
levofloxacin
Levofloxacin is a fluoroquinolone antibiotic used to treat certain bacterial infections. They include some skin infections, pneumonia, and urinary tract infections (UTIs). Levofloxacin is often used when other antibiotics aren't a good choice. This is because it can cause serious side effects, like tendon rupture and nerve damage, and has many drug interactions. Levofloxacin comes as a tablet and liquid that are taken by mouth, usually once a day. An injection is also available for hospital use. Common side effects are nausea, diarrhea, and headache.
What is Levofloxacin?
What is Levofloxacin used for?
Adults only
- Skin infections
- Sinus infections
- Pneumonia
- Chronic bronchitis flare-up caused by bacteria
- Urinary tract infections (UTIs)
- Kidney infections
- Long-term prostate infections
Adults and children
How Levofloxacin works
Levofloxacin is a fluoroquinolone (or "quinolone") antibiotic. It works by blocking proteins that bacteria need to grow and repair their genetic material. This kills the bacteria causing the infection.
Drug facts
| Common Brands | Levaquin |
|---|---|
| Drug Class | Fluoroquinolone antibiotic |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Levofloxacin essentials
Side effects of Levofloxacin
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (7%)
- Headache (6%)
- Diarrhea (5%)
- Trouble sleeping (4%)
Less Common Side Effects
- Dizziness
- Stomach pain
- Upset stomach
- Constipation
- Vomiting
- Rash
Levofloxacin serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Tendon problems: tendon pain, swelling, or tearing, especially around the Achilles tendon
- Nerve damage: pain, burning, tingling, numbness, weakness
- Seizures
- Changes in thoughts, mood, or behavior: confusion, hallucinations, anxiety, depression, suicidal thoughts
- Kidney problems: urinating less often than usual, swelling, unexplained weight gain
- Liver problems: swelling of your stomach, yellow skin or eyes, dark urine
- Bulge or tear in the aorta: sudden and severe chest, back, or stomach pain, shortness of breath
- Abnormal heart rhythm: pounding or irregular heartbeat, severe dizziness, fainting
- Infectious diarrhea (C. difficile-related diarrhea): severe or watery diarrhea, foul-smelling diarrhea, frequent bowel movements, stomach cramps, nausea, fever
- Serious allergic reaction or skin reaction: hives, rash, blisters, skin reddening, swelling of the lips or tongue, trouble breathing
More on Levofloxacin side effects
The following Levofloxacin side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Rare
Agitation
blisters
confusion
diarrhea (watery and severe) which may also be bloody
feeling that others can hear your thoughts or control your behavior
pain, inflammation, or swelling in the calves of the legs, shoulders, or hands
redness and swelling of the skin
seeing, hearing, or feeling things that are not there
sensation of burning on the skin
severe mood or mental changes
stomach cramps or pain (severe)
skin rash, itching, or redness
trembling
unusual behavior
Incidence not known
Black, tarry stools
blurred vision
burning, numbness, tingling, or painful sensations
dark urine
difficulty with breathing
difficulty with chewing, talking, or swallowing
drooping eyelids
fainting
fast or irregular heartbeat
general body swelling
hoarseness
joint or muscle pain
muscle cramps, spasms, pain, or stiffness
peeling or loosening of the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
seizures
severe dizziness
severe tiredness
tightness in the chest
unsteadiness or awkwardness
unusual bleeding or bruising
unusual tiredness or weakness
vision changes
voice changes
weakness in the arms, hands, legs, or feet
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Change in taste
dizziness
drowsiness
headache
lightheadedness
nervousness
stomach pain or discomfort
trouble sleeping
vaginal itching and discharge
vomiting
Incidence not known
Feeling of warmth or heat
flushing or redness of the skin, especially on the face and neck
sweating
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Levofloxacin
Pros
- Treats many types of bacterial infections
- Usually taken once a day
- Available as tablets, oral liquid, and injection
Cons
- Has a risk of serious side effects, such as tendon or nerve problems
- Interacts with some antacids and multivitamins
- Dose might need to be adjusted for people with kidney problems
Pharmacist tips for Levofloxacin
- Take levofloxacin exactly as prescribed, at around the same time each day. The tablets and liquid have different instructions. Make sure you follow the directions for the form you take.
