Levofloxacino Reiwa Healthcare (Levofloxacin Hemihydrate)

• Levofloxacin is indicated for several bacterial infections affecting the respiratory, urinary, abdominal and skin systems.
• Community‑acquired pneumonia: achieves clinical cure and microbiological eradication in adults.
• Hospital‑acquired pneumonia: provides effective treatment of severe nosocomial lung infections.
• Complicated urinary tract infections: resolves infection and prevents recurrence.
• Complicated intra‑abdominal infections: aids in bacterial clearance after surgical source control.
• Skin and soft tissue infections: promotes healing by eliminating causative pathogens.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription and repair. By stabilising the enzyme‑DNA complex, it prevents the resealing of DNA strands, leading to bacterial cell death. This bactericidal action is broad‑spectrum against Gram‑negative and Gram‑positive organisms.

Levofloxacin may be associated with a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea or vomiting
• Diarrhea or loose stools
• Headache
• Dizziness or vertigo
• Rash or mild skin irritation
• Elevated liver enzymes

Serious or Rare Side Effects

• Tendon rupture or tendinitis
• QT interval prolongation and cardiac arrhythmias
• Severe allergic reactions (anaphylaxis, Stevens‑Johnson syndrome)
• Clostridioides difficile‑associated colitis
• Peripheral neuropathy
• Hepatic failure or severe liver injury

• When prescribing Levofloxacino Reiwa Healthcare, clinicians should consider several precautionary measures to minimise risk.
• Renal impairment: adjust dose based on renal function.
• History of tendon disorders: avoid use or monitor closely for tendon pain.
• QT prolongation risk: assess cardiac history and electrolyte status.
• Concomitant CNS‑active drugs: monitor for seizures or heightened stimulation.
• Pregnancy and lactation: use only if benefits outweigh potential risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Levofloxacin can interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: markedly reduce levofloxacin absorption.
• Warfarin: may enhance anticoagulant effect and increase bleeding risk.
• Theophylline: levofloxacin can raise serum theophylline concentrations.
• Cyclosporine: increased risk of nephrotoxicity.
• Co‑administration with other fluoroquinolones: additive QT‑prolongation risk.

Moderate Interactions (Monitor Closely)

• Non‑steroidal anti‑inflammatory drugs: heightened central nervous system stimulation.
• Corticosteroids: increased likelihood of tendon rupture.
• Diabetes medications: potential for dysglycemia.
• Rifampin: may lower levofloxacin plasma levels.
• Oral contraceptives: possible reduction in contraceptive effectiveness.