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Levofloxacin, Oral Tablet

Highlights for levofloxacin

  1. Levofloxacin oral tablet is available as both a generic and brand-name drug. Brand-name Levaquin.
  2. This drug also comes as an oral solution, eye drops, and an intravenous (IV) drug that is only given by a healthcare provider.
  3. Levofloxacin is used to treat bacterial infections.
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Important warnings

Important warnings

FDA warnings
  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • Tendon rupture or inflammation warning. This drug is linked with an increased risk of tendon rupture and tendinitis (swelling of your tendons). This can happen at any age. This risk is higher if you’re over 60 years of age, taking corticosteroid drugs, or have had a kidney, heart, or lung transplant.
  • Peripheral neuropathy (nerve damage). This drug may cause peripheral neuropathy. This condition causes changes in sensation and damage to the nerves in your arms, hands, legs, or feet. This damage may be permanent. Stop taking this drug and call your doctor right away if you have any signs of peripheral neuropathy in your arms, hands, legs, or feet. Symptoms include pain, burning, tingling, numbness, and weakness.
  • Central nervous system effects. This drug raises your risk of central nervous system (CNS) effects. These can include convulsions, psychosis, and increased pressure inside your head. It can also cause tremors, anxiety, confusion, hallucinations, paranoia, depression, nightmares, and trouble sleeping. Rarely, it can cause suicidal thoughts or acts. Be sure to tell your doctor if you are at increased risk of seizures.
  • Worsening of myasthenia gravis warning. This drug may make your muscle weakness worse if you have myasthenia gravis. You shouldn’t take this drug if you have a history of this condition.
  • Restricted use. This drug can cause serious side effects. As a result, it should only be used to treat certain conditions if no other treatment options exist. These conditions are:
    • uncomplicated urinary tract infection
    • acute bacterial exacerbation of chronic bronchitis
    • acute bacterial sinusitis
  • Liver damage: This drug may cause liver damage. Call your doctor right away if you have any signs of liver problems. Symptoms include nausea or vomiting, stomach pain, fever, weakness and, abdominal pain or tenderness. They can also include itching, unusual tiredness, loss of appetite, light-colored bowel movements, dark-colored urine, and yellowing of your skin or the whites of your eyes.
  • Heart rhythm changes: Tell your doctor right away if you have a fast or irregular heartbeat or if you faint. This drug may cause a rare heart problem called QT interval prolongation. This serious condition can cause an abnormal heartbeat. Your risk may be higher if you’re a senior, have a family history of QT prolongation, have hypokalemia (low blood potassium), or take certain drugs to control your heart rhythm.
  • Suicidal thoughts and behaviors warning: This drug can cause suicidal thoughts or behaviors. Your risk is greater if you have a history of depression. Call your doctor right away if you have thoughts of harming yourself while taking this drug.

About

What is levofloxacin?

Levofloxacin oral tablet is a prescription drug that’s available as the brand-name drug called Levaquin. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. It also comes as an oral solution, an ophthalmic solution (eye drop), and an intravenous (IV) drug that is only given by a healthcare provider.

Why it's used

Levofloxacin is used to treat bacterial infections in adults. These include:

  • pneumonia
  • sinus infection
  • worsening of chronic bronchitis
  • skin infections
  • chronic prostate infection
  • urinary tract infections
  • pyelonephritis (kidney infection)
  • inhalational anthrax
  • plague

Levofloxacin may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

Levofloxacin belongs to a class of drugs called fluoroquinolone antibiotics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Levofloxacin works by killing the bacteria that are causing an infection. You should only use this drug to treat bacterial infections.

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Side effects

Levofloxacin side effects

Levofloxacin oral tablet can make you feel dizzy and lightheaded. You shouldn’t drive, use machinery, or do other tasks that require alertness or coordination until you know how it affects you. Levofloxacin can also cause other side effects.

