Levaquin (Levofloxacin)

Generic Name: Levofloxacin

Common Brand Name: Levaquin, Tavanic

Buy generic Levaquin Without Prescription

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Medical uses:
Levaquin (Levofloxacin) is a broad-spectrum antibacterial agent with activity against a range of Gram-positive, Gram-negative, atypicals and anaerobes.

• Respiratory Tract Infections: community-acquired pneumonia (CAP), nosocomial pneumonia, acute exacerbations of chronic bronchitis (AECB), acute sinusitis.
• Genitourinary Tract infections: chronic bacterial prostatitis, uncomplicated UTI, acute pyelonephritis, complicated UTI
• Complicated skin & skin structure infections
• Uncomplicated skin and skin structure infections

Levaquin dosage:

It is very important to take complete prescription exactly as prescribed, even if you begin to feel better. Stopping too soon can result in treatment failure.

• Acute Bacterial Exacerbation of Chronic Bronchitis
  Adults: 500 mg every 24 h for 7 days.
• Acute Bacterial Sinusitis
  Adults: 500 mg every 24 h for 10 to 14 days or 750 mg every 24 h for 5 days.
• Anthrax (inhalational; postexposure)
  Adults: 500 mg every 24 h for 60 days.
• Chronic Bacterial Prostatitis
  Adults: 500 mg every 24 h for 28 days.
• Community-Acquired Pneumonia
  Adults: 500 mg every 24 h for 7 to 14 days; or 750 mg every 24 h for 5 days.
• Complicated Skin and Skin Structure Infections,
  Nosocomial Pneumonia
  Adults: 750 mg every 24 h for 7 to 14 days.
• Complicated UTIs,
  Acute Pyelonephritis
  Adults: 250 mg every 24 h for 10 days.
• Uncomplicated Skin and Skin Structure Infections
  Adults: 500 mg every 24 h for 7 to 10 days.
• Uncomplicated UTIs
  Adults: 250 mg every 24 h for 3 days.

Levaquin side effects:

• Cardiovascular: torsades de pointes, vasodilation (postmarketing).
• CNS: headache (6%); insomnia (5%); dizziness (3%); anxiety, fatigue (1%); abnormal EEG, encephalopathy (postmarketing).
• Dermatologic: pruritus, rash (1%); erythema multiforme, Stevens-Johnson syndrome (postmarketing).
• Respiratory: pharyngitis, dyspnea, rhinitis, sinusitis (1%); allergic pneumonitis (postmarketing).
• Ophthalmic: foreign body sensation, ocular pain or discomfort, photophobia, transient decreased vision, transient ocular burning (1% to 3%); lid edema, ocular dryness, ocular itching (less than 1%).
• Gastrointestinal: nausea (7%); diarrhea (6%); constipation (4%); abdominal pain, vomiting (3%); dyspepsia (2%); flatulence (1%).
• Genitourinary: vaginitis (2%).
• Hematologic: eosinophilia, hemolytic anemia, increased INR/PT (postmarketing).
• Lab Tests: decreased glucose, decreased lymphocytes (2%).
• Miscellaneous: pain (2%); back pain, chest pain (1%); anaphylactic shock, anaphylactoid reactions, dysphonia, multisystem organ failure, peripheral neuropathy, rhabdomyolysis, tendon rupture (postmarketing).

Levaquin precautions:

• Children: Safety and efficacy in pediatric patients and adolescents less than 18 years of age have not been established.
• Altered cardiac conduction: Fluoroquinolones may prolong QTc interval; avoid use in patients with a history of QTc prolongation, uncorrected hypokalemia, hypomagnesemia, or concurrent administration of other medications known to prolong the QT interval (including Class Ia and Class III antiarrhythmics, cisapride, erythromycin, antipsychotics, and tricyclic antidepressants).
• CNS stimulation: Tremor, restlessness, confusion, and very rarely hallucinations or seizures may occur; use with caution in patients with known or suspected CNS disorder. Discontinue in patients who experience significant CNS adverse effects (eg, dizziness, hallucinations, suicidal ideations or actions).
• Peripheral neuropathy: The use of quinolones has been linked to peripheral neuropathy (rare); discontinue if symptoms of sensory or sensorimotor neuropathy occur.
• Tendon inflammation/rupture: There have been reports of tendon inflammation and/or rupture with quinolone antibiotics; risk may be increased with concurrent corticosteroids, particularly in the elderly. Discontinue at first sign of tendon inflammation or pain.
• Renal impairment: Use with caution in patients with renal impairment.
• Seizures: Use with caution in individuals at risk of seizures (CNS disorders or concurrent therapy with medications which may lower seizure threshold). Potential for seizures, although very rare, may be increased with concomitant NSAID therapy.
• Disturbances of blood glucose: Disturbances of blood glucose, including symptomatic hyper and hypoglycemia, have been reported, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide/glibenclamide) or with insulin. In these patients, careful monitoring of blood glucose is recommended. If a hypoglycemic reaction occurs in a patient being treated with Levaquin, discontinue it immediately and appropriate therapy should be initiated.

Levaquin drug interactions

Levaquin can interact with other prescription and over-the-counter medications.

• Corticosteroids: concurrent use may increase the risk of tendon rupture, particularly in elderly patients (overall incidence rare).
• Glyburide: fluoroquinolones may increase the effect of glyburide
• Antacids, iron salts, sucralfate, zinc salts; didanosine chewable buffered tablets, multivitamins (oral only): may decrease oral absorption of levofloxacin. Levaquin should be administered 2 hours before or 2 hours after these agents.
• Antiarrhythmic agents (Class Ia and Class III antiarrhythmics), erythromycin, cisapride, antipsychotics, and cyclic antidepressants: increased risk of life-threatening cardiac arrhythmias, including torsades de pointes. Avoid coadministration with levofloxacin.
• NSAIDs increased risk of CNS stimulation and convulsive seizures.
• Probenecid: decreased renal secretion of levofloxacin.
• Warfarin May increase bleeding.

Test Interactions:

• Some quinolone antibiotics may produce a false-positive urine screening result for opiates using commercially-available immunoassay kits. This has been demonstrated most consistently for levofloxacin and ofloxacin, but other quinolones have shown cross-reactivity in certain assay kits. Confirmation of positive opiate screens by more specific methods should be considered.

Pregnancy & Lactation:
Pregnancy Risk Factor: C
Reports of arthropathy (observed in immature animals and reported rarely in humans) have limited the use of fluoroquinolones in pregnancy. Teratogenic effects were not observed with levofloxacin in animal studies; however, decreased body weight and increased fetal mortality were reported. Based on limited data, quinolones are not expected to be a major human teratogen. Although quinolone antibiotics should not be used as first-line agents during pregnancy, when considering treatment for life-threatening infection and/or prolonged duration of therapy, the potential risk to the fetus must be balanced against the severity of the potential illness.

Breast-Feeding:
Other fluoroquinolones are known to be excreted in breast milk. Based on data from ofloxacin, excretion of levofloxacin would be expected. The manufacturer recommends to discontinue nursing or to discontinue Levaquin.

Overdose:
Symptoms of overdose include acute renal failure, seizures. Treatment should include GI decontamination and supportive care; not removed by peritoneal or hemodialysis.

References:

• 1. U.S. Food and Drug Administration. Levofloxacin (Levaquin, Tavanic) U.S. Prescribing Information. Available at (PDF format)