- Finish your full treatment course of levofloxacin, even if you feel better. Stopping too soon can cause the infection to come back and make it harder to treat.
- If you miss a dose of levofloxacin, take it when you remember if your next dose is at least 8 hours away. If it's less than 8 hours away, skip the missed dose and wait to take your next dose at your regularly scheduled time. Don't take 2 doses at once.
- Drink plenty of fluids while taking levofloxacin to stay hydrated. Levofloxacin can sometimes cause crystals to form in your urine. Drinking enough fluids can help prevent this from happening.
- Take levofloxacin at least 2 hours before or 2 hours after certain supplements and medications. This includes products with magnesium, iron, zinc, or aluminum, as well as sucralfate (Carafate). These products can keep your body from absorbing enough levofloxacin. This can make the antibiotic work less well.
- Separate levofloxacin from any dairy products, such as milk or yogurt, by a few hours. The calcium in dairy can make it harder for your body to absorb the antibiotic and affect how well it works.
- Tell your care team about all the medications you take. Also check with your care team before starting anything new. Levofloxacin can interact with some other medications. These can include warfarin and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil). Your care team can make sure your medications are safe to take together.
- Levofloxacin can make your skin more sensitive to sunlight. It's a good idea to use sunscreen and wear protective clothing when going outside. Limit your time in the sun and avoid tanning beds.
- Mild diarrhea can happen while taking levofloxacin. Get medical help if you have severe, watery, or bloody diarrhea, especially with fever or stomach cramps. This could be a sign of a serious intestinal infection that needs medical care.
- If you're pregnant or planning to become pregnant: Tell your prescriber. It's not completely clear if levofloxacin is safe to take during pregnancy. Your prescriber can explain the risks and benefits and help choose an antibiotic that's right for you.
- If you're breastfeeding: Talk to your prescriber. Because of possible serious risks to a breastfed baby, the manufacturer recommends avoiding breastfeeding while taking levofloxacin and for 2 days after your last dose for most infections. You can also pump and discard your breast milk instead. Ask your prescriber or a lactation expert which option is right for you.
Tips for levofloxacin tablets:
- You can take the levofloxacin tablets with or without food. If it upsets your stomach, taking it with food can help.
Tips for the levofloxacin liquid:
- Take the levofloxacin liquid on an empty stomach, 1 hour before or 2 hours after eating.
- Use a medication dose cup or oral syringe from the pharmacy to measure out your levofloxacin dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
- Store the levofloxacin liquid at room temperature.
Risks and warnings for Levofloxacin
Levofloxacin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Tendon inflammation and rupture
- Risk factors: Age over 60 years | History of kidney, heart, or lung transplant | Kidney failure | History of tendon-related problems, such as rheumatoid arthritis (RA) | Taking steroids | High-intensity exercise
Fluoroquinolone antibiotics like levofloxacin can raise the risk of swelling in your tendons (tendonitis). They can also raise the risk of tears in your tendons. Tendon problems most often happen to the Achilles tendon above your heel, but other tendons can also be affected. Tendon problems can start within hours or days of taking levofloxacin. They can also happen several months after you stop treatment.
Tendon problems can happen at any age, but the risk is higher if you're over 60 years old. It's also higher for people with a kidney, heart, or lung transplant and those taking steroids. Be sure to tell your prescriber if you've had tendon problems in the past so they can check your risk.
Stop taking levofloxacin and rest the affected area if you have tendon pain or swelling. Call your care team right away.
Nerve problems
Levofloxacin can raise the risk of peripheral neuropathy. This nerve damage can cause pain, burning, tingling, numbness, or weakness in your arms or legs. It can also change how you feel touch or temperature. These problems can start soon after treatment begins (within hours to weeks). They might not go away in some people.
