Levofloxacin Vioser (Levofloxacin)

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

• Community‑acquired pneumonia: eradicates the causative pathogens and improves respiratory function.
• Urinary tract infection: clears bacterial colonisation of the urinary tract.
• Skin and soft‑tissue infection: resolves cellulitis and related dermal infections.
• Acute bacterial sinusitis: reduces sinus inflammation and bacterial load.
• Chronic bronchitis exacerbation: shortens symptom duration and prevents complications.

• Levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication, transcription, and repair. By binding to these targets, it prevents the supercoiling and separation of DNA strands, leading to bacterial cell death and suppression of infection.

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

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhoea: loose stools that may be self‑limiting.
• Headache: transient cranial discomfort.
• Dizziness: sensation of light‑headedness.
• Rash: mild skin erythema.
• Elevated liver enzymes: transient laboratory changes.

Serious or Rare Side Effects

• Tendon rupture: sudden pain and loss of function, especially in the Achilles tendon.
• QT interval prolongation: risk of cardiac arrhythmias.
• Clostridioides difficile infection: severe colitis requiring medical attention.
• Severe allergic reactions: anaphylaxis, angioedema, or Stevens‑Johnson syndrome.
• Hepatic dysfunction: jaundice or hepatitis.
• Peripheral neuropathy: numbness or tingling in extremities.

Before initiating therapy, clinicians should evaluate patient‑specific risk factors and monitor for adverse events.

• Assess renal function: adjust dosing in impaired clearance.
• Monitor for tendon pain: discontinue if signs of tendonitis appear.
• Avoid in known hypersensitivity: do not use if allergic to fluoroquinolones.
• Caution with QT‑prolonging conditions: evaluate cardiac risk.
• Review concomitant medications: consider potential interactions.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Levofloxacin can alter the activity of several co‑administered drugs.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: reduce levofloxacin absorption.
• Warfarin: may increase INR and bleeding risk.
• Theophylline: can raise serum theophylline levels, leading to toxicity.
• Cyclosporine: increased cyclosporine concentrations.
• NSAIDs: heightened risk of central nervous system effects.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: may reduce contraceptive efficacy.
• Diabetic agents: possible alteration of blood glucose control.
• Corticosteroids: combined use raises tendon‑rupture risk.
• Other QT‑prolonging drugs: additive cardiac effects.
• Rifampin: may decrease levofloxacin plasma levels.