Levofloxacine Accord Healthcare (Levofloxacin Hemihydrate)

Levofloxacin is indicated for several bacterial infections affecting the respiratory, urinary and skin systems.

• Community‑acquired pneumonia: eradicates susceptible pathogens, improving respiratory symptoms.
• Acute bacterial sinusitis: reduces sinus inflammation and bacterial load, relieving congestion and facial pain.
• Acute exacerbations of chronic bronchitis: shortens cough and sputum production by targeting causative bacteria.
• Urinary tract infections: clears infection in the bladder and kidneys, alleviating dysuria and fever.
• Complicated skin and skin structure infections: eliminates bacterial involvement in deeper tissue infections, promoting wound healing.
• Prostatitis: treats bacterial inflammation of the prostate, improving urinary flow and pain.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription and repair. By stabilizing the enzyme‑DNA complex, it prevents resealing of DNA strands, leading to 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 stomach upset, often transient.
• Diarrhea: loose stools, sometimes watery.
• Headache: mild to moderate tension‑type pain.
• Dizziness: occasional sense of light‑headedness.
• Rash: mild skin erythema or itching.

Serious or Rare Side Effects

• Tendon rupture: sudden pain and loss of function, especially in the Achilles.
• QT prolongation: irregular heart rhythm that may cause palpitations.
• Severe allergic reaction: swelling, hives, or difficulty breathing.
• Clostridioides difficile colitis: persistent watery diarrhea with abdominal pain.
• Peripheral neuropathy: numbness or tingling in extremities.

Before prescribing levofloxacin, clinicians should consider several safety measures.

• Assess renal function: dose adjustment may be required in impaired clearance.
• Review cardiac history: avoid in patients with known QT prolongation or arrhythmias.
• Evaluate tendon health: discontinue if tendon pain or inflammation occurs.
• Monitor for hypersensitivity: discontinue at first sign of rash or anaphylaxis.
• Avoid use in children unless essential: risk of musculoskeletal adverse effects.
• Store at room temperature: keep below 25 °C, in original packaging, protected from moisture.

Levofloxacin can alter the activity of other medicines, requiring careful management.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: reduce levofloxacin absorption; separate dosing by at least 2 hours.
• Warfarin: may increase INR and bleeding risk; monitor coagulation parameters.
• NSAIDs (e.g., ibuprofen): heightened risk of central nervous system stimulation and seizures.
• Theophylline: increased plasma levels leading to toxicity; avoid concurrent use.
• Cyclosporine: elevated cyclosporine concentrations; monitor levels closely.

Moderate Interactions (Monitor Closely)

• Diabetic agents (e.g., insulin, sulfonylureas): may cause hypoglycemia; monitor blood glucose.
• Corticosteroids: increased risk of tendon rupture; advise patients to report tendon pain.
• Oral contraceptives: potential reduction in efficacy; consider alternative contraception.
• Antidepressants (e.g., SSRIs): possible additive CNS effects; observe for agitation.