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- What is Levaquin, and how does it work?
- Is this drug available as in generic form?
- Do I need a prescription for this drug?
- Why is Levaquin prescribed (uses)?
- What are the side effects of Levaquin?
- What are the serious side effects adverse effects of Levaquin?
- What is the dosage for for Levaquin, and how should I take it?
- Which drugs or supplements interact with this drug?
- Is this drug safe to take if I'm pregnant or breastfeeding?
- What else should I know about this medication?
What is Levaquin, and how does it work?
Levaquin (brand name) or levofloxacin (generic name) is an antibiotic that is used 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. Levaquin 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)
- lomefloxacin (Maxaquin)
The FDA approved levofloxacin in December 1996.
Do I need a prescription for this drug?
Yes, you need a prescription from your doctor or pharmacist for this drug.
Why is Levaquin prescribed (uses)?
- Levaquin is used to treat infections of the sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible bacteria.
- Levaquin also is frequently used to treat urinary infections, including those resistant to other antibiotics, as well as prostatitis (infection of the prostate).
- Levaquin is effective in treating infectious diarrhea caused by E. coli, Campylobacter jejuni, and Shigella bacteria.
- Levaquin also can be used to treat various obstetric infections, including mastitis (infection of the breast).
- Inhalational anthrax exposure also is treated with Levaquin.
What are the side effects of Levaquin?
Serious side effects and warnings include:
- Levaquin 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.
- Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.
The most frequently reported side effects are:
Less common side effects include:
Rare allergic reactions have been described are:
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What are the serious side effects adverse effects of Levaquin?Possible serious side effects of Levaquin include:
- Peripheral neuropathy
- Central nervous system effects
- Clostridium difficile-associated diarrhea (CDAD)
- Abnormal heart beats
- Liver dysfunction
- Sun sensitivity
Other serious side effects and adverse events of Levaquin include:
- Levaquin should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Levaquin.
- Levaquin should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.
- Many antibiotics, including Levaquin, 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 Levaquin (diarrhea, fever, abdominal pain, and possibly shock) should contact their physician immediately.
- Patients taking Levaquin can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.
- Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]).
- Because of serious side effects associate with fluoroquinolones, they should not be used for treating uncomplicated urinary tract infections, acute bacterial exacerbation of chronic bronchitis or acute bacterial sinusitis unless there are no other alternatives.
What is the dosage for for Levaquin, and how should I take it?
- The usual dose is 250-750 mg given once daily for 3-14 days depending on the type of infection.
- Anthrax is treated with 500 mg daily for 60 days.
- 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 Levaquin and prevent its absorption into the body.
Which drugs or supplements interact with this drug?
- Iron, calcium, zinc, or magnesium can attach to Levaquin 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 Levaquin. Other drugs that contain these minerals and can similarly interact with Levaquin include sucralfate (Carafate) and didanosine (Videx, Videx EC).
- Taking nonsteroidal anti-inflammatory drugs (NSAIDs) with Levaquin 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 the effect of warfarin (Coumadin, Jantoven).
Is this drug safe to take if I'm pregnant or breastfeeding?
What else should I know about this medication?
- Preparations for Levaquin are:
- Tablets: 250, 500 and 750 mg
- Oral solution: 25 mg/mL
- Injection: 500 mg/20 ml and 750 mg/30 ml
- Premix ready to use injection: 250 mg/50 ml, 500 mg/100 ml, and 750 mg/150 ml
- Levaquin should be stored at 15 C to 30 C (59 F to 86 F)
Reference: FDA Prescribing Information
- Urinary tract infections
- Diarrhea caused by E. coli
- Campylobacter jejuni
- Acute bacterial sinusitis
- Acute bacterial exacerbation of chronic bronchitis
- Anthrax inhalation
- Complicated skin and skin structure infections like cellulitis, impetigo, and wound infections due to methicillin-susceptible Staphylococcus aureus, or Streptococcus pyogenes.
Common side effects are rash, intestinal gas, vaginal itching or discharge, headache, nausea, vomiting, and diarrhea. Iron, calcium, zinc, nonsteroidal anti-inflammatory drugs (NSAIDs), and warfarin (Coumadin, Jantoven) interact with Levaquin. It also has been associated with tendonitis and tendon rupture; abnormal heart beats, and liver dysfunction. Levaquin is available as an oral solution of 25 mg/mL, clear greenish-yellow color. Talk with your doctor, pharmacist, or other health care professional if you have any questions about this drug.
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Medications & Supplements
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AnthraxAnthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flu-like and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, erythromycin, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
BioterrorismBioterrorism is a form of terrorism where there is the intentional release of biological agents such as viruses, germs, or bacteria. Diseases caused by bioterrorism agents include anthrax, botulism, plague, smallpox, tularemia, brucellosis, food poisoning, Q fever, ricin toxin poisoning, cholera, epidemic typhus, viral encephalitis, XDR TB, and MDR TB.
