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Levaquin Dosage

Generic name: levofloxacin 250mg
Dosage form: tablets, oral solution, injection

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Medically reviewed on September 6, 2018.

Dosage of LEVAQUIN® Tablets in Adult Patients with Creatinine Clearance ≥ 50 mL/minute

‚ÄčThe usual dose of LEVAQUIN® Tablets is 250 mg, 500 mg, or 750 mg administered orally every 24 hours, as indicated by infection and described in Table 1.

These recommendations apply to patients with creatinine clearance ≥ 50 mL/minute. For patients with creatinine clearance less than 50 mL/min, adjustments to the dosing regimen are required [see Dosage and Administration (2.3)].

Table 1: Dosage of LEVAQUIN® Tablets in Adult Patients with Creatinine Clearance greater than or equal to 50 mL/minute)
Type of Infection* Dosed Every 24 hours Duration
(days)
*
Due to the designated pathogens [see Indications and Usage (1)].
Sequential therapy (intravenous levofloxacin to oral LEVAQUIN® tablets) may be instituted at the discretion of the healthcare provider.
Due to methicillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae (including multi-drug-resistant isolates [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydophila pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae [see Indications and Usage (1.2)].
§
Due to Streptococcus pneumoniae (excluding multi-drug-resistant isolates [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Mycoplasma pneumoniae, or Chlamydophila pneumoniae [see Indications and Usage (1.3)].
Drug administration should begin as soon as possible after suspected or confirmed exposure to aerosolized B. anthracis. This indication is based on a surrogate endpoint. Levofloxacin plasma concentrations achieved in humans are reasonably likely to predict clinical benefit [see Clinical Studies (14.9)].
#
The safety of LEVAQUIN® in adults for durations of therapy beyond 28 days or in pediatric patients for durations beyond 14 days has not been studied. An increased incidence of musculoskeletal adverse events compared to controls has been observed in pediatric patients [see Warnings and Precautions (5.10), Use in Specific Populations (8.4), and Clinical Studies (14.9)]. Prolonged LEVAQUIN® therapy should only be used when the benefit outweighs the risk.
Þ
Drug administration should begin as soon as possible after suspected or confirmed exposure to Yersinia pestis. Higher doses of LEVAQUIN® typically used for treatment of pneumonia can be used for treatment of plague, if clinically indicated.
ß
This regimen is indicated for cUTI due to Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and AP due to E. coli, including cases with concurrent bacteremia.
à
This regimen is indicated for cUTI due to Enterococcus faecalis, Enterococcus cloacae, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa; and for AP due to E. coli.
Nosocomial Pneumonia 750 mg 7 to 14
Community Acquired Pneumonia 500 mg 7 to 14
Community Acquired Pneumonia§ 750 mg§ 5§
Complicated Skin and Skin Structure Infections (SSSI) 750 mg 7 to 14
Uncomplicated SSSI 500 mg 7 to 10
Chronic Bacterial Prostatitis 500 mg 28
Inhalational Anthrax (Post-Exposure), adult and pediatric patients weighing 50 kg ,# or greater 500 mg 60#
Pediatric patients weighing 30 kg to less than 50 kg,# see Table 2 below (2.2) 60#
Plague, adult and pediatric patients weighing 50 kg Þ or greater 500 mg 10 to 14
Pediatric patients weighing 30 kg to less than 50 kg see Table 2 below (2.2) 10 to 14
Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP)ß 750 mg 5
Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP)à 250 mgà 10à
Uncomplicated Urinary Tract Infection 250 mg 3
Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB) 500 mg 7
Acute Bacterial Sinusitis (ABS) 750 mg 5
500 mg 10 to 14

Dosage of LEVAQUIN® Tablets in Pediatric Patients with Inhalational Anthrax or Plague

The dosage of LEVAQUIN® Tablets for inhalational anthrax (post-exposure) and plague in pediatric patients who weigh 30 kg or greater is described below in Table 2. LEVAQUIN® Tablets cannot be administered to patients who weigh less than 30 kg because of the limitations of the available strength. Alternative formulations of levofloxacin may be considered for pediatric patients who weigh less than 30 kg.

