BMA Concise Guide to Medicine & Drugs

Levofloxacin

Brand names Evoxil, Tavanic

Used in the following combined preparations None

QUICK REFERENCE

Drug group Antibacterial drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Levofloxacin is a quinolone antibacterial drug used for soft-tissue and respiratory and urinary tract infections that have not responded to other antibiotics.

The drug is usually prescribed in the form of tablets, but it is administered by intravenous infusion to people with serious systemic infections or to those who cannot take drugs by mouth.

Like other quinolones, levofloxacin may occasionally cause tendon inflammation and damage, especially in the elderly, people with rheumatoid arthritis, and those taking corticosteroids. You should, therefore, report tendon pain or inflammation to your doctor immediately and stop taking the drug. The affected limb or limbs should be rested until the symptoms have subsided.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, injection.

Frequency and timing of doses 1 x 2 times daily for 7–14 days depending on infection (tablets).

Adult dosage range 250–1,000mg daily.

Onset of effect 1 hour.

Duration of action 12–24 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember, then take your next dose when it is due.

Stopping the drug Take the full course. Even if you feel better, the original infection may still be present, and symptoms may recur if treatment is stopped too soon.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Larger overdoses may cause mental disturbances and seizures. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Given by injection, levofloxacin may cause palpitations and a fall in blood pressure. Nausea and vomiting are the most common side effects of the drug taken by mouth. Diarrhoea and abdominal pain are also common. The drug may also cause headache, dizziness, and drowsiness or restlessness. Discuss with your doctor if any of these side effects are severe. If a rash, itching, jaundice, fever, or an allergic reaction occur, stop taking the drug and consult your doctor. If you experience confusion, seizures, or painful or inflamed tendons, stop taking the drug and contact your doctor immediately.

INTERACTIONS

Anticoagulants The effect of these drugs may be increased by levofloxacin.

Ciclosporin There is an increased risk of kidney damage if ciclosporin is taken with levofloxacin.

Non-steroidal anti-inflammatory drugs (NSAIDs) and theophylline There is an increased risk of seizures when these drugs are taken with levofloxacin.

Oral iron preparations and antacids containing magnesium or aluminium hydroxide interfere with absorption of levofloxacin. Do not take antacids within 2 hours of taking levofloxacin tablets.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have kidney problems.

· You suffer from epilepsy.

· You have porphyria.

· You have a history of psychotic illness.

· You have had a previous allergic reaction to a quinolone antibacterial.

· You have had a previous tendon problem with a quinolone.

· You are taking other medicines.

Pregnancy Safety not established. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 No special problems, except that tendon damage is more likely over the age of 60.

Driving and hazardous work Avoid such activities until you have learned how levofloxacin affects you because the drug can cause dizziness, drowsiness, visual disturbances, and hallucinations.

Alcohol Avoid. Alcohol may increase the sedative effects of levofloxacin.

Sunlight and sunbeds Avoid exposure to strong sunlight or artificial ultraviolet rays because photosensitization may occur.

PROLONGED USE

Levofloxacin is not usually prescribed for long-term use.