Levofloxacin Mercury Pharmaceuticals Limited (Levofloxacin Hemihydrate)

Levofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections in several organ systems.

• Community‑acquired pneumonia: Improves clinical cure rates by targeting common respiratory pathogens.
• Complicated urinary tract infections: Eradicates Gram‑negative organisms causing pyelonephritis and cystitis.
• Skin and soft tissue infections: Provides bactericidal activity against Staphylococcus aureus and Streptococcus species.
• Acute bacterial sinusitis: Reduces symptom duration by eliminating sinus pathogens.
• Acute bacterial prostatitis: Achieves high prostatic tissue concentrations to resolve infection.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for supercoiling and separation of DNA during replication and transcription. By binding to the quinolone‑resistance‑determining region of these enzymes, it prevents the resealing of DNA breaks, leading to accumulation of double‑strand breaks and 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, varying from mild to severe.

Common Side Effects

• Nausea: mild gastrointestinal upset.
• Diarrhea: loose stools, often self‑limiting.
• Headache: transient cranial discomfort.
• Dizziness: occasional vertigo or light‑headedness.
• Rash: mild skin erythema.

Serious or Rare Side Effects

• Tendon rupture: especially Achilles, may occur during or after therapy.
• QT prolongation: cardiac arrhythmia risk in susceptible patients.
• Severe hypersensitivity: anaphylaxis or Stevens‑Johnson syndrome.
• Central nervous system effects: seizures or psychosis.
• Clostridioides difficile infection: antibiotic‑associated colitis.

Before prescribing levofloxacin, clinicians should consider several safety precautions.

• Renal impairment: adjust dose based on creatinine clearance.
• History of tendon disorders: avoid use in patients with prior tendon injury.
• Cardiac risk: monitor QT interval in patients with known prolongation.
• Concomitant CNS active drugs: use caution with antipsychotics or antidepressants.
• Pregnancy and lactation: assess risk‑benefit; limited data available.
• Store below 25°C: keep in original container, protect from light and moisture.

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

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: reduce absorption; separate dosing by at least 2 hours.
• Iron supplements: chelate drug, decreasing bioavailability; separate dosing.
• Warfarin: may increase INR and bleeding risk; monitor coagulation.
• Cyclosporine: increased serum levels of both agents; monitor renal function.
• Theophylline: elevated theophylline concentrations; monitor for toxicity.

Moderate Interactions (Monitor Closely)

• NSAIDs: may increase risk of CNS stimulation or seizures.
• Diabetic agents (e.g., insulin, sulfonylureas): potential hypoglycemia; monitor glucose.
• Corticosteroids: heightened risk of tendon rupture; advise caution.