplicated, and acute pyelonephritis), respiratory tract infections (nosocomial pneumonia, community-acquired pneumonia), skin and soft tissue infections (complicated and uncomplicated), inhalation anthrax (post-exposure), plague, chronic bacterial prostatitis, pelvic inflammatory disease, otitis externa (swimmer's ear), and bacterial conjunctivitis (pink eye infection).
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Dosage in patients with normal renal function: - Nosocomial Pneumonia: 750 mg every 24 hours for 7 to 14 days. - Community-Acquired Pneumonia: 500 mg every 24 hours for 7 to 14 days, or 750 mg every 24 hours for 5 days. - Complicated Skin and Skin Structure Infections (SSSI): 750 mg every 24 hours for 7 to 14 days. - Uncomplicated SSSI: 500 mg every 24 hours for 7 to 10 days. - Chronic Bacterial Prostatitis: 500 mg every 24 hours for 28 days. - Inhalational Anthrax (Post-Exposure): Adults and pediatric patients > 50 kg receive 500 mg every 24 hours for 60 days. Pediatric patients < 50 kg and ≥ 6 months of age receive 8 mg/kg twice daily (not to exceed 250 mg/dose) for 60 days. - Plague: Adults and pediatric patients > 50 kg receive 500 mg every 24 hours for 10 to 14 days. Pediatric patients < 50 kg and ≥ 6 months of age receive 8 mg/kg twice daily (not to exceed 250 mg/dose) for 10 to 14 days. - Complicated Urinary Tract Infection or Acute Pyelonephritis: 750 mg every 24 hours for 5 days, or 250 mg every 24 hours for 10 days. |
Safety & Warnings
Common Side Effects
- Common side effects include nausea, headache, diarrhea, insomnia (difficulty in sleeping), constipation, dizziness, GI upset, raised liver enzymes, anorexia (loss of appetite), dysgeusia (bad taste), dyspnoea (difficulty in breathing), arthralgia (joint pain), myalgia (muscle pain), tinnitus (ringing in ear), asthenia (weakness), pyrexia (fever), and visual disturbances.
- More serious adverse effects include hepatic (liver) injury, severe skin disorders, tendinitis and tendon rupture, peripheral neuropathy (damage to the nerves outside the brain and spinal cord), central nervous system effects, exacerbation of myasthenia gravis, and severe hypersensitivity reactions.
Serious Warnings
- Black Box Warning: WARNING: SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS. Fluoroquinolones, including Levofloxacin, have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together, including: Tendinitis and tendon rupture, Peripheral neuropathy, Central nervous system effects, and Exacerbation of myasthenia gravis.
- Levofloxacin has been associated with disabling and potentially irreversible serious adverse reactions, including tendinitis and tendon rupture, peripheral neuropathy, central nervous system effects (such as seizures, increased intracranial pressure, psychosis, anxiety, depression, insomnia, and dizziness), and exacerbation of myasthenia gravis.
- Patients should be advised to discontinue the drug immediately if symptoms of tendon disorders or peripheral neuropathy are observed.
- Levofloxacin can cause QT prolongation, a heart rhythm disorder that may lead to dangerous (occasionally fatal) irregular or fast heartbeats, as well as symptoms like fainting and dizziness requiring immediate medical intervention.
- The risk of QT prolongation is increased in patients with certain heart problems (e.
- g.
- , heart failure, sluggish pulse, known QT prolongation on ECG), a family history of specific heart problems (e.
- g.
- , QT prolongation in ECG, sudden cardiac death), low levels of magnesium or potassium in the blood, or when co-administered with other QT-prolonging medications.
- Significant blood sugar fluctuations, including both hypoglycemia and hyperglycemia, can occur, especially in diabetic patients; blood sugar levels should be monitored as prescribed.
- Use with extreme caution in patients with pre-existing medical conditions such as diabetes, joint or tendon issues (e.
- g.
- , bursitis, tendonitis), kidney problems, mental conditions (e.
- g.
- , depression), seizure disorders, specific muscle disorders (myasthenia gravis), nerve disorders (e.
- g.
- , peripheral neuropathy), and blood vessel problems (e.
- g.
- , aneurysm, obstruction of the aorta or any other blood vessels, stiffening of the arteries), Ehlers-Danlos syndrome, or Marfan Syndrome.
- Inform your doctor about all current medications.
- Avoid use during pregnancy and lactation as research suggests potential risks.
- Due to the potential for dizziness, patients should avoid driving or operating machinery immediately after taking levofloxacin.
- Patients with any kind of liver disease or kidney disease should use levofloxacin with extreme caution and under medical supervision.
- The interaction with alcohol is unknown, and medical consultation is advised before consuming alcohol.
How it Works (Mechanism of Action)
Levofloxacin is a member of the fluoroquinolone class of antibacterial agents. It exerts its bactericidal effect by inhibiting bacterial topoisomerase IV and DNA gyrase, enzymes required for DNA replication, transcription, repair, and recombination.