Generic Name: levofloxacin (LEE-voe-FLOX-a-sin)
Brand Name: Levaquin
Levofloxacin is associated with an increased risk of tendon problems. These include pain, swelling, inflammation, and possible breakage of tendons. The risk of tendon problems is greater in patients who are older than 60 years old, patients who take corticosteroids (eg, prednisone), and in those who have received kidney, heart, or lung transplants. The Achilles tendon in the back of the foot/ankle is most often affected. However, problems may also occur in other tendons (eg, in the shoulder, arm, or hand). Problems may occur while you take levofloxacin or up to several months after you stop taking it.
Signs of tendon problems may include pain, soreness, redness, or swelling of a tendon or joint; bruising right after an injury in a tendon area; hearing or feeling a snap or pop in a joint or tendon area; or inability to move or bear weight on a joint or tendon area. Tell your doctor right away if you experience any of these symptoms while you take levofloxacin or within several months after you stop taking it.
Levofloxacin may worsen muscle weakness and breathing problems in patients with myasthenia gravis. Do not take levofloxacin if you have a history of myasthenia gravis.
Levofloxacin is used for:
Treating infections caused by certain bacteria. It is also used to prevent or treat anthrax or plague in certain patients.
Levofloxacin is a quinolone antibiotic. It works by killing sensitive bacteria.
Do NOT use levofloxacin if:
- you are allergic to any ingredient in levofloxacin or to any other quinolone antibiotic (eg, ciprofloxacin)
- you have a certain type of irregular heartbeat (QT prolongation, long QT syndrome) or low blood potassium levels
- you have a history of myasthenia gravis
- you are taking certain antiarrhythmics (eg, amiodarone, procainamide, quinidine, sotalol), asenapine, cisapride, nilotinib, or tetrabenazine
Contact your doctor or health care provider right away if any of these apply to you.
Before using levofloxacin:
Some medical conditions may interact with levofloxacin. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of severe or persistent diarrhea, skin sensitivity to the sun, diabetes or high blood sugar, low blood sugar, low blood potassium levels, chest pain, angina, heart problems (eg, enlarged heart, heart failure), a heart attack, irregular heartbeat, or if you have a family member with a history of irregular heartbeat (eg, QT prolongation)
- if you have a stomach infection, brain or nervous system problems, myasthenia gravis, increased pressure in the brain, brain blood vessel problems, or a history of seizures
- if you have a history of bone, joint, or tendon problems; rheumatoid arthritis; liver problems; kidney problems or decreased kidney function; myasthenia gravis; nerve problems; or a heart, kidney, or lung transplant
- if you participate in strenuous physical work or exercise
- if you take any medicines that may increase the risk of seizures. Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of seizures
Some MEDICINES MAY INTERACT with levofloxacin. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Antiarrhythmics (eg, amiodarone, dofetilide, procainamide, quinidine, sotalol), arsenic, asenapine, bepridil, chloroquine, cisapride, citalopram, clozapine, crizotinib, dolasetron, droperidol, halofantrine, haloperidol, iloperidone, imidazoles (eg, fluconazole, ketoconazole), macrolides (eg, erythromycin), maprotiline, methadone, nilotinib, ondansetron, paliperidone, pentamidine, phenothiazines (eg, chlorpromazine), pimozide, quetiapine, romidepsin, tacrolimus, telithromycin, tetrabenazine, toremifene, tricyclic antidepressants (eg, nortriptyline), tyrosine kinase inhibitors (eg, sunitinib), vandetanib, or ziprasidone because the risk of serious heart problems, including irregular heartbeat, may be increased
- Insulin or oral diabetes medicines (eg, glyburide) because the risk of high or low blood sugar may be increased
- Corticosteroids (eg, prednisone) because the risk of tendon problems may be increased
- Anticoagulants (eg, warfarin) because the risk of bleeding may be increased
- Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) or theophylline because the risk of serious side effects, including seizures, may be increased
This may not be a complete list of all interactions that may occur. Ask your health care provider if levofloxacin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use levofloxacin:
Use levofloxacin as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Levofloxacin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get levofloxacin refilled.