Table 2: LEVAQUIN® Tablets Dosage in Pediatric Patients Weighing 30 kg or greater with Inhalational Anthrax (Post-Exposure) and Plague*
Type of Infection* Dose Frequency Duration
*
Due to Bacillus anthracis [see Indications and Usage (1.13)] and Yersinia pestis [see Indications and Usage (1.14)].
Sequential therapy (intravenous levofloxacin injection to oral LEVAQUIN® Tablets) may be instituted at the discretion of the healthcare provider.
Begin LEVAQUIN® Tablets as soon as possible after suspected or confirmed exposure to aerosolized B. anthracis.
§
The safety of LEVAQUIN® in pediatric patients for durations of therapy beyond 14 days has not been studied. [see Warnings and Precautions (5.10), Use in Specific Populations (8.4), and Clinical Studies (14.9)]. Begin LEVAQUIN® Tablets as soon as possible after suspected or confirmed exposure to Yersinia pestis.
Inhalational Anthrax (post-exposure),§
Pediatric patients weighing 50 kg or greater 500 mg every 24 hours 60 days§
Pediatric patients weighing 30 kg to less than 50 kg 250 mg every 12 hours 60 days§
Plague
Pediatric patients weighing 50 kg or greater 500 mg every 24 hours 10 to 14 days
Pediatric patients weighing 30 kg to less than 50 kg 250 mg every 12 hours 10 to 14 days

Dosage Adjustment in Adults with Renal Impairment

Administer LEVAQUIN® with caution in patients with renal impairment. Careful clinical observation and appropriate laboratory studies should be performed prior to and during therapy since elimination of levofloxacin may be reduced in these patients.

In patients with renal impairment (creatinine clearance less than 50 mL/min), adjustment of the dosage regimen is necessary to avoid the accumulation of levofloxacin due to decreased clearance [see Use in Specific Populations (8.6)]. No adjustment is necessary for patients with a creatinine clearance greater than or equal to 50 mL/minute.

Table 3 shows how to adjust dose based on creatinine clearance.

Table 3: Dosage Adjustment in Adult Patients with Renal Impairment (Creatinine Clearance less than 50 mL/minute)
Creatinine Clearance greater than or equal to 50 mL/minute Creatinine Clearance 20 to 49 mL/minute Creatinine Clearance 10 to 19 mL/minute Hemodialysis or Chronic Ambulatory Peritoneal Dialysis (CAPD)
750 mg every 24 hours 750 mg every 48 hours 750 mg initial dose, then 500 mg every 48 hours 750 mg initial dose, then 500 mg every 48 hours
500 mg every 24 hours 500 mg initial dose, then 250 mg every 24 hours 500 mg initial dose, then 250 mg every 48 hours 500 mg initial dose, then 250 mg every 48 hours
250 mg every 24 hours No dosage adjustment required 250 mg every 48 hours.
If treating uncomplicated UTI, then no dosage adjustment is required
No information on dosing adjustment is available

Drug Interaction With Chelation Agents: Antacids, Sucralfate, Metal Cations, Multivitamins

LEVAQUIN® Tablets should be administered at least two hours before or two hours after antacids containing magnesium, aluminum, as well as sucralfate, metal cations such as iron, and multivitamin preparations with zinc or didanosine chewable/buffered tablets or the pediatric powder for oral solution [see Drug Interactions (7.1) and Patient Counseling Information (17)].

Administration Instructions

LEVAQUIN® Tablets can be administered without regard to food.

Hydration for Patients Receiving LEVAQUIN® Tablets

Adequate hydration of patients receiving LEVAQUIN® should be maintained to prevent the formation of highly concentrated urine. Crystalluria and cylindruria have been reported with quinolones [see Adverse Reactions (6.1) and Patient Counseling Information (17)].

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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