What is levofloxacin?
Levofloxacin is a fluoroquinolone antibiotic with a broad spectrum of action. It is used in severe bacterial infections, including complicated urinary tract infections and renal pelvic inflammation.
Important note: Due to the risk of severe side effects (seen, nerves, psyche), EMA and BfArM have restricted fluoroquinolones for uncomplicated infections. Levofloxacin should only be used in severe infections if no suitable alternatives are available.
Active Ingredients & Mechanism of Action
Active ingredient: Levofloxacin
Active mechanism:
- inhibits bacterial DNA gyrase (Topoisomerase II) and topoisomerase IV
- Prevents DNA replication and transcription of bacteria
- bactericidal action (abkilling)
Activity spectrum:
- Very broad spectrum against Gram-positive and Gram-negative pathogens
- Also atypical pathogens (mycoplasma, chlamydia, legionella)
- Good tissue penetration (animal, prostate, lung)
Pharmacokinetics:
- High oral bioavailability (~99 %)
- Once daily gift sufficient
- Excreation via the kidney (good urinary path concentrations)
Who is it suitable for?
Levofloxacin is suitable for:
- Complicated urinary tract infections including pyelonephritis
- Complicated prostatitis
- Heavy infections if other antibiotics are not suitable
Not suitable for:
- Uncomplicated bladder inflammation (red-hand letter!)
- Light to moderate infections with alternatives
- Children and youth (cartilage damage)
- Pregnancy and breastfeeding
- tendon diseases in prehistory under fluoroquinolones
Available Dosages
Harnweg infections:
- Uncomplicated (only if no alternative): 250 mg once a day for 3 days
- Complicated incl. Pyelonephritis: 500 mg once a day for 7–14 days
Available starches:
- 250 mg, 500 mg film tablets
Dosis adjustment for kidney failure:
- GFR 20–49 ml/min: 250 mg every 24 hours (after initial dose)
- GFR 10–19 ml/min: 250 mg every 48 hours
How to Take
Intake:
- Once a day, regardless of meals
- With sufficient water (min. 1 glass)
- At least 2 hours distance to: antazida, iron preparations, zinc, magnesium, dairy products
Important notes:
- Avoid sun and UV radiation (phototoxicity!)
- Leave immediately and contact doctor
- Drink enough
- Complete antibiotic treatment
Contraindications
**Levofloxacin must not be taken at:* *
- hypersensitivity to fluoroquinolones
- tendon disorder after previous fluoroquinolone therapy
- Epilepsy (lowering of the cramp threshold)
- Pregnancy and breastfeeding
- Children and youth under 18 years
- simultaneous use of tizanidine
Preview at:
- Older patients (increased tendon rupture risk)
- Kidney insufficiency (dose adjustment)
- G6PD deficiency (hemolysis risk)
- QT-time extension or medications that extend QT
- Myasthenia gravis (deterior)
- Diabetes (blood sugar removal possible)
Forewarning: Fluoroquinones can cause tendonitis and tendon cracks, especially on the Achilles tendon. Risk increases with simultaneous cortisone therapy and older people.
Possible Side Effects
Family (1–10 %):
- nausea, diarrhea
- headache, dizziness
- Sleep disorders
- Increased liver levels
** Occasionally (0.1-1 %):* *
- tendonitis
- Skin rash, phototoxicity
- Fungal infections
- Fear, confusion
- muscle and joint pain
Selten, but seriously (Red Hand Letter):
- tendon rupture (especially Achillessehne)
- Peripheral neuropathy (cribing, deafness)
- Psychic disorders (depression, suicide thoughts, psychosis)
- Aortenaneurysma/dissection
- QT-time extension
- Hypoglycemia to coma
**FQAD (Fluorquinone-associated disability):* * In rare cases, side effects on tendons, nerves and psyches can be long-lasting.
Frequently Asked Questions
Similar Medications
Is levofloxacin right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.