Levofloxacin

About Levofloxacin

Levofloxacin kills bacteria by blocking two enzymes they need to copy their DNA. The tablets and oral solution treat community and hospital pneumonia, complicated urinary and kidney infections, chronic bacterial prostatitis and skin infections, and are approved after inhaled anthrax exposure and for plague, its only uses in children. A dose is taken every 24 hours, less often when kidney function is reduced.

The boxed warning covers disabling and possibly permanent side effects that can occur together: tendinitis and tendon rupture, nerve damage in the arms and legs, and brain effects such as seizures and psychiatric reactions. It can also worsen myasthenia gravis, so it is avoided with that condition. The label reserves it for uncomplicated bladder infections, acute sinusitis and bronchitis flare-ups only when no other treatment is available. Tendon damage is more likely over 60, with steroid medicines and after a kidney, heart or lung transplant.

Nausea, headache, diarrhea, insomnia, constipation and dizziness are the most common side effects. Other warnings cover aortic aneurysm, blood sugar swings, heart rhythm changes, liver injury, allergic reactions, sun sensitivity and C. difficile diarrhea.

The eye drops carry no boxed warning: the 5 mg per mL drops treat bacterial conjunctivitis and the 15 mg per mL drops treat corneal ulcers. An injection is used in hospitals.

Taking Levofloxacin

How to take it

Tablets once a day, with or without food; the oral solution 1 hour before or 2 hours after eating. Drink plenty of fluids. Conjunctivitis drops: one to two drops every 2 hours while awake on days 1 and 2, then every 4 hours while awake on days 3 to 7. Avoid contact lenses while the eye looks infected, and do not let the dropper tip touch the eye or fingers.

If you miss a dose

Take it as soon as you remember, up to 8 hours before the next dose; with less than 8 hours to go, skip it.

Storage

At room temperature in the original container, tightly closed, away from excess heat and moisture, and out of reach of children.

Interactions to know about

Take antacids with magnesium or aluminum, sucralfate, iron, multivitamins with zinc and didanosine at least 2 hours before or after levofloxacin. It strengthens warfarin, anti-inflammatory painkillers add to seizure risk, diabetes medicines can cause blood sugar swings, theophylline levels are watched, and quinidine, procainamide, amiodarone and sotalol are avoided. Avoid excess sun, and do not drive until you know how it affects you.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Levofloxacin differs from pharmacy to pharmacy

Generic levofloxacin tablets come from many makers and cost pharmacies little, so quotes differ mainly by dispensing fee and mark-up; some pharmacies put them on a flat-price antibiotic list.

The oral solution and each strength of eye drops have only a few makers, so quotes vary more, and a pharmacy that rarely fills them may need to order them.

Ways to pay less for Levofloxacin without insurance

• Ask whether levofloxacin tablets are on the pharmacy’s flat-price antibiotic list.
• If the liquid was chosen only for easier swallowing, ask whether tablets would suit you.
• For sinusitis, a bronchitis flare-up or a simple bladder infection, ask whether another antibiotic would work.
• For the eye drops or oral solution, call ahead to check they are in stock.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Levofloxacin

1. 1.How far apart should I take it from antacids, iron, zinc or my multivitamin?
2. 2.Which tendon, nerve or mood symptoms mean I should stop and call?
3. 3.Is it safe with my diabetes medicine, blood thinner or heart rhythm medicine?
4. 4.Are these the conjunctivitis drops or the corneal ulcer drops?

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