Levofloxacine Cristers (Levofloxacin)

Levofloxacin is a fluoroquinolone antibiotic indicated for infections caused by susceptible bacteria in various organ systems.

• Urinary tract infection: eliminates the causative bacteria, relieving symptoms and preventing recurrence.
• Respiratory tract infection: treats community‑acquired pneumonia and acute exacerbations of chronic bronchitis caused by susceptible pathogens.
• Skin and soft‑tissue infection: clears bacterial involvement in cellulitis, abscesses and wound infections.
• Acute bacterial prostatitis: eradicates infection within the prostate gland, improving urinary function.
• Other susceptible bacterial infections: provides effective therapy for infections where the pathogen is known to be sensitive to levofloxacin.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA supercoiling and replication. By binding to these enzymes, it prevents the unwinding and resealing of DNA strands, halting bacterial DNA synthesis and transcription, which leads to bacterial cell death. This bactericidal action is effective against a wide spectrum of Gram‑positive and Gram‑negative organisms.

Levofloxacine Cristers may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea
• Diarrhea
• Headache
• Dizziness
• Insomnia
• Abdominal pain

Serious or Rare Side Effects

• Tendon rupture or tendinitis, especially of the Achilles tendon
• QT interval prolongation leading to cardiac arrhythmias
• Clostridioides difficile‑associated colitis
• Severe allergic reactions such as anaphylaxis
• Peripheral neuropathy
• Photosensitivity reactions

Before prescribing Levofloxacine Cristers, clinicians should consider several precautionary measures to minimize risk.

• Assess renal function: adjust dosing in patients with impaired clearance.
• Evaluate cardiac history: avoid in patients with known QT prolongation or arrhythmias.
• Review concomitant medications: avoid concurrent use with drugs that may increase tendon toxicity.
• Monitor blood glucose: fluoroquinolones can cause dysglycemia, especially in diabetic patients.
• Caution in elderly patients: increased risk of tendon injury and central nervous system effects.
• Store at ambient temperature below 25°C: keep in the original container, protect from moisture and light.

Levofloxacine Cristers can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Antacids or supplements containing aluminum, magnesium, calcium, or iron: they chelate levofloxacin and markedly reduce absorption.
• Warfarin: concurrent use may enhance anticoagulant effect and increase bleeding risk.
• Corticosteroids: combined therapy raises the chance of tendon rupture.

Moderate Interactions (Monitor Closely)

• Theophylline: levofloxacin may increase plasma levels, leading to toxicity.
• Oral contraceptives: efficacy may be reduced; additional non‑hormonal contraception is advised.
• Cimetidine or other CYP1A2 inhibitors: can raise levofloxacin concentrations.
• Rifampin or other CYP inducers: may lower levofloxacin levels, reducing effectiveness.