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Levofloxacin Patient Tips

Written by C. Fookes, BPharm on Oct 6, 2016.

How it works

  • Levofloxacin is an antibiotic which means that it kills bacteria. Levofloxacin converts two bacterial enzymes, topoisomerase IV and DNA gyrase, into toxic enzymes that inhibit the manufacture and repair of DNA and other DNA processes.
  • Levofloxacin belongs to a group of medicines called fluoroquinolone antibiotics.

Upsides

  • Levofloxacin may be used to treat infections of the skin, sinuses, kidneys, bladder, and prostate caused by susceptible bacteria. However, it is usually only used in the treatment of urinary tract infections, chronic bronchitis, and sinusitis when other alternative treatment options have failed or cannot be used.
  • Levofloxacin may also be used to treat certain types of lung infections.
  • May be given as a preventive measure when people have been exposed to anthrax.
  • Effective against susceptible strains of a number of different gram-positive and gram-negative bacteria, for example: Staphylococcus aureus (methicillin-susceptible strains only), S. epidermidis (methicillin-susceptible isolates), S. pneumoniae (including multi-drug resistant isolates), S. pyogenes, Escherichia coli, Haemophilus influenzae, and Pseudomonas aeruginosa. Also effective against Chlamydophila pneumoniae and Mycoplasma pneumoniae.
  • Available as oral tablets, oral solution, eye drops and in an injectable form.
  • Generic levofloxacin is available.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Headache, insomnia, nausea, diarrhea, constipation, and abdominal pain.
  • Tendonitis and tendon rupture, peripheral neuropathy (nerve pain in fingers and toes) and central nervous system effects (side effects that affect the brain including psychosis, convulsions, hallucinations) have been associated with levofloxacin and other fluoroquinolones. These side effects may be irreversible and can all occur together in some patients. May occur at any time after starting levofloxacin and in any patient. If any of these very severe side effects happen levofloxacin should be discontinued immediately and all fluoroquinolones avoided in the future. The risk of tendonitis and tendon rupture is increased in people over the age of 60, in those taking corticosteroids, or with a history of organ transplant. Previous tendon disorders or strenuous activity may also increase risk.
  • May disturb blood glucose levels in people with diabetes; careful monitoring of blood glucose is required.
  • May cause photosensitivity reactions and severe sunburn on exposed areas of skin.
  • May exacerbate muscle weakness in people with myasthenia gravis.
  • Should only be used by adults (at least 18 years old).
  • Not suitable for people with myasthenia gravis, certain heart rhythm disturbances, or pediatric patients (unless being given to prevent inhalation anthrax or plague). Dosage may need the reducing in people with poor kidney function. May cause liver damage or heart rhythm disturbances.
  • May interact with some medications including antacids or preparations containing iron or zinc. Administer at least two hours before or two hours after these preparations.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Levofloxacin treats a wide range of bacterial infections; however, it can cause some very severe and potentially irreversible side effects such as tendonitis or tendon rupture and should only be used to treat infections that have not responded to alternative treatment options.

Tips

  • Oral levofloxacin tablets can be administered without regard to food. Take oral levofloxacin solution one hour before or two hours after food.
  • Take levofloxacin at least two hours before or two hours after antacids or preparations containing iron or zinc.
  • Should be taken exactly as directed and for the time period indicated to reduce the risk of resistant bacteria developing, unless side effects force early discontinuation.
  • Ensure you keep hydrated while taking levofloxacin to prevent crystal formation in your urine.
  • Discontinue levofloxacin immediately if you experience tendon pain, swelling, inflammation or rupture and contact your healthcare provider.
  • Discontinue levofloxacin immediately and contact your healthcare provider if you experience pain, tingling, or numbness in your fingers and toes; severe diarrhea; or any central nervous system effects (such as paranoia, depression, hallucinations), a severe rash, jaundice (skin yellowing), a change in your heartbeat, or any sign of an allergic reaction.
  • Do not drive or operate machinery if levofloxacin makes you feel dizzy or tired. Avoid alcohol.
  • Avoid excessive sun or UV light exposure, and wear sunblock when outdoors. Report any apparent sunburn to your doctor immediately.

Response and Effectiveness

  • Peak levels are reached within one to two hours but it may take up to three days before symptoms of the infection begin to resolve.
  • Levofloxacin is the L-isomer of ofloxacin, which is also a quinolone antimicrobial agent. However, the majority of the antibacterial activity of ofloxacin resides in the L-isomer, which is levofloxacin.

References

Levofloxacin [Package Insert] Revised 08/2017 Hospira, Inc. https://www.drugs.com/pro/levofloxacin.html Aldred KJ, Kerns RJ, Osheroff N. Mechanism of Quinolone Action and Resistance. Biochemistry. 2014;53(10):1565-1574. doi:10.1021/bi5000564.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use levofloxacin only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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