Levofloxacin

GENERIC NAME: levofloxacin
BRAND NAME: Levaquin

DRUG CLASS AND MECHANISM:
Many common infections in humans are caused by single cell organisms, called bacteria. Bacteria can grow and multiply, infecting different parts of the body. Medicines that control and eradicate these bacteria are called antibiotics. Levofloxacin is an antibiotic that stops multiplication of bacteria by preventing the reproduction and repair of their genetic material (DNA). It is in a class of antibiotics called fluoroquinolones, a class that includes ciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin), trovafloxacin (Trovan), and lomefloxacin (Maxaquin). Levofloxacin was approved by the FDA in 1996.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 250, 500, and 750 mg. Oral solution, 25 mg/mL.

STORAGE: Levofloxacin should be stored below 86°F.

PRESCRIBED FOR:
Levofloxacin is used to treat infections of the sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible bacteria. Levofloxacin also is frequently used to treat urinary infections, including those resistant to other antibiotics, as well as prostatitis. Levofloxacin is effective in treating infectious diarrheas caused by E. coli, campylobacter jejuni, and shigella bacteria. Levofloxacin also can be used to treat various obstetric infections, including mastitis.
DOSING: Levofloxacin usually is given once daily. It is important to take it at least 2 hours before or 2 hours after any antacid, or mineral supplement with iron, calcium, zinc, or magnesium since these minerals bind levofloxacin and prevent its absorption.
DRUG INTERACTIONS: Minerals with 2 or 3 positive charges, called divalent or trivalent ions, respectively, can attach to levofloxacin and other fluoroquinolones and prevent their absorption from the intestine into the blood. Therefore, such products (containing iron, calcium, zinc, or magnesium) as well as antacids, should be taken at least 2 hours before or 2 hours after levofloxacin. Other drugs which contain these ions and which can similarly interact with levofloxacin include sucralfate (Carafate) and didanosine, dDI.
Taking non-steroidal anti-inflammatory drugs (NSAIDs) with levofloxacin may increase the risk of CNS stimulation, resulting in over-excitation. There have been reports of changes in blood sugar in patients treated with other fluoroquinolones and antidiabetic agents. Other fluoroquinolones have been reported to increase blood levels of theophylline (Theodur), warfarin (Coumadin), and cyclosporine (Sandimmune; Neoral). There have not yet been similar reports with levofloxacin.

PREGNANCY:
Levofloxacin is not recommended for use in pregnant women since levofloxacin causes joint and bone deformities in juvenile animals of several species.

NURSING MOTHERS:
Levofloxacin is not recommended for use in lactating women since levofloxacin causes joint and bone deformities in juvenile animals of several species. In fact, levofloxacin is not recommended in persons under the age of 18 years.

SIDE EFFECTS:
The most frequently reported side events are nausea or vomiting (1 out of every 12 persons), diarrhea (1 out 20), headache (1 out 20), and constipation (1 out of 30). Less common side effects include difficulty sleeping, dizziness, abdominal pain, rash, abdominal gas, and itching.