Levofloxacin Actavis (Levofloxacin Hemihydrate)

Levofloxacin Actavis is a fluoroquinolone antibiotic indicated for several bacterial infection categories.

• Community‑acquired respiratory tract infections: effective in eradicating the causative bacteria and improving respiratory symptoms.
• Acute bacterial sinusitis: reduces sinus inflammation by eliminating the infecting organisms.
• Acute exacerbations of chronic bronchitis: shortens the duration of exacerbation and aids recovery.
• Uncomplicated urinary tract infections: clears the infection and relieves urinary symptoms.
• Skin and soft tissue infections: treats bacterial skin infections and promotes healing.
• Prostatitis: eliminates bacterial pathogens in the prostate and alleviates associated discomfort.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA supercoiling and replication. By binding to the quinolone‑resistance‑determining region of these enzymes, the drug prevents DNA strand separation, halting bacterial replication and transcription, which leads to bacterial cell death. This bactericidal action is broad‑spectrum against Gram‑negative and Gram‑positive organisms. The inhibition is concentration‑dependent and remains effective even against many resistant strains.

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

Common Side Effects

• Nausea: mild stomach upset that may resolve without treatment.
• Diarrhea: loose stools, sometimes accompanied by abdominal cramping.
• Headache: transient head pain that usually improves with rest.
• Dizziness: sensation of light‑headedness, especially when standing quickly.

Serious or Rare Side Effects

• Tendon rupture: sudden tendon pain or rupture, most often in the Achilles tendon.
• QT interval prolongation: cardiac rhythm changes that can lead to serious arrhythmias.
• Severe allergic reaction: rash, swelling, breathing difficulty, or anaphylaxis requiring immediate medical attention.

Before prescribing Levofloxacin, clinicians should consider several safety precautions.

• Renal impairment: adjust therapy based on kidney function to avoid drug accumulation.
• History of tendon disorders: avoid use in patients with prior tendon inflammation or rupture.
• Cardiac risk factors: monitor QT interval in patients with known cardiac arrhythmias or electrolyte disturbances.
• Concomitant CNS active drugs: use caution with medications that may lower seizure threshold.
• Pregnancy and lactation: assess risk versus benefit, as safety data are limited.
• Store at ambient temperature: keep below 25 °C in original packaging, protect from moisture.

Levofloxacin can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: reduce levofloxacin absorption; separate dosing by at least 2 hours.
• Warfarin: may increase anticoagulant effect, requiring closer INR monitoring.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): increase risk of central nervous system stimulation and seizures.

Moderate Interactions (Monitor Closely)

• Theophylline: levofloxacin can raise plasma theophylline levels, necessitating dosage adjustment.
• Diabetic agents (e.g., insulin, sulfonylureas): may cause hypoglycemia; monitor blood glucose.