More common side effects

Some of the more common side effects of levofloxacin include:

  • nausea
  • headache
  • diarrhea
  • insomnia (trouble sleeping)
  • constipation
  • dizziness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Allergic reaction. Symptoms can include:
    • hives
    • trouble breathing or swallowing
    • swelling of your lips, tongue, face
    • throat tightness or hoarseness
    • fast heart rate
    • fainting
    • skin rash
  • Central nervous system effects. Symptoms can include:
    • seizures
    • hallucinations (hearing voices, seeing things, or sensing things that aren’t there)
    • restlessness
    • anxiety
    • tremors (uncontrollable rhythmic movement in one part of your body
    • feeling anxious or nervous
    • confusion
    • depression
    • trouble sleeping
    • nightmares
    • lightheadedness
    • paranoia (feeling suspicious)
    • suicidal thoughts or acts (thoughts or behaviors of harming yourself)
    • a headache that won’t go away, with or without blurred vision
  • Tendon damage, including tendinitis (inflammation of the tendon) and tendon rupture (tear in the tendon). Symptoms can occur in joints such as the knee or elbow and include:
    • pain
    • reduced ability to move
  • Peripheral neuropathy (nerve damage in your hands, feet, arms, or legs). Symptoms typically occur in the hands and feet and can include:
    • pain
    • numbness
    • weakness
  • Joint and muscle pain
  • Liver damage, which can be fatal. Symptoms can include:
    • loss of appetite
    • nausea
    • vomiting
    • fever
    • weakness
    • tiredness
    • itching
    • yellowing of your skin and whites of your eyes
    • light-colored bowel movements
    • pain in your abdomen
    • dark-colored urine
  • Severe diarrhea caused by the bacteria Clostridium difficile. Symptoms can include:
    • watery and bloody stools
    • stomach cramps
    • fever
  • Heart rhythm problems, such as prolongation of the QT interval. Symptoms can include:
    • irregular heart rhythm
    • loss of consciousness
  • Increased sensitivity to the sun. Symptoms can include sunburn of the skin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Interactions

Levofloxacin may interact with other medications

Levofloxacin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Drugs that increase the risk of side effects

Taking levofloxacin with certain medications raises your risk of side effects from those drugs. Examples of these drugs include:

  • Insulin and certain oral diabetes drugs, such as nateglinide, pioglitazone, repaglinide, and rosiglitazone. You may have a significant decrease or increase in your blood sugar levels. You may need to monitor your blood sugar levels closely while taking these drugs together.
  • Warfarin. You may have an increase in bleeding. Your doctor will monitor you closely if you take these drugs together.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Drugs such as ibuprofen and naproxen may increase the risk of central nervous system stimulation and seizures. Tell your doctor if you have a history of seizures before you start taking levofloxacin.
  • Theophylline. You may have symptoms such as seizures, low blood pressure, and irregular heartbeat due to increased levels of theophylline in your blood. Your doctor will monitor you closely if you take these drugs together.

Drugs that can make levofloxacin less effective

When used with levofloxacin, these drugs can make levofloxacin less effective. This means it won’t work as well to treat your condition. This is because the amount of levofloxacin in your body is decreased. Examples of these drugs include:

  • Sucralfate, didanosine, multivitamins, antacids, or other drugs or supplements that have magnesium, aluminum, iron, or zinc may reduce levels of levofloxacin and stop it from working correctly. Take this drug either 2 hours before or 2 hours after taking these drugs or supplements.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

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Other warnings

Levofloxacin warnings

Allergy warning

Levofloxacin can cause a severe allergic reaction, even after only one dose. Symptoms can include:

  • hives
  • trouble breathing or swallowing
  • swelling of your lips, tongue, face
  • throat tightness or hoarseness
  • fast heart rate
  • fainting
  • skin rash

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain conditions

For people with diabetes: People who take levofloxacin with diabetes drugs or insulin can develop low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia). Test your blood sugar as often as your doctor recommends. If you have low blood sugar while taking this drug, stop taking it and call your doctor right away. Your doctor may need to change your antibiotic.

For people with kidney damage: Your doctor will adjust your dose and how often you take levofloxacin, based on how much your kidneys are damaged.

For people with myasthenia gravis: This drug may make your muscle weakness worse. You should not take this drug if you have a history of this condition.

Warnings for other groups

For pregnant women: Levofloxacin is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus. Call your doctor if your infection doesn’t get better within a week of finishing this drug.

