Levofloxacin/Rafarm [pf] (Levofloxacin Hemihydrate)

Levofloxacin is a fluoroquinolone antibiotic indicated for bacterial infections of the eye.

• Bacterial conjunctivitis: reduces bacterial load and alleviates symptoms such as redness, discharge and irritation.
• Bacterial keratitis: eradicates causative organisms and supports corneal healing, helping to preserve visual acuity.

• Levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication and transcription. By binding to these targets, it prevents bacterial DNA supercoiling and separation, leading to inhibition of bacterial cell division and ultimately bacterial death. The drug exhibits concentration‑dependent bactericidal activity against a broad spectrum of Gram‑positive and Gram‑negative ocular pathogens.

Levofloxacin ophthalmic solution may cause local and systemic adverse reactions.

Common Side Effects

• Eye irritation or burning sensation.
• Redness of the conjunctiva.
• Tearing or increased lacrimation.
• Transient blurred vision.
• Foreign‑body sensation.
• Mild itching.

Serious or Rare Side Effects

• Allergic reactions such as eyelid edema, rash or urticaria.
• Corneal ulceration or severe keratitis.
• Vision loss or sudden decrease in visual acuity.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis involving the ocular surface.
• Persistent severe eye pain.

Levofloxacin ophthalmic solution should be used with caution and under professional supervision.

• Hypersensitivity: discontinue if any signs of allergic reaction appear.
• Corneal disease: avoid in patients with active corneal ulcer unless specifically indicated.
• Contact lenses: remove lenses during treatment and re‑insert only after therapy completion.
• Concomitant steroids: monitor closely as combined use may increase risk of infection.
• Pediatric use: follow ophthalmologist guidance for dosing and duration.
• Store at room temperature: keep in original container, protect from light and moisture.

Levofloxacin ophthalmic solution can interact with other ocular or systemic agents.

Major Interactions (Avoid)

• Co‑administration with other fluoroquinolone eye drops may increase local toxicity.
• Systemic fluoroquinolones combined with corticosteroids can raise the risk of tendon rupture.

Moderate Interactions (Monitor Closely)

• Use with anticholinergic eye drops may reduce drug penetration.
• Concurrent use of non‑steroidal anti‑inflammatory eye drops may heighten irritation.
• Systemic cation‑containing supplements (e.g., calcium, iron) can reduce overall fluoroquinolone exposure if systemic absorption occurs.