A Detailed Understanding Of Levaquin Generic (Levofloxacin)

Levaquin Levofloxacin is a fluoroquinolone antibiotic. Chemically, this drug is S(-) enantiomer of racemic compound named Ofloxacin – another antibiotic from a fluoroquinolone group. Levaquin Generic works by inhibiting DNA-DNA gyrase complex and the enzyme called topoisomerase IV, thus leading to bactericidal activity.

The degree of bactericidal activity of Levaquin depends on the relationship between the maximum serum concentration (Cmax) or the area under the curve (PIK) and the minimum inhibitory concentration (MIC). Bacteria may develop resistance to this drug. Therefore, antibiogram should be done prior starting the Levaquin therapy.

Indications

Levaquin Levofloxacin is used to treat following bacterial infections:

  • Upper and lower respiratory tract infections (sinusitis, acute exacerbations of chronic bronchitis, and outpatient pneumonia).
  • Infections of the skin.
  • Infections of the soft tissues.
  • Pyelonephritis and other urinary tract infections (including the complicated ones).
  • Chronic bacterial prostatitis.
  • Prophylactic treatment of inhalation anthrax.

Never use Levaquin Generic if it is not recommended by your doctor.

Dosage Instructions

The following dosage regimens are recommended in adult patients (over the 18 years of age):

  • Acute bacterial sinusitis: 500mg once a day, for 10-14 days.
  • Acute exacerbations of chronic bronchitis: 500mg once a day, for 7-14 days.
  • Outpatient pneumonia: 500mg once a day, for 7-10 days. For severe cases, this dose may be increased up to 1000mg daily divided in two doses and may last for up to 14 days.
  • Pyelonephritis: 500mg once a day, for 7-10 days.
  • Complicated urinary tract infections: 500mg once a day, for 1-2 weeks.
  • Uncomplicated urinary tract infections: 250mg once a day, for 3 days.
  • Chronic prostatitis: 500mg once a day, for 4 weeks.
  • Infections of the skin: 500mg once a day, for 7-10 days. For severe cases, the dose may be increased up to 1000mg.
  • Infections of the soft tissues: 500mg once a day, for 7-10 days.
  • Prophylactic treatment of inhalation anthrax: 500mg once a day, for 40 days.

The dosage can be adjusted to an individual patient, and your doctor is the only person who can prescribe you the appropriate dose. Therefore, you should never change the dose on your own.

The dosage should be adjusted in patients who have renal impairment. In patients who have hepatic impairment, there is no need for a dosage adjustment. Elderly patients also do not require dosage adjustments.

Levaquin Levofloxacin is contraindicated for use in patients under the age of 18.

Swallow the table whole and avoid chewing it (this may reduce the Levaquin’s efficacy). You should take the tablet between the meals, as pharmacokinetic studies have shown that the drug has the best effects if taken that way.

If you are taking antacids (drugs used to treat heartburn), such as those containing aluminum, magnesium or zinc, you must take them separately from Levaquin Levofloxacin, as these medicines may affect an absorption rate of Levaquin, thus resulting in decreased effectiveness.

Precautions

Levaquin Levofloxacin is contraindicated in following patients:

  • In patients who have or have had epileptic seizures. Levaquin Generic increases the risk of seizures in these individuals.
  • In pregnant and breastfeeding women.
  • In patients under the age of 18. Clinical studies have confirmed that Levaquin may interfere with development of children and adolescents.
  • In patients who are known to be allergic to any fluoroquinolone antibiotic.
  • In patients who have tendinitis developed after the fluoroquinolone use.

Recent studies have demonstrated that E.coli is now resistant to Levaquin Levofloxacin (depending on the region/country). Therefore, checking if E.coli is resistant prior starting the treatment is highly recommended.

Levaquin Generic may cause tendinitis which most commonly affects Achilles tendon. Even tendon rupture may occur. Therefore, if you notice muscle/joint pain/inflammation without obvious cause, you must immediately call your doctor. It has been shown that risk of tendinitis is higher in patients older than 60 years as well as in patients taking corticosteroids. High doses of Levaquin are more likely to cause tendinitis than low doses as recommended by Meds4sure.

It has been demonstrated that Levofloxacin lowers the threshold for epileptic seizures and therefore must be avoided in patients who suffer from epilepsy or are taking other drugs that may also lower the threshold for seizures (such as theophylline).

Levaquin Levofloxacin may affect glucose levels in the blood, and therefore it must be used with extra precaution in patients who suffer from diabetes. Cases of hypoglycemic coma have been reported in patients who were taking Levaquin and insulin concomitantly. If needed, this drug can be used in diabetics, but careful monitoring of blood glucose levels is the must.

Levaquin Generic may prolong QT interval and cause torsade de pointes (severe type of irregular heart rhythm). If you notice palpitations or rapid heartbeat, you must inform your doctor immediately.

Side Effects

Levaquin Levofloxacin may cause following side effects:

  • Fungal infections
  • Low white blood cell count
  • Low blood platelet count
  • Weakened immunity
  • Anemia
  • Anorexia
  • Anxiety
  • Nervousness
  • Confusion
  • Hallucinations
  • Insomnia
  • Dizziness
  • Drowsiness
  • Headache
  • Nausea
  • Vomiting
  • Somnolence
  • Taste perversions
  • Tremor
  • Seizures
  • Paresthesia
  • Neuropathy
  • Visual disturbances
  • Loss of hearing
  • Rapid heartbeat
  • Palpitations
  • Irregular heart rhythm
  • Diarrhea
  • Abdominal discomfort
  • Hepatitis
  • Liver damage
  • Allergic reactions

Always inform your doctor if you notice any adverse effects.

Interaction with Other Drugs

There are 78 major, 513 moderate, and 58 minor interactions reported so far. Levaquin Levofloxacin should not be used concomitantly with following medicines:

  • Corticosteroids, such as Hydrocortisone, Methylprednisolone, Triamcinolone, Dexamethasone, and others. The concomitant use increases the risk of seizures.
  • Drugs used to treat arrhythmias, such as Amiodarone, Sotalol, Timolol, and others.
  • Opioid analgesics, such as Tramadol, Fentanyl, Alfentanil, Oxycodone, Morphine, and others. Taking Levaquin concomitantly with these drugs increase the risk of seizures.
  • Haloperidol and Droperidol (used to treat psychiatric disorders). The concomitant use increases risk of torsade de pointes.

Don’t forget to inform your doctor about all medicines you are taking.

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