Before starting levofloxacin, tell your prescriber if you've had nerve problems before. You might need a different type of antibiotic.
If you develop signs of nerve damage during treatment, stop taking levofloxacin and tell your care team right away.
Brain, nervous system, and mental health effects
- Risk factors: History of seizure | Medical conditions that raise the risk of seizures | Taking medications that raise the risk of seizures | Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
Fluoroquinolone antibiotics like levofloxacin can raise the risk of serious effects on your brain and nervous system. These can include seizures, dizziness, or tremors. It's happened within hours of weeks of starting treatment. Tell your prescriber if you have a brain or nervous system condition, such as epilepsy. They can check if levofloxacin is safe for you. Stop taking levofloxacin and get medical help right away if you have a seizure.
Levofloxacin can also raise the risk of having changes in your mood, thoughts, or behavior. This can sometimes happen within hours to weeks after starting the medication. Examples include anxiety, confusion, hallucinations, trouble sleeping, depression, or thoughts of suicide. Stop taking levofloxacin and get medical help right away if you notice any unusual changes in your mood, thoughts, or behavior.
Worsening of myasthenia gravis
If you have myasthenia gravis, levofloxacin can make muscle weakness worse. Rarely, this can be serious and affect the muscles you use to breathe, causing trouble breathing. Tell your prescriber if you have myasthenia gravis. They'll likely choose a different type of antibiotic for you.
Severe allergic reactions or skin reactions
It's possible for antibiotics like levofloxacin to cause a serious allergic reaction, including anaphylaxis. Signs can include hives, swelling of the face, lips, or tongue, trouble breathing, or passing out. Get medical help right away if you have any of these symptoms.
Levofloxacin can also cause rare but serious skin reactions. One example is Stevens-Johnson syndrome (SJS). Stop taking levofloxacin and get medical help right away if you develop a rash, blisters, peeling skin, or fever.
Liver damage
- Risk factors: Age over 65 years
Rarely, people taking levofloxacin have had serious liver problems, including liver failure. Severe cases have happened within 6 to 14 days after starting treatment.
Get medical help right away if you have stomach pain or swelling, yellow skin or eyes, dark urine, or black, tarry, or bloody stools. These could be signs of liver problems. Your care team might have you stop levofloxacin to prevent more liver damage.
Risk of a bulge or tear in a major blood vessel
- Risk factors: Older adults
It's rare, but studies have found a higher risk of a bulge or tear in the aorta within 2 months after taking antibiotics like levofloxacin. The aorta is the largest blood vessel in your body. This problem can be life-threatening. And the risk might be higher in older adults, but it's not clear why it could happen.
Tell your prescriber if you've had an aortic aneurysm or other problems with your aorta. Because of this risk, your prescriber might choose a different antibiotic for you.
Call 911 or get medical help right away if you have sudden, severe pain in your chest, back, or stomach that doesn't go away. This can be a sign of a serious problem with your aorta.
Diarrhea from Clostridioides difficile infection
Antibiotics like levofloxacin can change the normal bacteria in your gut. This can let harmful bacteria called Clostridioides difficile (C. diff) grow too much and cause a serious infection. This infection can lead to severe diarrhea, even up to 2 months after you stop the antibiotic.
It's important to know the difference between mild diarrhea from levofloxacin and serious diarrhea from C. diff. Signs of a C. diff infection include fever, nausea, severe or watery diarrhea, foul-smelling diarrhea, frequent bowel movements, or bloody stool. Get medical help right away if you have any signs of this infectious diarrhea. This can be a medical emergency and should get treated as soon as possible.
Heart rhythm problem called QT prolongation
- Risk factors: Older adults | Known QT prolongation | Certain arrhythmias | Low potassium | Taking certain heart rhythm medications | Taking other medications that cause QT prolongation
Levofloxacin can cause a serious heart rhythm problem called QT prolongation. This happens when your heart takes longer than usual to reset between beats.
