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Levofloxacin (Ophthalmic)

Medically reviewed by Last updated on May 20, 2020.


(lee voe FLOKS a sin)

Index Terms

  • Iquix
  • Quixin

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic:

Generic: 0.5% (5 mL)

Pharmacologic Category

  • Antibiotic, Fluoroquinolone
  • Antibiotic, Ophthalmic


Levofloxacin is the L-isomer of ofloxacin. Levofloxacin inhibits DNA-gyrase and topoisomerase IV in susceptible organisms and thereby inhibits relaxation of supercoiled DNA and promotes breakage of DNA strands. DNA gyrase (topoisomerase II), is an essential bacterial enzyme that maintains the superhelical structure of DNA and is required for DNA replication, transcription, repair, and recombination.


Only small amounts are absorbed systemically after ophthalmic instillation

Use: Labeled Indications

Bacterial conjunctivitis: Treatment of bacterial conjunctivitis caused by susceptible strains of Corynebacterium species, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus groups C/F, Streptococcus group G, Viridans group streptococci, Acinetobacter lwoffii, Haemophilus influenzae, and Serratia marcescens.


Hypersensitivity to levofloxacin, other quinolones, or to any component of the formulation.

Dosing: Adult

Bacterial conjunctivitis: Ophthalmic:

Treatment day 1 and day 2: Instill 1 to 2 drops into affected eye(s) every 2 hours while awake, up to 8 times daily

Treatment day 3 through day 7: Instill 1 to 2 drops into affected eye(s) every 4 hours while awake, up to 4 times daily

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Bacterial conjunctivitis: Children and Adolescents: Ophthalmic: 0.5% solution:

Day 1 and 2: Instill 1 to 2 drops into affected eye(s) every 2 hours while awake, up to 8 times/day

Day 3 to 7: Instill 1 to 2 drops into affected eye(s) every 4 hours while awake, up to 4 times/day


For topical ophthalmic use only; not for injection. Avoid touching tip of applicator to eye or other surfaces.


Store at 20°C to 25°C (68°F to 77°F).

Drug Interactions

There are no known significant interactions.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Central nervous system: Headache (1% to 3%)

Ophthalmic: Burning sensation of eyes (transient, 1% to 3%), eye pain (1% to 3%), foreign body sensation of eye (1% to 3%), photophobia (1% to 3%), vision loss (transient, 1% to 3%)

Respiratory: Pharyngitis (1% to 3%)

Miscellaneous: Fever (1% to 3%)

<1%, postmarketing, and/or case reports: Dry eye syndrome, eyelid edema, eye pruritus, hypersensitivity reaction


Concerns related to adverse effects:

• Hypersensitivity: Serious hypersensitivity reactions, including anaphylaxis, have been reported with systemic quinolone therapy. Prompt discontinuation of drug should occur if skin rash or other symptoms arise.

• Superinfection: Prolonged use may lead to overgrowth of nonsusceptible organisms, including fungi. Discontinue use and institute appropriate alternative therapy if superinfection is suspected.

Other warnings/precautions:

• Appropriate use: For topical use only. Do not inject subconjunctivally or introduce into anterior chamber of the eye. Contact lenses should not be worn during treatment for bacterial conjunctivitis.

Pregnancy Risk Factor


Pregnancy Considerations

Adverse events have been observed in some animal reproduction studies. When administered orally or IV, levofloxacin crosses the placenta (Ozyüncü and Beksac 2010; Ozyüncü and Nemutlu 2010). The amount of levofloxacin available systemically following topical application of the ophthalmic drops is significantly less in comparison to oral or IV doses. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion for 3 to 5 minutes after application to decrease potential exposure to the fetus (Samples 1988).

Patient Education

What is this drug used for?

• It is used to treat eye infections.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Burning

• Headache

• Foreign body sensation in eye

• Sensitivity to light

• Sore throat

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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