Levofloxacine Viatris (Levofloxacin)

Levofloxacin is a fluoroquinolone antibiotic that interferes with bacterial DNA replication, making it effective for several common infections.

• Community-acquired pneumonia: effective treatment to eradicate the causative bacteria and improve respiratory function.
• Acute bacterial sinusitis: helps clear sinus infection and relieve associated symptoms.
• Acute exacerbations of chronic bronchitis: reduces bacterial load and aids recovery of lung function.
• Urinary tract infections: eliminates pathogenic bacteria causing cystitis or pyelonephritis.
• Skin and soft tissue infections: treats bacterial cellulitis, abscesses and wound infections.

• Levofloxacin exerts its antibacterial effect by binding to the A subunits of DNA gyrase and topoisomerase IV, enzymes essential for supercoiling and separation of bacterial DNA during replication and transcription. Inhibition of these enzymes prevents DNA synthesis, leading to bacterial cell death and resolution of the infection.

Levofloxacin may cause a range of adverse reactions, most of which are dose‑related and reversible.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhea: loose stools that may be watery.
• Headache: transient cranial pain.
• Dizziness: sensation of light‑headedness.
• Insomnia: difficulty falling or staying asleep.
• Abdominal pain: cramping or discomfort.

Serious or Rare Side Effects

• Tendon rupture or tendinitis: especially of the Achilles tendon.
• QT‑interval prolongation: may precipitate cardiac arrhythmias.
• Peripheral neuropathy: numbness or tingling in extremities.
• Severe Clostridioides difficile‑associated diarrhea.
• Anaphylactic reactions: swelling, hives, or breathing difficulty.
• Photosensitivity: increased skin sensitivity to sunlight.

Before initiating therapy, consider patient‑specific factors and monitor for potential complications.

• Assess renal function: dose adjustment may be required in impaired clearance.
• Avoid in patients with known tendon disorders: risk of tendon injury is increased.
• Monitor cardiac status: caution in individuals with prolonged QT interval.
• Use cautiously in the elderly: higher susceptibility to adverse events.
• Store below 25°C: keep in the original pack, protect from moisture.

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

Major Interactions (Avoid)

• Co‑administration with other fluoroquinolones: additive toxicity.
• Concomitant use of QT‑prolonging agents (e.g., quinidine, macrolides): heightened arrhythmia risk.
• NSAIDs (especially high‑dose): may increase central nervous system stimulation.
• Theophylline: levofloxacin can raise plasma levels, risking toxicity.
• Warfarin: enhanced anticoagulant effect, requiring INR monitoring.

Moderate Interactions (Monitor Closely)

• Antacids containing magnesium or aluminum: reduce levofloxacin absorption.
• Iron supplements or sucralfate: may bind and lower drug bioavailability.
• Caffeine: potential for increased stimulation.
• Corticosteroids: combined use may raise tendon injury risk.