Levaquin

Levaquin Prescribing Information

Levaquin is an antibiotic drug that is used in the treatment of a variety of bacterial infections. The generic name of Levaquin is levofloxacin. It is basically a fluoroquinolone antibiotic. It is not effective in the treatment of infections caused by viruses.

This drug can lead to very serious and debilitating side effects hence, the use of this drug is limited to the infections that show no positive sign with the treatment with safer antibiotics.

Uses of Levaquin

Here are some common uses of Levaquin:

• Respiratory Infections: Antibiotic is often prescribed to treat respiratory tract infections, such as pneumonia, bronchitis, and sinusitis caused by susceptible bacteria.
• Urinary Tract Infections (UTIs): It can be used to treat UTIs caused by certain bacteria, including complicated urinary tract infections and pyelonephritis (kidney infection).
• Skin and Soft Tissue Infections: Levaquin can be effective in treating skin and soft tissue infections, including cellulitis, wound infections, and abscesses.
• Gastrointestinal Infections: It may be prescribed for certain gastrointestinal infections caused by bacteria, such as travelers' diarrhea.
• Prostatitis: Medicine can be used to treat bacterial prostatitis, which is an infection of the prostate gland.
• Bone and Joint Infections: In some cases, Levaquin might be used to treat bone and joint infections caused by susceptible bacteria.
• Septicemia: It can be employed to treat septicemia (bloodstream infection) caused by susceptible bacteria.
• Intra-Abdominal Infections: Tablets might be prescribed for certain intra-abdominal infections caused by susceptible bacteria.
• Infections in Immunocompromised Patients: It can be used to treat various infections in individuals with compromised immune systems.
• Prevention of Anthrax: Drug is sometimes used to prevent and treat inhalational anthrax following exposure to anthrax spores.

Dosage

The dosage of Levaquin can vary depending on the type of infection being treated, the severity of the infection, the patient's age, weight, and overall health. It's crucial to follow your doctor's prescribed dosage and instructions carefully. The following dosages are general guidelines, and your doctor will provide you with the specific dosage that's appropriate for your situation:

Respiratory Tract Infections:

• Pneumonia: 500 mg orally or intravenously once daily for 7 to 14 days.
• Bronchitis: 500 mg orally or intravenously once daily for 7 to 10 days.

Urinary Tract Infections:

• Uncomplicated UTI: 250 mg orally or intravenously once daily for 3 days.
• Complicated UTI or Pyelonephritis: 250 mg orally or intravenously once daily for 7 to 14 days.

Skin and Soft Tissue Infections:

• 500 mg orally or intravenously once daily for 7 to 14 days.

Gastrointestinal Infections:

• Travelers' Diarrhea: 500 mg orally once daily for 3 days.

Prostatitis:

• Chronic Bacterial Prostatitis: 500 mg orally or intravenously once daily for 28 days.

Bone and Joint Infections:

• 500 mg orally or intravenously once daily for 28 days or longer, depending on the severity of the infection.

Other Infections:

• Dosage can vary depending on the specific infection being treated. Your doctor will determine the appropriate dosage.

Side Effects of Levaquin

Levaquin is generally well-tolerated by many individuals, but like any medication, it can have potential side effects. Some of these side effects are more common, while others are less common but potentially more serious. It's important to be aware of these side effects and to contact your healthcare provider if you experience any unusual or severe symptoms while taking Levaquin. Here are some of the possible side effects:

Common Side Effects:

• Nausea
• Diarrhea
• Headache
• Dizziness
• Insomnia
• Abdominal pain or discomfort
• Vomiting
• Skin rash or itching
• Changes in taste

Less Common but Potentially Serious Side Effects:

• Tendonitis or tendon rupture (particularly in the Achilles tendon)
• Peripheral neuropathy (nerve damage), which can lead to symptoms such as pain, numbness, tingling, or weakness in the limbs
• Central nervous system effects, including confusion, hallucinations, and seizures (these are rare)
• Allergic reactions, including severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
• Photosensitivity (increased sensitivity to sunlight), which can lead to severe sunburn
• Liver problems, such as elevated liver enzymes or hepatitis
• Low blood sugar (hypoglycemia) in individuals with diabetes
• Increased risk of Clostridium difficile-associated diarrhea (a serious intestinal infection)
• Cardiac arrhythmias (irregular heart rhythms)

It's important to note that while some of these side effects are rare, they can still occur. If you experience any severe or concerning symptoms, it's crucial to seek medical attention immediately.