Ciprofloxacin (generic name), Cipro, Cipro XR (brand names) is an antibiotic prescribed for the treatment of many skin, lung, airway, bone, and joint infections caused by susceptible bacteria. Examples include:
- Complicated urinary tract infections (UTIs)
- Chronic bacterial prostatitis
- Typhoid fever
- Chronic bronchitis
- Infectious diarrhea caused by E. coli, Shigella, and Campylobacter jejuni.
- Anthrax patients
- TB (tuberculosis)
Cipro should not be used for treating uncomplicated UTIs, acute bacterial chronic bronchitis, or acute bacterial sinusitis because of the serious side effects it may cause.
The FDA has issued a warning for fluoroquinolenes like Cipro because they have been associated with some serious adverse reactions, for example:
- Tendinitis or tendon rupture, particularly the Achilles tendon
- It can worsen weakness in people with a disease called myasthenia gravis.
- Peripheral neuropathy
- CNS problems, for example, nervousness, agitation, dizziness, paranoia, hallucinations, nightmares, and anxiety
Common side effects of include:
- Abdominal pain
Other possible serious side effects and adverse events include:
- Liver dysfunction or failure
- High blood sugar (hyperglycemia)
- Renal failure (kidney failure)
- Cardiac arrest
- C. difficile associated diarrhea.
- Respiratory failure
- Anaphylaxis (shock)
This medicine interacts with drugs, for example:
- Diabetes medications
- theophylline (Respbid, Slo-Bid, Theo-24, Theolair)
- warfarin (Coumadin, Jantoven).
- Iron salts (sulfates)
- Sevelamer (Renagel)
- sildenafil (Viagra)
Doctors don't know if Cipro is safe to take if you are pregnant or breastfeeding. The dosage of this drug depends upon the type of bacterial infection you have. The brand name Proquin XR has been discontinued and is no longer available in the US.
Clostridium Difficile ColitisClostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found:
- on bedpans,
- toilet seats,
- rooms, and
- diaper pails.
- replenishment of electrolyte deficiencies,
- discontinuing the antibiotic that caused the colitis, and
- using antibiotics to eradicate the C. difficile bacterium.
DiarrheaDiarrhea is a change is the frequency and looseness of bowel movements. Symptoms associated with diarrhea are cramping, abdominal pain, and the sensation of rectal urgency. Causes of diarrhea include viral, bacterial, or parasite infection, gastroenteritis, food poisoning, and drugs. Absorbents and anti-motility medications are used to treat diarrhea.
E. Coli 0157:H7There are many types of E. coli (Escherichia coli ). E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
FolliculitisFolliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas may infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Folliculitis PictureAn infection of the hair follicles of the skin. See a picture of Folliculitis and learn more about the health topic.
Jock ItchJock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Legionnaire Disease and Pontiac FeverLegionellosis is an infection caused by the Legionella pneumophila bacterium. There are two forms of legionellosis: Pontiac fever and Legionnaires' disease, which is the more severe of the two infections. Symptoms of Pontiac fever include fever, headache, muscle aches, and chills. Symptoms of Legionnaires' disease include cough, chills, fever and sometimes muscle aches, headaches, loss of appetite, diarrhea, and severe pneumonia. While Pontiac fever resolves on its own, Legionnaires' disease must be treated with antibiotics.
ofloxacinOfloxacin (Floxin [Discontinued Brand]) is a medication prescribed for the treatment of pneumonia, bronchitis, staph infections, STDs (gonorrhea, chlamydia), urinary tract infections, and prostate infections caused by E. coli. Side effects, drug interactions, and pregnancy information should be reviewed prior to taking this medication.
Peptic or stomach ulcers are ulcers are an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to H. pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking. Symptoms of peptic or stomach ulcers include:
- Abdominal burning or hunger pain
- Abdominal discomfort after meals
Treatment for stomach ulcers depends upon the cause.
Prostatitis (Inflammation of the Prostate Gland)Prostatitis is an inflammation of the prostate gland. Causes of prostatitis include
- bacteria from urinary tract infections, or
- e. Coli.
- painful or difficulty urinating;
- body aches;
- blood in the urine;
- pain in the rectum;
- groin, abdomen, or low back;
- and painful ejaculation or sexual dysfunction.
SinusitisSinus infection (sinusitis) is caused by allergies, infection, and chemicals or other irritants of sinuses. Signs and symptoms are headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Small Intestinal Bacterial Overgrowth (SIBO)
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine, but they are more like the bacteria that are found in the colon. There are many conditions associated with SIBO, including:
- Crohn's disease
- Irritable bowel syndrome (IBS)
It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome.
Symptoms of SIBO include:
- Excess gas
- Abdominal bloating
- Abdominal pain
Treatment for SIBO can include:
- Low FODMAP Diet
Urinary Tract InfectionA urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency and frequency. Treatment involves a course of antibiotics.