Return to Common Drugs Index
levofloxacin
Levaquin

Pregnancy Risk Category C

How supplied
Tablets:
250 mg, 500 mg
Single-use vials:
500 mg
Infusion (premixed):
250 mg in 50 ml D5W, 500 mg in 100 ml D5W

Action
Inhibits bacterial DNA gyrase and prevents DNA replication, transcription, repair, and recombination in susceptible bacteria.

Indications & dosage
Note:
Indicated for treatment of mild, moderate, and severe infections due to susceptible microorganisms in adults ages 18 and older.
Acute maxillary sinusitis due to susceptible strains of
Streptococcus pneumoniae, Moraxella catarrhalis, or Haemophilus influenzae-
Adults:
500 mg P.O. or I.V. daily for 10 to 14 days. (See Adjust-a-dose, p. 147.)
Acute bacterial exacerbation of chronic bronchitis due to
Staphylococcus aureus, S. pneumoniae, M. catarrhalis, H. influenzae, or H. parainfluenzae-
Adults:
500 mg P.O. or I.V. daily for 7 days. (See Adjust-a-dose, p. 147.)
Community-acquired pneumonia due to
S. aureus, S. pneumoniae, M. catarrhalis, H. influenzae, H. parainfluenzae, Klebsiella pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae-
Adults:
500 mg P.O. or I.V. daily for 7 to 14 days. (See Adjust-a-dose, p. 147.)
Mild to moderate skin and skin-structure infections due to
S. aureus or S. pyogenes-
Adults:
500 mg P.O. or I.V. daily for 7 to 10 days. (See Adjust-a-dose, p. 147.)
Mild to moderate uncomplicated urinary tract infection due to Escherichia coli, K. pneumoniae, or S. saprophyticus-

Adults:
250 mg P.O. daily for 3 days.
Adjust-a-dose:
If creatinine clearance is 20 to 49 ml/minute, subsequent dosages are half the initial dose. If 10 to 19 ml/
minute, subsequent dosages are half initial dose and the interval is increased to q 48 hours for above indications.
Urinary tract infections (mild to moderate) due to
Enterococcus faecalis, Enterobacter cloacae, E. coli, K. pneumoniae, Proteus mirabilis, or Pseudomonas aeruginosa-
Adults:
250 mg P.O. or I.V. daily for 10 days. (See Adjust-a-dose below.)
Acute pyelonephritis (mild to moderate) due to
E. coli-
Adults:
250 mg P.O. or I.V. daily for 10 days. (See Adjust-a-dose below.)
Adjust-a-dose:
If creatinine clearance is 10 to 19 ml/minute, dosage interval is increased to q 48 hours.

Adverse reactions
CNS:
headache, insomnia, dizziness, encephalopathy, paresthesia, seizures.
CV:
chest pain, palpitations, vasodilation.
GI:
nausea, diarrhea, constipation, vomiting, abdominal pain, dyspepsia, flatulence, pseudomembranous colitis.
GU:
vaginitis.
Hematologic:
eosinophilia, hemolytic anemia, lymphopenia.
Metabolic:
hypoglycemia.
Musculoskeletal:
back pain, tendon rupture.
Respiratory:
allergic pneumonitis.
Skin:
rash, photosensitivity, pruritus, erythema multiforme, Stevens-Johnson syndrome.
Other:
pain, hypersensitivity reactions, anaphylaxis, multisystem organ failure.

Interactions
Drug-drug.
Antacids containing aluminum or magnesium, iron salts, products containing zinc, sucralfate: may interfere with GI absorption of levofloxacin. Administer at least 2 hours apart.
Antidiabetics:
may alter blood glucose levels. Monitor blood glucose levels closely.
NSAIDs:
may increase CNS stimulation. Monitor for seizure activity.
Theophylline:
decreased clearance of theophylline with some fluoroquinolones. Monitor theophylline levels.
Warfarin and derivatives:
increased effect of oral anticoagulant with some fluoroquinolones. Monitor PT and INR.
Drug-lifestyle.
Sun exposure: photosensitivity reactions may occur. Take precautions.

Effects on diagnostic tests
Drug may cause an abnormal ECG.

Contraindications
Contraindicated in patients with hypersensitivity to drug, its components, or other fluoroquinolones.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

Return to Common Drugs Index