Oftaquix (Levofloxacin Hemihydrate)

Levofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections of the eye.

• Bacterial conjunctivitis: Reduces bacterial load and alleviates symptoms such as redness, discharge and irritation in acute bacterial conjunctival infection.
• Bacterial keratitis: Provides broad‑spectrum coverage to eradicate causative organisms, promoting healing of corneal epithelial defects and preventing vision loss.
• Corneal ulcer (bacterial): Facilitates rapid bacterial eradication, supporting re‑epithelialization and reducing risk of scarring in infectious corneal ulceration.
• Post‑operative ocular prophylaxis: Applied after eye surgery to prevent postoperative bacterial infections and maintain surgical outcomes.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription and repair. By binding to the ATP‑binding sites of these enzymes, it prevents supercoiling and separation of bacterial DNA, leading to bactericidal activity against a wide range of Gram‑negative and Gram‑positive ocular pathogens. The drug achieves high intracellular concentrations in ocular tissues, ensuring effective eradication of susceptible organisms.

Levofloxacin ophthalmic solution may cause local and systemic adverse reactions, ranging from mild irritation to rare serious events.

Common Side Effects

• Burning or stinging sensation at the application site.
• Temporary eye redness.
• Tearing or excessive lacrimation.
• Blurred vision shortly after instillation.
• Mild eye irritation or foreign‑body sensation.
• Conjunctival hyperemia.

Serious or Rare Side Effects

• Allergic reactions including angioedema or anaphylaxis.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Tendon rupture or tendinopathy (systemic exposure).
• Severe ocular inflammation or worsening of corneal ulcer.
• Photosensitivity reactions.
• Persistent or worsening visual impairment.

When using Levofloxacin ophthalmic solution, consider the following precautions:

• Pregnancy: Use only if clearly needed, as safety has not been fully established.
• Breastfeeding: Caution is advised due to limited data on excretion in breast milk.
• Hypersensitivity: Discontinue immediately if signs of allergic reaction appear.
• Pre‑existing corneal disease: Apply with caution in patients with compromised corneal integrity.
• Concurrent systemic fluoroquinolone therapy: Avoid to reduce risk of additive toxicity.
• Drug interactions: Review concomitant ocular medications for compatibility.
• Store at room temperature: Keep in original container, protect from light and moisture.

Levofloxacin ophthalmic solution can interact with other medications; careful assessment is required.

Major Interactions (Avoid)

• Concurrent systemic fluoroquinolones: Increases risk of systemic toxicity.
• Anticholinergic eye drops: May reduce ocular absorption of levofloxacin.
• Corticosteroid eye drops: Heightens risk of secondary ocular infection.

Moderate Interactions (Monitor Closely)

• Topical NSAID eye drops: May increase local irritation.
• Other topical antibiotics: Potential for antagonistic effects.
• Ocular anesthetic agents: May exacerbate corneal toxicity.