💊 Levofloxacin (Levofloxacin)

🏷️ Brand names & manufacturers

Levofloxacin🏭 Viona Pharmaceuticals IncDailyMed

Levofloxacin🏭 Redpharm DrugDailyMed

Levofloxacin🏭 Lannett Company, LLCDailyMed

✅ What it is used for

• Nosocomial pneumonia
• Community-acquired pneumonia
• Skin and skin structure infections (complicated and uncomplicated)
• Chronic bacterial prostatitis
• Inhalational anthrax (post-exposure) in adults and pediatric patients
• Plague in adults and pediatric patients
• Urinary tract infections (complicated and uncomplicated)
• Acute pyelonephritis
• Acute bacterial exacerbation of chronic bronchitis
• Acute bacterial sinusitis

🧪 Active ingredient

The active ingredient is levofloxacin, a fluoroquinolone antibacterial that acts against susceptible bacteria causing infection.

🌿 Benefits

• Treats susceptible bacterial infections across several body systems (respiratory, skin, urinary, prostate)
• Used for post-exposure inhalational anthrax and for plague

📝 How to use

• The dose and duration are determined by your doctor or pharmacist based on the infection and kidney function; do not change them without consulting them.
• Taken by mouth, usually once every 24 hours.
• Stay well hydrated during treatment.
• Take levofloxacin at least 2 hours before or 2 hours after antacids and iron- or zinc-containing supplements.
• The tablets cannot be given to children weighing less than 30 kg.

💊 Dosage forms

• Tablets 250 mg
• Tablets 500 mg
• Tablets 750 mg

🔄 Drug interactions

• Antacids containing magnesium or aluminum, sucralfate, iron, zinc-containing multivitamins and didanosine reduce absorption; separate by at least 2 hours.
• Warfarin: effect may be enhanced; monitor prothrombin time/INR and watch for bleeding.
• Antidiabetic agents: monitor blood glucose carefully.
• Drugs that prolong the QT interval (e.g., Class IA or III antiarrhythmics): use with caution.

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👨‍⚕️ For healthcare professionals

Mechanism of action

Levofloxacin is a fluoroquinolone antibacterial, the pure (-)-(S)-enantiomer of racemic ofloxacin.

Labeled dosing

Usual adult dose (CrCl ≥ 50 mL/min): 250, 500, or 750 mg orally every 24 hours depending on infection: nosocomial pneumonia 750 mg for 7 to 14 days; community-acquired pneumonia 500 mg for 7 to 14 days or 750 mg for 5 days; complicated SSSI 750 mg for 7 to 14 days, uncomplicated SSSI 500 mg for 7 to 10 days; chronic bacterial prostatitis 500 mg for 28 days; inhalational anthrax (post-exposure) 500 mg for 60 days; plague 500 mg for 10 to 14 days; complicated UTI or acute pyelonephritis 750 mg for 5 days or 250 mg for 10 days; uncomplicated UTI 250 mg for 3 days; acute bacterial exacerbation of chronic bronchitis 500 mg for 7 days; acute bacterial sinusitis 750 mg for 5 days or 500 mg for 10 to 14 days. Adjust dose when CrCl is below 50 mL/min. Final dosing is determined by the prescriber.

• Pediatric tablets only for patients ≥ 30 kg; for anthrax and plague, 250 mg every 12 hours for those 30 kg to less than 50 kg.
• For nosocomial pneumonia with Pseudomonas aeruginosa, combination therapy with an anti-pseudomonal β-lactam is recommended.
• Most common reactions (≥ 3%): nausea, headache, diarrhea, insomnia, constipation, dizziness.
• Discontinue at the first sign of any serious fluoroquinolone-associated adverse reaction.

🎓 Key points for students

• Class: fluoroquinolone antibacterial.
• Boxed warning: tendinitis/tendon rupture, peripheral neuropathy, CNS effects, and exacerbation of myasthenia gravis.
• Contraindication: hypersensitivity to levofloxacin or other quinolones.
• Interactions: polyvalent cations (separate by 2 hours), warfarin, antidiabetic agents, QT-prolonging drugs.
• Dose adjustment required when CrCl is below 50 mL/min.
• Tablets not for children weighing less than 30 kg.