For women who are breastfeeding: Levofloxacin passes into breast milk and may cause side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You will need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children:

  • Age range: This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.
  • Increased risk of muscle and bone problems: This drug can cause problems in children. These problems include joint pain, arthritis, and tendon damage.
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Dosage

How to take levofloxacin

This dosage information is for levofloxacin oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Forms and strengths

Generic: levofloxacin

  • Form: Oral tablet
  • Strengths: 250 mg, 500 mg, 750 mg

Brand: Levaquin

  • Form: Oral tablet
  • Strengths: 250 mg, 500 mg, 750 mg

Dosage for pneumonia

Adult dosage (ages 18–64 years)

  • Nosocomial pneumonia: 750 mg taken every 24 hours for 7–14 days.
  • Community acquired pneumonia: 500 mg or 750 mg taken every 24 hours for 5–14 days. Your dose will depend on bacteria causing the infection.

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for acute bacterial sinusitis

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 10–14 days or 750 mg taken every 24 hours for 5 days. Your dose will depend on bacteria causing the infection.

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for acute bacterial exacerbation of chronic bronchitis

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 7 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for skin and skin structure infections

Adult dosage (ages 18–64 years)

  • Complicated skin and skin structure infections (SSSI): 750 mg taken every 24 hours for 7–14 days.
  • Uncomplicated SSSI: 500 mg taken every 24 hours for 7–10 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for chronic bacterial prostatitis

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 28 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for urinary tract infections

Adult dosage (ages 18–64 years)

  • Complicated urinary tract infection or acute pyelonephritis: 250 mg taken every 24 hours for 10 days or 750 mg taken every 24 hours for 5 days. Your dose will depend on bacteria causing the infection.
  • Uncomplicated urinary tract infection: 250 mg taken every 24 hours for 3 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for acute pyelonephritis

Adult dosage (ages 18–64 years)

250 mg taken every 24 hours for 10 days or 750 mg taken every 24 hours for 5 days. Your dose will depend on bacteria causing the infection.

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for inhalational anthrax, postexposure

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 60 days

Child dosage (ages 6 months–17 years)

  • Inhalational anthrax (post-exposure) in children who weigh more than 50 kg: 500 mg taken every 24 hours for 60 days
  • Inhalational anthrax (post-exposure) in children who weigh 50 kg or less: 8 mg/kg (not to exceed 250 mg per dose) taken every 12 hours for 60 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for plague

Adult dosage (ages 18–64 years)

500 mg taken every 24 hours for 10–14 days

Child dosage (ages 6 months–17 years)

  • Plague in children who weigh more than 50 kg: 500 mg taken every 24 hours for 10–14 days
  • Plague in children who weigh 50 kg or less: 8 mg/kg (not to exceed 250 mg per dose) taken every 12 hours for 10–14 days

Child dosage (ages 0–5 months)

This drug hasn’t been studied in children younger than 6 months. It shouldn’t be used in this age group.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

If you have kidney problems, your doctor will adjust your dose and how often you take this drug. Your dose will be based on how much your kidneys are damaged.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

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Take as directed

Take as directed

Levofloxacin oral tablet is used for short-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: Your infection won’t get better and may get worse. Even if you feel better, don’t stop taking the drug.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose can include:

  • dizziness
  • drowsiness
  • disorientation
  • slurred speech
  • nausea
  • vomiting

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your symptoms should get better and your infection should go away.

Important considerations

Important considerations for taking this drug

Keep these considerations in mind if your doctor prescribes levofloxacin oral tablet for you.

General

  • You can take this drug with or without food. Taking it with food may help to reduce upset stomach.
  • You can crush the tablet.

Storage

  • Store this drug at 68°F to 77°F (20°C to 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you.
  • When flying, never put it into a checked bag.
  • Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor may check your kidney and liver function while you take this drug. This will help them make sure your kidneys and liver are working correctly. They may do this monitoring using:

  • Liver function tests: Your doctor may do blood tests to check how well your liver is working. If your liver isn’t working well, your doctor may have you stop taking this drug.
  • Kidney function tests: Your doctor may do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may give you less of the drug.
  • White blood cell count: A white blood cell count measures the number of cells in your body that fight infection. An increased count is a sign of that.

Sun sensitivity

This drug can make your skin more sensitive to the sun. This increases your risk of sunburn. Stay out of the sun if you can. If you have to be in the sun, wear protective clothing and sunscreen.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

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Alternatives

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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