Additionally, Levaquin, like other fluoroquinolone antibiotics, has been associated with potential serious risks, including tendon rupture, peripheral neuropathy, and certain central nervous system effects. Due to these risks, fluoroquinolones are generally reserved for situations where other antibiotics cannot be used, especially for less serious infections.

Interaction with other drugs

Levaquin can interact with other drugs, potentially affecting how they work or increasing the risk of certain side effects. It's important to inform your healthcare provider about all the medications, supplements, and herbal products you are taking before starting Levaquin. Below are some examples of drug interactions that can occur with Levaquin:

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Taking tablets along with NSAIDs like ibuprofen or naproxen can increase the risk of tendonitis or tendon rupture, especially in older adults.
• Antacids, Sucralfate, and Multivitamins: These products containing aluminum, magnesium, calcium, or iron can bind to Levofloxacin and reduce its absorption. To avoid this interaction, take Levaquin a few hours before or after these products.
• Warfarin and Other Blood Thinners: Levaquin may enhance the effects of blood-thinning medications, increasing the risk of bleeding. Monitoring of blood clotting parameters may be necessary.
• Certain Antiarrhythmic Drugs: There is a potential for interactions with drugs like amiodarone, sotalol, and quinidine, which can increase the risk of cardiac arrhythmias.
• Theophylline: Co-administration of Levaquin and theophylline (a medication used for respiratory conditions) can lead to increased theophylline levels in the blood, which can cause adverse effects.
• Oral Diabetes Medications or Insulin: Medicine can affect blood sugar levels, so close monitoring is necessary if you're taking oral diabetes medications or insulin.
• Caffeine: There have been reports of increased caffeine effects (such as nervousness, restlessness, and insomnia) when caffeine is consumed with fluoroquinolone antibiotics like Levaquin.
• Corticosteroids: Combining Drug with corticosteroids can increase the risk of tendon rupture, especially in elderly patients.
• Class IA and III Antiarrhythmic Medications: Combining Levaquin with these drugs can increase the risk of QT interval prolongation, which can lead to a potentially life-threatening irregular heartbeat.

What to avoid while on Levaquin

While taking Levaquin, there are certain things you should avoid or be cautious about to ensure your safety and minimize the risk of potential interactions or side effects. Here are some important considerations:

• Avoid Dairy Products, Calcium-Fortified Foods, and Antacids: Levaquin can interact with calcium-containing products, such as dairy products, calcium-fortified foods, and antacids. These products can bind to the medication and reduce its absorption. To avoid this interaction, take Levaquin at least 2 hours before or 2 hours after consuming these items.
• Avoid Grapefruit and Grapefruit Juice: Grapefruit and grapefruit juice can interact with certain medications, including Levofloxacin, and affect their absorption and metabolism. It's generally a good idea to avoid consuming grapefruit or its products while taking Levaquin.
• Limit Caffeine Intake: Some people may experience increased nervousness, restlessness, and insomnia when consuming caffeine while on Levaquin. Consider limiting your caffeine intake or monitoring how your body responds.
• Sunlight and UV Exposure: Medicine can increase sensitivity to sunlight (photosensitivity), leading to an increased risk of sunburn. When taking Levaquin, it's important to protect your skin from excessive sunlight and UV exposure. Wear protective clothing and use sunscreen with a high SPF when outdoors.
• Alcohol: While moderate alcohol consumption is generally not known to interact directly with Levaquin, it's always a good practice to consult your healthcare provider about alcohol consumption while taking any medication. Additionally, alcohol can weaken your immune system, potentially reducing the effectiveness of antibiotics.
• Tendon Stress: Levaquin and other fluoroquinolone antibiotics have been associated with an increased risk of tendonitis and tendon rupture, especially in older adults. Avoid activities that put excessive stress on your tendons, and if you experience any tendon pain or discomfort, contact your doctor.
• Other Medications: Inform your healthcare provider about all the medications, supplements, and herbal products you're taking. Some medications and supplements can interact with Levaquin and affect its effectiveness or increase the risk of side effects.
• Driving and Operating Machinery: Levaquin can cause dizziness and confusion in some individuals. If you experience these side effects, it's important to avoid driving or operating heavy machinery until you know how the medication affects you.

