Levofloxacin Injection
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Levofloxacin Injection
(lee voe flox' a sin)
(lee voe flox' a sin)
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Levaquin I.V.
[Posted 07/08/2008] FDA notified healthcare professionals that a BOXED WARNING and Medication Guide are to be added to the
prescribing information to strengthen existing warnings about the increased risk of developing tendinitis and tendon rupture
in patients taking fluoroquinolones for systemic use.
Fluoroquinolones are associated with an increased risk of tendinitis and tendon rupture. This risk is further increased in
those over age 60, in kidney, heart, and lung transplant recipients, and with use of concomitant steroid therapy. Physicians
should advise patients, at the first sign of tendon pain, swelling, or inflammation, to stop taking the fluoroquinolone, to
avoid exercise and use of the affected area, and to promptly contact their doctor about changing to a non-fluoroquinolone
antimicrobial drug. Selection of a fluoroquinolone for the treatment or prevention of an infection should be limited to those
conditions that are proven or strongly suspected to be caused by bacteria. For more information visit the FDA website at:
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Fluoroquinolone, http://www.fda.gov/cder/drug/infopage/fluoroquinolones/default.htm, http://www.fda.gov/cder/drug/InfoSheets/HCP/fluoroquinolonesHCP.htm and http://www.fda.gov/bbs/topics/NEWS/2008/NEW01858.html.
Your doctor has ordered levofloxacin, an antibiotic, to help treat your infection. The drug will be added to an intravenous
fluid that will drip through a needle or catheter placed in your vein for at least 60 minutes, once a day.
Levofloxacin eliminates bacteria that cause many infections, including skin, respiratory tract, and urinary tract infections.
It also kills bacteria that cause many venereal diseases. This medication is sometimes prescribed for other uses; ask your
doctor or pharmacist for more information.
Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment
using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking levofloxacin. The length
of treatment depends on how your infection and symptoms respond to the medication.
Pending revision, the material in this section should be considered in light of more recently available information in the
MedWatch notification at the beginning of this monograph.
Before administering levofloxacin,
- tell your doctor and pharmacist if you are allergic to cinoxacin (Cinobac), ciprofloxacin (Cipro), enoxacin (Penetrex), erythromycin, levofloxacin, lomefloxacin (Maxaquin), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), sparfloxacin (Zagam), or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antibiotics; anticoagulants ('blood thinners') such as warfarin (Coumadin); aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); cancer chemotherapy agents; cimetidine (Tagamet); cisapride (Propulsid); cyclosporine (Neoral, Sandimmune); medications for irregular heartbeats such as amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Procanbid, Pronestyl), quinidine (Quinidex), and sotalol (Betapace, Betapace AF); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); phenytoin (Dilantin); pimozide (Orap); probenecid (Benemid); theophylline (Theo-Dur); thioridazine (Mellaril); and vitamins.
- tell your doctor if you have or have ever had kidney or liver disease, seizures, colitis, stomach problems, vision problems, heart disease, or a history of stroke.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking levofloxacin, call your doctor immediately.
- you should know that this drug may cause dizziness, lightheadedness, and tiredness. Do not drive a car or operate machinery until you know how levofloxacin affects you.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Levofloxacin may make your skin sensitive to sunlight.
- keep in mind that it causes increased or decreased blood sugar in patients taking antidiabetes medications or insulin. Careful monitoring of blood glucose is advised. If you experience a significant drop in blood glucose, stop taking levofloxacin and call your doctor.
Before you administer levofloxacin, look at the solution closely. It should be clear and free of floating material. Gently
squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored,
if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care
provider.
It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because
your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health
care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage
in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy
can continue.
Pending revision, the material in this section should be considered in light of more recently available information in the
MedWatch notification at the beginning of this monograph.
Levofloxacin may cause side effects. Tell your health care provider if any of these symptoms are severe or do not go away:
- upset stomach
- diarrhea
- vomiting
- stomach pain
- headache
- restlessness
If you experience any of the following symptoms, call your health care provider immediately:
- skin rash
- itching
- hives
- difficulty breathing or swallowing
- swelling of the face or throat
- yellowing of the skin or eyes
- dark urine
- pale or dark stools
- blood in urine
- pain, inflammation, or rupture of a tendon
- seizures
- rapid, irregular, or pounding heartbeats
- Your health care provider probably will give you a several-day supply of levofloxacin at a time. If you are receiving levofloxacin intravenously (in your vein), you probably will be told to store it in the refrigerator or freezer.
- Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.
- If you are told to store additional levofloxacin in the freezer, always move a 24-hour supply to the refrigerator for the next day's use.
- Do not refreeze medications.
Store your medication only as directed. Make sure you understand what you need to store your medication properly.
Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of
children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid
accidental injury.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing,
call local emergency services at 911.
If you are receiving levofloxacin in your vein or under your skin, you need to know the symptoms of a catheter-related infection
(an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter,
tell your health care provider as soon as possible:
- tenderness
- warmth
- irritation
- drainage
- redness
- swelling
- pain
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