Levofloxacin

Warning

Levofloxacin is associated with serious adverse reactions, including tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects.

Contraindications

• Levofloxacin is contraindicated in patients with known hypersensitivity to levofloxacin or other quinolone antibacterials.

Adverse Reactions

• Tendinitis and tendon rupture
• Peripheral neuropathy
• Central nervous system effects
• Exacerbation of myasthenia gravis
• Hypersensitivity reactions
• Hepatotoxicity
• Clostridium difficile-associated diarrhea
• Prolongation of the QT interval

General Guidance

Dose adjustments are recommended for patients with renal impairment, including those with creatinine clearance < 50 mL/min.

Pregnancy

• Levofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers

• Levofloxacin is excreted in human milk, and caution should be exercised when administering levofloxacin to nursing mothers.

Pediatric Use

• Levofloxacin is indicated for use in pediatric patients 6 months of age and older for the treatment of inhalational anthrax and plague.
• The safety and effectiveness of levofloxacin in pediatric patients have not been established for other indications.

Geriatric Use

• Geriatric patients are at increased risk for developing severe tendon disorders, including tendon rupture, when being treated with levofloxacin.
• Levofloxacin should be used with caution in geriatric patients, especially those with renal impairment or those taking corticosteroids.