Levofloxacin: Brands, Price & Uses in Bangladesh

Levofloxacin is a fluoroquinolone antibiotic indicated for the treatment of infections caused by susceptible strains of bacteria. Because of the risk of serious adverse effects associated with fluoroquinolones, Levofloxacin should be reserved for patients who have no alternative treatment options for certain indications.

Established/FDA-approved uses

• Community-acquired pneumonia and nosocomial (hospital-acquired) pneumonia
• Acute bacterial sinusitis
• Acute bacterial exacerbation of chronic bronchitis
• Uncomplicated and complicated urinary tract infections, including acute pyelonephritis
• Uncomplicated and complicated skin and skin structure infections
• Chronic bacterial prostatitis

Guideline-supported / special-situation uses

• Post-exposure prophylaxis and treatment of inhalational anthrax (with other measures as advised by health authorities)
• Treatment of plague (Yersinia pestis infection)

Off-label uses (used in some settings, not FDA-approved indications)

• As part of combination regimens for multidrug-resistant tuberculosis, under specialist supervision
• Certain intra-abdominal infections in combination with an agent active against anaerobes

Levofloxacin should only be used for infections confirmed or strongly suspected to be caused by susceptible bacteria; it is not effective against viral infections such as the common cold or flu.

Levofloxacin dosing is individualized according to the type and severity of infection and renal function. Take Levofloxacin exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice. Complete the full prescribed course even if symptoms improve early, to reduce the risk of treatment failure and antibiotic resistance.

Renal impairment: Dose or dosing interval must be adjusted in patients with reduced creatinine clearance (see Use in Special Populations).

Administration: Oral Levofloxacin may be taken with or without food, but should be taken at least 2 hours before or after antacids, sucralfate, metal cations (iron, zinc), or multivitamins containing minerals, and separated from dairy products, as these reduce absorption. Adequate fluid intake should be maintained. The intravenous formulation must be administered as a slow infusion over 60-90 minutes; it must not be given as a rapid or bolus intravenous injection.

Most patients tolerate Levofloxacin well, but side effects can occur.

Common side effects

• Nausea, vomiting, diarrhea, abdominal pain
• Headache, dizziness, insomnia
• Flatulence, constipation

Less common but serious side effects

• Tendinitis and tendon rupture (especially Achilles tendon), which can occur during or after treatment (see Precautions and Warnings)
• Peripheral neuropathy (numbness, tingling, weakness) that may be irreversible
• Central nervous system effects: seizures, confusion, tremors, hallucinations, anxiety, depression, and rarely suicidal thoughts
• Photosensitivity (increased sensitivity to sunlight, causing exaggerated sunburn)
• QT interval prolongation and, rarely, serious arrhythmias
• Clostridioides difficile-associated diarrhea, ranging from mild to life-threatening colitis
• Hypersensitivity reactions, including rash, and rarely severe skin reactions or anaphylaxis
• Blood glucose disturbances (hypoglycemia or hyperglycemia), particularly in diabetic patients
• Aortic aneurysm and aortic dissection (rare but serious risk signal, especially in older adults with risk factors)

Patients should seek prompt medical attention if they experience tendon pain/swelling, unusual numbness or tingling, severe diarrhea, sudden severe chest/back/abdominal pain, fainting, or signs of an allergic reaction while taking Levofloxacin.