Levofloxacin Kabi (Levofloxacin Hemihydrate)

Levofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections of the respiratory, urinary, skin and systemic systems.

• Community‑acquired pneumonia: achieves clinical cure and bacterial eradication.
• Hospital‑acquired pneumonia: provides coverage against typical and atypical pathogens.
• Complicated urinary tract infections: resolves infection and prevents recurrence.
• Skin and soft‑tissue infections: reduces lesion size and promotes healing.
• Septicemia: helps achieve systemic bacterial clearance.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription, and repair. By binding to these enzymes, it prevents the supercoiling and separation of DNA strands, leading to bacterial cell death. The drug exhibits concentration‑dependent bactericidal activity against a broad spectrum 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: sensation of light‑headedness.
• Rash: mild skin erythema or pruritus.
• Elevated liver enzymes: transient increase in hepatic transaminases.

Serious or Rare Side Effects

• Tendon rupture: especially Achilles tendon, may occur without warning.
• QT interval prolongation: risk of cardiac arrhythmias.
• Clostridioides difficile infection: severe colitis after antibiotic exposure.
• Severe allergic reactions: anaphylaxis, angioedema.
• Peripheral neuropathy: sensory deficits or pain.
• Seizures: particularly in patients with CNS disorders.

Levofloxacin should be used with caution, considering patient‑specific factors and safety measures.

• Renal function: adjust dose in patients with impaired renal clearance.
• Age: use cautiously in elderly patients due to increased risk of tendon injury.
• Concomitant QT‑prolonging drugs: monitor cardiac rhythm and avoid combined use when possible.
• History of tendon disorders: avoid use or monitor closely for tendon pain.
• Pregnancy and lactation: safety not established; avoid unless benefit outweighs risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Levofloxacin can interact with several medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: reduce levofloxacin absorption.
• Warfarin: increase risk of bleeding.
• Cyclosporine: raise levofloxacin plasma levels.
• NSAIDs: heighten risk of central nervous system stimulation.
• Theophylline: may increase theophylline toxicity.

Moderate Interactions (Monitor Closely)

• Corticosteroids: increased risk of tendon rupture.
• Diabetes medications: may affect glucose control.
• Rifampin: may reduce levofloxacin efficacy.
• HIV protease inhibitors: may increase levofloxacin concentrations.
• Oral contraceptives: may reduce hormonal effectiveness.