
Medical Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.
GENERIC NAME: levofloxacin
BRAND NAME: Levaquin
DRUG CLASS AND MECHANISM: Levofloxacin is an antibiotic for treating
bacterial infections. Many common infections in humans are caused by bacteria.
Bacteria can grow and multiply, infecting different parts of the body. Drugs
that control and eradicate these bacteria are called antibiotics. Levofloxacin
is an antibiotic that stops multiplication of bacteria by preventing the
reproduction and repair of their genetic material, DNA. It is in a class of
antibiotics called fluoroquinolones, a class that includes ciprofloxacin
(Cipro), norfloxacin (Noroxin), ofloxacin (Floxin),
trovafloxacin (Trovan), and
lomefloxacin (Maxaquin). The FDA approved levofloxacin in December 1996.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: Tablets: 250, 500, and 750 mg; Oral solution: 25 mg/mL;
Injection: 5 mg/ml and 25 mg/ml
STORAGE: Levofloxacin should be stored between 15-30 C (59-86 F)
PRESCRIBED FOR: Levofloxacin is used to treat infections of the
sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible
bacteria. Levofloxacin also is frequently used to treat
urinary infections,
including those resistant to other antibiotics, as well as prostatitis
(infection of the prostate). Levofloxacin is effective in treating infectious
diarrhea caused by
E. coli,
Campylobacter jejuni, and
Shigella bacteria.
Levofloxacin also can be used to treat various obstetric infections, including
mastitis (infection of the breast).
DOSING: The usual dose is 250-750 mg given once daily for 5-60 days
depending on the type of infection. It is important to take oral formulations at
least 2 hours before or 2 hours after any antacid or mineral supplement
containing iron, calcium, zinc, or magnesium since these bind levofloxacin and
prevent its absorption into the body.
DRUG INTERACTIONS: Iron, calcium, zinc, or magnesium can attach to
levofloxacin and other fluoroquinolones and prevent their absorption from the
intestine into the blood. Therefore, products (for example, antacids) that
contain iron, calcium, zinc or magnesium should be taken at least 2 hours before
or 2 hours after levofloxacin. Other drugs that contain these minerals and can
similarly interact with levofloxacin include sucralfate (Carafate) and
didanosine (Videx, Videx
EC).
Taking nonsteroidal antiinflammatory drugs (NSAIDs) with levofloxacin may
increase the risk of CNS stimulation, resulting in over-excitation. There have
been reports of changes in blood sugar (increases and decreases) in patients
treated with fluoroquinolones and antidiabetic agents. Fluoroquinolones may
increase blood levels of theophylline (Theodur), cyclosporine (Sandimmune,
Neoral), and the effect of warfarin (Coumadin).
PREGNANCY: Levofloxacin is not recommended for use in
pregnant women
since levofloxacin causes joint and bone deformities in juvenile animals of
several species.
NURSING MOTHERS: Levofloxacin is not recommended for use in lactating
women because of the likelihood that, like other fluoroquinolones, levofloxacin
is excreted in breast-milk.
SIDE EFFECTS: The most frequently reported side events are nausea or
vomiting, diarrhea, headache, and constipation. Less common side effects include
difficulty sleeping, dizziness, abdominal pain, rash, abdominal gas, and
itching.
Rare allergic reactions have been described, such as hives and anaphylaxis
(shock). Levofloxacin should be used with caution in patients with central
nervous system diseases such as seizures, because rare seizures have been
reported in patients receiving levofloxacin. Levofloxacin should be avoided in
children and adolescents less than 18 years of age, as safe use in these
patients has not been established.
Levofloxacin as well as other antibiotics in the fluoroquinolone class of
antibiotics, has been associated with
tendinitis and even rupture of tendons,
particularly the Achilles tendon. Many antibiotics, including levofloxacin, can
alter the normal bacteria in the colon and encourage overgrowth of a bacterium
responsible for the development of inflammation of the colon, (C. difficile or
pseudomembranous colitis). Patients who develop signs of pseudomembranous
colitis after starting levofloxacin (diarrhea, fever, abdominal pain, and
possibly shock) should contact their physician immediately. Patients taking
levofloxacin can develop sensitivity of the skin to direct sunlight
(photosensitivity) and should avoid exposure to sunlight or use sunblock.
Last Editorial Review: 12/15/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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