levofloxacin (injection)

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Pronunciation: LEE voe FLOX a sin

Brand: Levaquin

What is the most important information I should know about levofloxacin?

Levofloxacin may cause swelling or tearing of a tendon, especially if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

What is levofloxacin?

Levofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.

Levofloxacin is used to treat bacterial infections of the skin, sinuses, kidneys, bladder, or prostate. Levofloxacin is also used to treat bacterial infections that cause bronchitis or pneumonia, and to treat people who have been exposed to anthrax or certain types of plague.

Fluoroquinolone antibiotics can cause serious or disabling side effects that may not be reversible. Levofloxacin should be used only for infections that cannot be treated with a safer antibiotic.

Levofloxacin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using levofloxacin?

You should not use this medicine if you are allergic to levofloxacin or other fluoroquinolones (ciprofloxacin, gemifloxacin, moxifloxacin, ofloxacin, norfloxacin, and others).

To make sure levofloxacin is safe for you, tell your doctor if you have:

  • tendon problems, bone problems, arthritis or other joint problems (especially in children);
  • a history of myasthenia gravis or other nerve-muscle disorder;
  • slow heartbeats or other heart rhythm disorder (especially if you take medication to treat it);
  • a personal or family history of long QT syndrome;
  • liver or kidney disease;
  • a history of epilepsy or other seizure disorder;
  • a nerve disorder;
  • diabetes (especially if you use insulin or take oral diabetes medication);
  • low levels of potassium in your blood (hypokalemia); or
  • if you use a blood thinner (warfarin, Coumadin, Jantoven) and have "INR" or prothrombin time tests.

Levofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. This can happen during treatment or up to several months after you stop using levofloxacin. Tendon problems may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

Do not give this medicine to a child without medical advice. Tendon and joint problems may be more likely in a child using levofloxacin.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Levofloxacin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How is levofloxacin given?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Levofloxacin is injected into a vein through an IV. You may be shown how to use an IV at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of needles, IV tubing, and other items used.

Levofloxacin must be injected slowly, over at least 60 minutes.

For most infections, levofloxacin is given once or twice daily for 5 to 14 days. For prostate conditions or anthrax exposure, you may need to use levofloxacin for 1 to 2 months. Follow your doctor's dosing instructions very carefully.

Drink extra fluids to keep your kidneys working properly while using this medicine.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Levofloxacin will not treat a viral infection such as the flu or a common cold.

This medication can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are using levofloxacin.

Store at room temperature away from moisture, heat, and light. Do not freeze.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using levofloxacin?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop using levofloxacin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Avoid exposure to sunlight or tanning beds. Levofloxacin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

What are the possible side effects of levofloxacin?

Get emergency medical help if you have signs of an allergic reaction: hives, or the first sign of a skin rash; rapid heart rate, difficult breathing; swelling of your face, lips, tongue, or throat.

Levofloxacin may cause swelling or tearing of (rupture) a tendon. Levofloxacin can also have serious effects on your nerves, and may cause permanent nerve damage.

Stop using levofloxacin and call your doctor at once if you have:

  • severe stomach pain, diarrhea that is watery or bloody;
  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
  • sudden weakness or ill feeling, fever, chills, sore throat, swollen glands, mouth sores, easy bruising or bleeding;
  • a seizure (convulsions);
  • muscle weakness or trouble breathing;
  • liver problems --upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • signs of tendon rupture --sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints (rest the joint until you receive medical care or instructions);
  • nerve symptoms --numbness, tingling, burning pain, or being more sensitive to temperature, light touch, or the sense of your body position;
  • changes in mood or behavior --depression, confusion, hallucinations, paranoia, tremors, feeling restless or anxious, suicidal thoughts, insomnia, nightmares;
  • increased pressure inside the skull --severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or
  • severe skin reaction --skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, constipation, diarrhea;
  • dizziness;
  • headache; or
  • sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect levofloxacin?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • a diuretic or "water pill";
  • theophylline;
  • heart rhythm medication --amiodarone, disopyramide, dofetilide, dronedarone, procainamide, quinidine, sotalol, and others;
  • medicine to treat depression or mental illness --amitriptylline, clomipramine, desipramine, iloperidone, imipramine, nortriptyline, and others; or
  • NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with levofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about levofloxacin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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