Contraindications of Levaquin

Levaquin has certain contraindications, which are specific situations or conditions in which the use of the medication is not recommended due to the potential risks involved. If you have any of these contraindications, your healthcare provider will likely advise against using Levaquin. Here are some common contraindications:

• Hypersensitivity to Levofloxacin or Other Fluoroquinolones: If you have had an allergic reaction to levofloxacin or other fluoroquinolone antibiotics in the past, you should not take Levaquin.
• Tendon Disorders: Levaquin is associated with an increased risk of tendonitis and tendon rupture, especially in older adults. If you have a history of tendon disorders, such as tendonitis or a tendon rupture, or if you are currently using corticosteroids, Levaquin is generally contraindicated.
• Myasthenia Gravis: Myasthenia gravis is a neuromuscular disorder that causes muscle weakness and fatigue. The use of fluoroquinolones like Levaquin can exacerbate the symptoms of myasthenia gravis, making it a contraindication in individuals with this condition.
• Children and Adolescents: Antibiotic is generally not recommended for use in children and adolescents due to concerns about potential adverse effects on developing bones and joints.
• Pregnancy and Breastfeeding: Levaquin is generally avoided during pregnancy, as its safety for the developing fetus has not been established. The medication can also pass into breast milk and may harm a nursing baby.
• Certain Heart Rhythm Disorders: Medicine can prolong the QT interval on an electrocardiogram (ECG), which can lead to potentially life-threatening irregular heart rhythms (arrhythmias). If you have a history of certain heart rhythm disorders, Levaquin might be contraindicated.
• Seizures or Epilepsy: Medicine can lower the seizure threshold, increasing the risk of seizures. If you have a history of seizures or epilepsy, the use of Levaquin should be approached cautiously.
• History of Central Nervous System Disorders: Some individuals with a history of central nervous system disorders, such as traumatic brain injury or cerebral arteriosclerosis, may be at an increased risk of adverse central nervous system effects with Levaquin.
• Severe Liver Impairment: Levaquin is metabolized by the liver, and its use is not recommended in individuals with severe liver impairment, as it can lead to higher levels of the medication in the bloodstream.

Pregnancy and Levaquin

Levaquin is generally not recommended for use during pregnancy due to concerns about its potential effects on the developing fetus. While there is limited human data available on the safety of Levofloxacin in pregnancy, studies in animals have shown adverse effects on fetal development, including potential joint and cartilage problems. As a result, Levofloxacin is classified as a Pregnancy Category C medication by the U.S. Food and Drug Administration (FDA), indicating that there may be potential risks to the fetus, but the benefits of the medication might outweigh the risks in certain situations.

If you are pregnant or planning to become pregnant, it's essential to discuss the potential risks and benefits of using Levofloxacin with your healthcare provider. In some cases, if there is a serious bacterial infection that cannot be effectively treated with other antibiotics, your doctor might consider the use of Levaquin after careful consideration of the potential risks to both you and the fetus.

However, in most cases, safer alternative antibiotics are available for treating infections during pregnancy. Your doctor will weigh the potential risks of the medication against the severity of the infection and your overall health to determine the best course of action.