Levofloxacin is a fluoroquinolone antibiotic available for oral or intravenous administration. Levofloxacin is the optically active L-isomer of ofloxacin. It has a slightly longer half-life than ofloxacin and can be administered once-daily. Levofloxacin is more active than ofloxacin against staphylococci and streptococci. Levofloxacin is FDA approved for the treatment of sinusitis, chronic bronchitis, community-acquired pneumonia, skin and skin structure infections, complicated urinary tract infections and acute pyelonephritis. It tablets and injection were FDA approved for the treatment these infections on 12/20/96. It inhibits bacterial DNA gyrase, a type II topoisomerase. Topoisomerases alter DNA by introducing superhelical twists into double-stranded DNA and by facilitating unwinding of DNA strands
6 Anti-infective drugs 6.2 Antibiotics, systemic 6.2.2 Other anti-bacterial drugs 220.127.116.11 Quinolones
. It is of Semi Synthetic origin and belongs to Piperazine. It belongs to DNA Gyrase inhibitor pharmacological group on the basis of mechanism of action and also classified in Antibiotics pharmacological group.The Molecular Weight of Levofloxacin is 361.40.
Oral absorption of Levofloxacin is found to be 99% ±10. Volume of distribution is found to be 1.36l/kg and plasma protien binding is 30-40%. Renal Excretion accounts for > 85% and plasma half life is 6 - 8 hr.
Levofloxacin is primarily indicated in conditions like
Acute pyelonephritis/prostatitis, Bronchiolitis, Bronchitis, Complicated UTIS, Folliculitis, Nephrogenic and partial pituitary diabetes insipidus, Oedema, Otitis externa, Pneumonia, Pyelonephritis, Respiratory tract infections, Short-term treatment of severe congestive heart failure, Skin and soft tissue infections.
Levofloxacin is known to interact with other drugs, the details of drug interactions is as follows:
Drug Details Severity Onset Management Aluminium Hydroxide and Oxide Aluminium and magnesium hydroxide containing antacids, and products containing calcium, ion and zinc salts reduce the absorption of levofloxacin. Cyclosporin A Concomitant use of levofloxacin and cyclosporin increases nephrotoxicity. Fenbufen Use of fenbufen with quinolones may increase the incidence of quinolone CNS adverse effects. Probenecid The urinary excretion of levofloxacin is reduced by probenecid; plasma concentration are not necessarily increased. Theophylline Levofloxacin decrease the clearance of theophylline and caffeine. VORICONAZOLE Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation Warfarin (Na) Levofloxacin enhances the effect of oral anticoaggulants.
These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interference in Pathology
Elevation in BUN False-positive urine screening results False-positive urine screening results elevated creatinine
The severe or irreversible adverse effects of Levofloxacin, which give rise to further complications include Stevens johnson syndrome, Epidermal necrolysis, Stevens johnson syndrome, Epidermal necrolysis, Tendon rupture, QT prolongation.
Levofloxacin produces potentially life-threatening effects which include Anaphylaxis. which are responsible for the discontinuation of Levofloxacin therapy.
The signs and symptoms that are produced after the acute overdosage of Levofloxacin include QT prolongation.
The symptomatic adverse reactions produced by Levofloxacin are more or less tolerable and if they become severe, they can be treated symptomatically, these include Flatulence, Dizziness, Diarrhea, Anxiety, Restlessness, Constipation, Abdominal pain, Confusion, Pruritus, Vaginitis, Hallucination, Dyspepsia, Depression, Nightmares, Chest pain, Hypoglycemia, Confusion, dizziness, dyspepsia.
Click on the appropriate strength of the dosage form to view its available brands.
Single Ingredient Inj: 40 mg, 500 mg, 5 mg/ml, 2.5 mg/ml, 7.5 mg/ml, Inj-IV: 500 mg, Inf: 500 mg, 5 mg/ml, 2.5 mg/ml, 7.5 mg/ml, Eye Drops: 0.5 %w/v, Syrup: 250 mg/5ml, 500 mg/5ml, Susp: 125 mg, 125 mg/5ml, 250 mg/5ml, 500 mg/5ml, Susp DS: 250 mg, Tabs: 200 mg, 250 mg, 400 mg, 500 mg, 750 mg, Caps: 250 mg, 500 mg, 750 mg, Multi ingredient
Inf: 7.5 mg,
Levofloxacin's dosage details are as follows:
500 mg 500 (500) 12 hourly IV 250 to 500 mg 380 (375) 12 hourly PO
5 % 5 (5) As recommended. Topical (eye drop)
Paedriatic Dosage ( 20 Kg. )
Not recommende for this age group
10 mg/kg 10 (10) As recommended.
Neonatal Dosage ( 3 Kg. )
No data regarding the neonatal dosage details of Levofloxacin is available.
High Risk Groups
Drug should not be given to Paediatrics, Pregnant Mothers, and Neonates.
If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Warning / Precautions
Levofloxacin should be used with caution in patients with epilepsy, kidney disease, tendon problems, nervous system disorders, liver disease and of any allergy, including drug allergy. It should be used with caution while driving or performing tasks requiring alertness because it causes dizziness, lightheaded or drowsiness. Limit alcohol intake. Because this may cause sensitivity to the sun, so avoid prolonged sun exposure, wear protective clothing and use a sunscreen when outdoors. Caution is advised when this drug is used in children under 18 years of age. It should be used only when clearly needed during pregnancy. It is not recommended during lactation.
Inj (Reconstituted soln)
Store at room temperature or refrigerator. Do not Freeze. Protect from Sunlight and Heat. Use within 2 weeks if refrigerated and within 2 weeks if kept at room temperature.
Store Below 30°C. Protect from Sunlight and Moisture.
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