Levofloxacin Accord Healthcare (Levofloxacin Hemihydrate)

Levofloxacin is a broad‑spectrum fluoroquinolone used to treat infections caused by susceptible bacteria.

• Community‑acquired pneumonia: eradicates the causative pathogens and improves respiratory symptoms.
• Acute bacterial sinusitis: reduces sinus inflammation and clears infection.
• Uncomplicated urinary tract infection: eliminates uropathogens and resolves dysuria.
• Skin and skin‑structure infections: treats cellulitis, abscesses and wound infections.
• Chronic bronchitis exacerbation: shortens illness duration and improves lung function.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA supercoiling and replication. By binding to these enzymes, it prevents DNA strand separation, halting bacterial DNA synthesis and transcription, which leads to bacterial cell death. The drug exhibits concentration‑dependent bactericidal activity against a wide range of Gram‑positive and Gram‑negative organisms.

Levofloxacin may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: loose stools, occasionally watery.
• Headache: transient cranial discomfort.
• Dizziness: occasional light‑headedness.
• Insomnia: difficulty falling or staying asleep.
• Rash: mild skin erythema or pruritus.

Serious or Rare Side Effects

• Tendon rupture: especially Achilles, often linked to sudden activity.
• QT prolongation: may precipitate cardiac arrhythmias.
• Severe hypersensitivity: anaphylaxis or Stevens‑Johnson syndrome.
• Central nervous system effects: seizures or psychosis.
• Hepatotoxicity: elevated liver enzymes or jaundice.
• Clostridioides difficile colitis: severe diarrhea with abdominal pain.

Levofloxacin should be used with caution in specific clinical situations.

• Tendon safety: avoid use in patients with recent tendon injury or steroid therapy.
• Cardiac risk: monitor patients with known QT prolongation or electrolyte disturbances.
• Renal function: adjust dose in severe renal impairment.
• CNS effects: use carefully in patients with a history of seizures.
• Pregnancy and lactation: avoid unless clearly needed; safety data are limited.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Levofloxacin can interact with several medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: reduce levofloxacin absorption.
• Warfarin: may increase anticoagulant effect and bleeding risk.
• NSAIDs (e.g., ibuprofen): heighten risk of central nervous system stimulation.

Moderate Interactions (Monitor Closely)

• Theophylline: may increase serum theophylline levels, causing toxicity.
• Cyclosporine: potential for increased cyclosporine concentrations.
• Diabetic agents (e.g., insulin, sulfonylureas): may enhance hypoglycaemic effect.