- Drinking extra fluids while you are taking levofloxacin is recommended. Check with your doctor for instructions.
- Levofloxacin is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using levofloxacin at home, a health care provider will teach you how to use it. Be sure you understand how to use levofloxacin. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
- Do not use levofloxacin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
- Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
- Levofloxacin works best if it is used at the same time each day.
- To clear up your infection completely, use levofloxacin for the full course of treatment. Keep using it even if you feel better in a few days.
- Do not miss any doses of levofloxacin. If you miss a dose of levofloxacin, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once or more than 1 dose in 1 day.
Ask your health care provider any questions you may have about how to use levofloxacin.
Important safety information:
- Levofloxacin may cause dizziness or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use levofloxacin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
- Nerve problems in the arms, hands, legs, or feet can happen in people taking levofloxacin. These nerve problems can happen soon after levofloxacin is started and may be permanent. Call your doctor right away if you have symptoms or nerve problems (eg, not able to handle heat or cold; decreased sensation of touch; unusual burning, numbness, tingling, pain, or weakness of the arms, hands, legs, or feet).
- Levofloxacin only works against bacteria; it does not treat viral infections (eg, the common cold).
- Be sure to use levofloxacin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
- Long-term or repeated use of levofloxacin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
- Tell your doctor right away if you experience pain or swelling of a tendon or weakness or loss of use of a joint area. Rest the area and avoid exercise until further instruction from your doctor.
- Levofloxacin may cause you to become sunburned more easily. Avoid sunlamps or tanning booths, and try to limit your time in the sun. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Do not receive a live vaccine (eg, typhoid) while you are taking levofloxacin. Talk with your doctor before you receive any vaccine.
- Diabetes patients - Levofloxacin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Levofloxacin may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using levofloxacin.
- Lab tests, including liver and kidney function and complete blood cell counts, may be performed while you use levofloxacin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use levofloxacin with caution in the ELDERLY; they may be more sensitive to its effects, especially tendon problems, irregular heartbeat, and liver problems.
- Levofloxacin should be used with extreme caution in CHILDREN younger than 18 years old; they may be more sensitive to its effects, especially joint and tendon problems.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using levofloxacin while you are pregnant. Levofloxacin is found in breast milk. Do not breast-feed while using levofloxacin.
Possible side effects of levofloxacin:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Constipation; diarrhea; dizziness; gas; headache; nausea; trouble sleeping.
Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest or throat; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bloody or tarry stools; chest pain; decreased or painful urination; fainting; fast or irregular heartbeat; fever, chills, persistent sore throat, or unusual cough; hallucinations; inability to move or bear weight on a joint or tendon area; moderate or severe sunburn; mood or mental changes (eg, new or worsening anxiety, nervousness, agitation, confusion, depression, paranoia, restlessness, sleeplessness); muscle pain or weakness; new or worsening nightmares; pain, soreness, redness, swelling, weakness, or bruising of a tendon or joint area; red, swollen, blistered, or peeling skin; seizures; severe or persistent diarrhea; severe or persistent dizziness, light-headedness, headache, tiredness, or weakness; severe or persistent stomach pain or cramps; shortness of breath or trouble breathing; suicidal thoughts or actions; symptoms of high or low blood sugar (eg, dizziness; fainting; fast breathing; flushing; increased thirst, hunger, or urination; increased sweating; vision changes); symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, stomach pain, unusual nausea or vomiting, yellowing of the skin or eyes); tremors; unusual bruising or bleeding; vaginal discharge, irritation, or odor; vision changes (eg, blurred vision); wheezing.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of levofloxacin:
Levofloxacin is usually handled and stored by a health care provider. If you are using levofloxacin at home, store levofloxacin as directed by your pharmacist or health care provider. Keep levofloxacin out of the reach of children and away from pets.
- If you have any questions about levofloxacin, please talk with your doctor, pharmacist, or other health care provider.
- Levofloxacin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take levofloxacin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about levofloxacin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to levofloxacin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using levofloxacin.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
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