Levofloxacin

What is the most important information I should know about levofloxacin?

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Levofloxacin will not treat a viral infection such as the common cold or flu.

Take levofloxacin with a full glass of water (8 ounces). Drink several extra glasses of fluid each day to prevent crystals from forming in the urine.

Take levofloxacin on an empty stomach 1 hour before or 2 hours after meals.

Levofloxacin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 18 years old. Levofloxacin may interfere with bone development in a child.

There are certain medicines you should not take within the 2 hours before or after you take levofloxacin. This includes antacids that contain magnesium or aluminum (Tums or Rolaids), the ulcer medicine sucralfate (Carafate), didanosine (Videx), and vitamin or mineral supplements that contain iron or zinc. Taking these other medicines too close to your dose of levofloxacin can make the antibiotic much less effective.

What is levofloxacin?

Levofloxacin is in a group of antibiotics called fluoroquinolones (flor-o-KWIN-o-lones). Levofloxacin fights bacteria in the body.

Levofloxacin is used to treat bacterial infections that cause bronchitis, pneumonia, chlamydia, gonorrhea, skin infections, urinary tract infections, and infections of the prostate.

Levofloxacin may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking levofloxacin?

You should not use this medication if you are allergic to levofloxacin or other fluoroquinolones such as ciprofloxacin (Cipro), ofloxacin (Floxin), norfloxacin (Noroxin), lomefloxacin (Maxaquin), and others.

Before taking levofloxacin, tell your doctor if you have:

• kidney disease;
• seizures or epilepsy;
• a personal or family history of Long QT syndrome; or
• a history of head injury or brain tumor.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Levofloxacin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 18 years old. Levofloxacin may interfere with bone development in a child.

How should I take levofloxacin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take levofloxacin with a full glass of water (8 ounces). Drink several extra glasses of fluid each day to prevent crystals from forming in the urine.

Take levofloxacin on an empty stomach 1 hour before or 2 hours after meals.

Measure the liquid form of levofloxacin with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Take levofloxacin at evenly spaced intervals. Follow your doctor's instructions.

Take this medication for the entire length of time prescribed by your doctor. Your symptoms may get better before the infection is completely treated. Levofloxacin will not treat a viral infection such as the common cold or flu.

To be sure this medication is not causing harmful effects, your blood may need to be tested on a regular basis. Your kidney function may also need to be tested. Do not miss any scheduled appointments.

Levofloxacin can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using levofloxacin.

Store this medication at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If you are more than 2 hours late in taking your medicine, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medicine. Overdose symptoms may include loss of balance or coordination, drooping eyelids, weakness, decreased activity, trouble breathing, sweating, tremors, or seizure (convulsions).

What should I avoid while taking levofloxacin?

There are certain medicines you should not take within the 2 hours before or after you take levofloxacin. This includes antacids that contain magnesium or aluminum (Tums or Rolaids), the ulcer medicine sucralfate (Carafate), didanosine (Videx), and vitamin or mineral supplements that contain iron or zinc. Taking these other medicines too close to your dose of levofloxacin can make the antibiotic much less effective.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Levofloxacin can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Levofloxacin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of levofloxacin?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using levofloxacin and call your doctor at once if you have any of these serious side effects:

• seizure (convulsions);
• confusion, hallucinations (seeing things that are not there);
• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
• urinating less than usual or not at all;
• tremors or shaking;
• easy bruising or bleeding, unusual weakness;
• unusual thoughts or behavior;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• sudden pain or swelling near your joints (especially in your arm or ankle);
• numbness, burning, pain, or tingly feeling; or
• diarrhea that is watery or bloody.

Less serious side effects may include:

• feeling restless or anxious;
• nausea, vomiting, diarrhea, stomach pain;
• headache, drowsiness, dizziness;
• sleep problems (insomnia);
• vaginal itching or discharge; or
• mild skin itching.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect levofloxacin?

Before taking levofloxacin, tell your doctor if you are taking any of the following drugs:

• bepridil (Vascor),
• cisapride (Propulsid);
• droperidol (Inapsine);
• methadone (Methadose);
• pentamidine (NebuPent, Pentam);
• theophylline (Theo-Dur, Theolair, Slo-Phyllin, Slo-Bid, Elixophyllin);
• a blood thinner such as warfarin (Coumadin);
• cyclosporine (Neoral, Sandimmune, Gengraf);
• insulin or an oral diabetes medication such as glipizide (Glucotrol), glyburide (Micronase, Diabeta, Glynase), and others;
• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), indomethacin, naproxen (Aleve, Naprosyn), piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others;
• antibiotics such as clarithromycin (Biaxin) or erythromycin (Ery-Tab, Erythrocin, E.E.S);
• medicines to treat psychiatric disorder, such as pimozide (Orap), haloperidol (Haldol), or thioridazine (Mellaril); or
• heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procan), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace).

This list is not complete and there may be other drugs that can interact with levofloxacin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about levofloxacin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2003 Cerner Multum, Inc. Version: 4.07. Revision date: 01/03/2008.