Gray (Levofloxacin Hemihydrate)

Gray is indicated for the treatment of several bacterial infections where levofloxacin is appropriate. Clinical use is guided by susceptibility testing and local guidelines.

• Community‑acquired and hospital‑acquired respiratory tract infections, including pneumonia and bronchitis
• Uncomplicated urinary tract infections and acute pyelonephritis
• Skin and soft‑tissue infections such as cellulitis and wound infections
• Acute bacterial sinusitis and chronic prostatitis
• Certain infections caused by susceptible Gram‑negative and Gram‑positive organisms

Levofloxacin, the active component of Gray, can cause a range of adverse reactions. They are typically categorized by frequency and severity.

Common

• Nausea, vomiting, or abdominal discomfort
• Diarrhea or loose stools
• Headache or dizziness
• Mild skin rash or itching
• Photosensitivity (increased sensitivity to sunlight)

Serious

• Tendon rupture or tendonitis, especially in the Achilles tendon
• Peripheral neuropathy (numbness, tingling, or weakness)
• QT interval prolongation leading to cardiac arrhythmias
• Severe hypersensitivity reactions such as Stevens‑Johnson syndrome
• Clostridioides difficile‑associated colitis

Before prescribing Gray, clinicians should evaluate patient‑specific factors and potential risks. Key safety considerations include:

• Known hypersensitivity to levofloxacin, other fluoroquinolones, or any formulation components
• History of tendon disorders, especially in patients over 60 years or those on corticosteroids
• Pre‑existing cardiac conditions that may predispose to QT prolongation
• Renal impairment, which may require dose adjustment
• Pregnancy and lactation status, as safety data are limited
• Concomitant use of drugs that may lower seizure threshold

Levofloxacin can interact with other medications, affecting efficacy or safety. Interaction management is essential.

Avoid

• Antacids, sucralfate, or multivitamins containing magnesium, aluminum, calcium, or iron taken within 2 hours of the dose (reduces absorption)
• Non‑steroidal anti‑inflammatory drugs (NSAIDs) that increase seizure risk
• Drugs that prolong the QT interval, such as certain antiarrhythmics or macrolide antibiotics

Use with caution

• Warfarin (may enhance anticoagulant effect; monitor INR)
• Theophylline (potential for increased plasma concentrations)
• Corticosteroids (higher risk of tendon injury)
• Diabetes medications (possible alteration of glucose control)
• Other antibiotics that may compete for the same bacterial targets