Levofloxacin Oral
(lee voe flox' a sin)
(lee voe flox' a sin)
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Levaquin
[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.
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 is used treat infections such as pneumonia; chronic bronchitis; and sinus, urinary tract, kidney, and skin infections.
Levofloxacin is in a class of antibiotics called fluoroquinolones. It works by eliminating bacteria that cause infections.
Antibiotics will not work for colds, flu, or other viral infections.
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 comes as a tablet to take by mouth. It is usually taken once daily for 7-14 days. Treatment for some infections
may take 6 weeks or longer. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist
to explain any part you do not understand. Take levofloxacin exactly as directed. Do not take more or less of it or take it
more often than prescribed by your doctor.
Tablets should be taken with a full glass of water.
Continue to take levofloxacin even if you feel well. Do not stop taking levofloxacin without talking to your doctor.
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 doctor if any of these symptoms are severe or do not go away:
- upset stomach
- diarrhea
- vomiting
- stomach pain
- headache
- restlessness
Some side effects can be serious. If you experience any of these symptoms, call your doctor 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
- rapid, irregular, or pounding heartbeats
Levofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this 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 taking levofloxacin,
- tell your doctor and pharmacist if you are allergic to levofloxacin, ciprofloxacin (Cipro), enoxacin (Penetrex), lomefloxacin (Maxaquin), norfloxacin (Noroxin), ofloxacin (Floxin), sparfloxacin (Zagam), cinoxacin (Cinobac), nalidixic acid (NegGram), or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: other antibiotics; anticoagulants ('blood thinners') such as warfarin (Coumadin); 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); sucralfate (Carafate); theophylline (Theo-Dur); and thioridazine (Mellaril). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- do not take with antacids (Mylanta, Maalox), didanosine (Videx) chewable/buffered tablets or solution, iron or zinc supplements, sucralfate (Carafate), or vitamins that contain iron or zinc. Take these medications 2 hours before or after levofloxacin.
- tell your doctor if you have or have ever had kidney or liver disease, convulsions, colitis, stomach problems, vision problems, heart disease, or 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.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking levofloxacin.
- you should know that this medication may cause dizziness, lightheadedness, and tiredness. Do not drive a car or work on dangerous machines until you know how levofloxacin will affect 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.
Levofloxacin can be taken with or without food. If an upset stomach occurs, take with food. Drink at least eight full glasses
of water or other liquid every day.
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and
continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room
temperature and away from excess heat and moisture (not in the bathroom). Keep away from light. Throw away any medication
that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
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.
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.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response
to levofloxacin.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking levofloxacin.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection
after you finish the levofloxacin, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines
you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list
with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with
you in case of emergencies.











