Levaquin: How to use, Side Effects, Dosage

Levaquin: How to use, Side Effects, Dosage

What is Levaquin?

LEVAQUIN is a synthetic broad-spectrum antibacterial agent for oral and intravenous administration. Chemically, levofloxacin, a chiral fluorinated carboxyquinolone, is the pure()-(S)-enantiomer of the racemic drug substance ofloxacin.

Levofloxacin is a light yellowish-white to yellow-white crystal or crystalline powder. The molecule exists as a zwitterion at the pH conditions in the small intestine. The data demonstrate that from pH 0.6 to 5.8, the solubility of levofloxacin is essentially constant (approximately 100 mg/mL). Levofloxacin is considered soluble to freely soluble in this pH range, as defined by USP nomenclature. Above pH 5.8, the solubility increases rapidly to its maximum at pH 6.7 (272 mg/mL) and is considered freely soluble in this range. Above pH 6.7, the solubility decreases and reaches a minimum value (about 50 mg/mL) at a pH of approximately 6.9. Levofloxacin has the potential to form stable coordination compounds with many metal ions. This in vitro chelation potential has the following formation order: Al+3>Cu+2>Zn+2>Mg+2>Ca+2.

Chemical name: (-) - (S)-9-fluoro 2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido[1,2,3-de]-1,4 benzoxazine-6-carboxylic acid hemihydrate

Empirical formula: C18H20FN3O4 • ½ H2O

Molecular weight: 370.38

Color: light yellowish-white to yellow-white crystal or crystalline

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How to use Levaquin?

Take LEVAQUIN exactly as your healthcare provider tells you to take it.

Take LEVAQUIN at about the same time each day.

Drink plenty of fluids while you take LEVAQUIN.

LEVAQUIN can be taken with or without food.

If you miss a dose of LEVAQUIN, take it as soon as you remember. Do not take more than 1 dose in 1 day.

Do not skip any doses of LEVAQUIN or stop taking it, even if you begin to feel better, until you finish your prescribed treatment.

Taking all of your LEVAQUIN doses will help make sure that all of the bacteria are killed. Taking all of your LEVAQUIN doses will help you lower the chance that the bacteria will become resistant to LEVAQUIN. If your infection does not get better while you take LEVAQUIN, it may mean that the bacteria causing your infection may be resistant to LEVAQUIN. If your infection does not get better, call your healthcare provider. If your infection does not get better, LEVAQUIN and other similar antibiotic medicines may not work for you in the future.

If you take too much LEVAQUIN, call your healthcare provider or get medical help right away.

Dosage of Levaquin

Administer LEVAQUIN Tablets to pediatric patients weighing 30 kg and greater only.

LEVAQUIN Tablets cannot be administered to pediatric patients who weigh less than 30 kg because of the limitations of the available strengths. Alternative formulations of levofloxacin may be considered for pediatric patients who weigh less than 30 Kg.

Adjust dose for creatinine clearance less than 50 mL/minute.

Overdosage

In the event of an acute overdosage, the stomach should be emptied. The patient should be observed and appropriate hydration maintained. Levofloxacin is not efficiently removed by hemodialysis or peritoneal dialysis.

LEVAQUIN exhibits a low potential for acute toxicity. Mice, rats, dogs and monkeys exhibited the following clinical signs after receiving a single high dose of LEVAQUIN: ataxia, ptosis, decreased locomotor activity, dyspnea, prostration, tremors, and convulsions. Doses in excess of 1500 mg/kg orally and 250 mg/kg IV produced significant mortality in rodents.

for whom Levaquin not be safe

Do not take Levaquinif you have ever had a severe allergic reaction to an antibiotic known as a fluoroquinolone, or if you are allergic to levofloxacin or any of the ingredients in Levaquin.

Levaquin

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Side effects of Levaquin

The following serious and otherwise important adverse drug reactions are discussed in greater detail in other sections of labeling:

Tendon Effects

Hypersensitivity Reactions

Other Serious and Sometimes Fatal Reactions

Hepatotoxicity

Central Nervous System Effects

Clostridium difficile - Associated Diarrhea

Peripheral Neuropathy

Prolongation of the QT Interval

Musculoskeletal Disorders in Pediatric Patients

Blood Glucose Disturbances

Photosensitivity/Phototoxicity

Development of Drug Resistant Bacteria

Hypotension has been associated with rapid or bolus intravenous infusion of LEVAQUIN. LEVAQUIN should be infused slowly over 60 to 90 minutes, depending on dosageCrystalluria and cylindruria have been reported with quinolones, including LEVAQUIN. Therefore, adequate hydration of patients receiving LEVAQUIN should be maintained to prevent the formation of a highly concentrated urine.

Drug that may intreact with Levaquin

Before taking Levaquin, tell your doctor if you are also using any of the following drugs:

A blood thinner such as warfarin (Coumadin);

Insulin or diabetes medication you take by mouth, such as glyburide (Micronase, Diabeta, Glynase);

A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), etodolac (Lodine), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), nabumetone (Relafen), meloxicam (Mobic), naproxen (Aleve, Naprosyn, Anaprox), piroxicam (Feldene), and others; or

An oral steroid medication such as betamethasone (Celestone), dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), prednisolone (Orapred), prednisone (Meticorten,Sterapred), and others.

This list is not complete and there may be other drugs that can interact with Levaquin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using anew medication without telling your doctor.

Warnings of Levaquin

Anaphylactic reactions and allergic skin reactions, serious, occasionally fatal, may occur after first dose.

Hematologic (including agranulocytosis, thrombocytopenia), and renal toxicities may occur after multiple doses.

Hepatotoxicity: Severe, and sometimes fatal, hepatotoxicity has been reported. Discontinue immediately if signs and symptoms of hepatitis occur

Clostridium difficile-associated colitis: evaluate if diarrhea occurs.

Prolongation of the QT interval and isolated cases of torsade de pointes have been reported. Avoid use in patients with known prolongation, those with hypokalemia, and with other drugs that prolong the QT interval.

Levaquin

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