Before starting levofloxacin, tell your prescriber about your health conditions and medications. Your risk can be higher if you have certain heart rhythm problems or abnormal electrolyte levels. It can also be higher if you take other medications that can cause QT prolongation, such as amiodarone (Pacerone). Your prescriber can check if levofloxacin is safe for you.
Call 911 right away if you have a pounding or irregular heartbeat, chest pain, trouble breathing, or severe dizziness. These can be signs of a serious heart rhythm problem.
Other serious reactions
Rarely, people taking fluoroquinolone antibiotics like levofloxacin have had serious reactions in different parts of the body. These can affect your kidneys, lungs, joints, or blood cells. Reactions can happen after taking several doses of the medication. Some can be severe or life-threatening.
Stop taking levofloxacin and tell your care team right away if you have new or unusual symptoms. These can include yellow skin or eyes, fever, unusual bleeding or bruising, trouble breathing, or new muscle or joint pain.
Muscle, bone, or joint problems in children
In studies, some children taking levofloxacin had muscle, bone, or joint problems. This has included joint pain, arthritis, and changes in the pattern they walk. Because of this risk, levofloxacin is usually used in children only when other antibiotics aren't a good choice. Your child's prescriber will decide if levofloxacin is right for them.
Changes in blood sugar
- Risk factors: Diabetes | Taking diabetes medications
Fluoroquinolones, including levofloxacin, can cause changes in your blood sugar. It can make your blood sugar too low or too high. Usually, this can happen if you have diabetes and take diabetes medications. Tell your prescriber if you have diabetes. You might need to check your blood sugar more often while taking levofloxacin.
Watch for symptoms of low blood sugar. These can include feeling shaky, confused, nervous, or very hungry. You also might have a fast heartbeat, sweating, or chills. If this happens, stop taking levofloxacin and get medical help right away. Low blood sugar should be treated right away.
Skin that's more sensitive to sunlight
Levofloxacin makes your skin more sensitive to the sun and ultraviolet (UV) light. This means you can get sunburns more easily than usual. It might cause redness, burning, swelling, or blisters on skin exposed to the sun or UV light.
To lower your risk, protect your skin from the sun. Wear sunscreen and clothing that covers your skin when you're outside, even during the winter or on cloudy days. Also, avoid tanning beds and try not to spend too much time in direct sunlight.
Levofloxacin dosage
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 250mg | 7 tablets | $13.52 | $1.93 |
| 500mg | 7 tablets | $9.88 | $1.41 |
| 750mg | 7 tablets | $10.45 | $1.49 |
Typical dosage for Levofloxacin
Your levofloxacin dose will depend on different factors, such as the type of infection you have and how serious it is. It will also depend on your kidney function.
-
Adults only
- Skin infection: The typical dose is 500 mg or 750 mg by mouth every 24 hours for 7 to 14 days.
- Sinus infection: The typical dose is 750 mg by mouth every 24 hours for 5 days. An alternative is 500 mg every 24 hours for 10 to 14 days.
- Pneumonia: The typical dose is 500 mg or 750 mg by mouth every 24 hours. Depending on the type of pneumonia, treatment lasts between 5 and 14 days.
- Chronic bronchitis flare-up due to bacteria: The typical dose is 500 mg by mouth every 24 hours for 7 days.
- Urinary tract infection: For most UTIs, the typical dose is 250 mg by mouth every 24 hours for 3 days. For more serious UTIs, dosing examples include 250 mg every 24 hours for 10 days or 750 mg every 24 hours for 5 days.
- Long-term prostate infection: The typical dose is 500 mg by mouth every 24 hours for 28 days.
-
Adults and children
- Anthrax
- Weighing 110 lbs or more: The typical dose is 500 mg by mouth every 24 hours for 60 days (2 months).
- Weighing 66 lbs to less than 110 lbs: The typical dose is 250 mg by mouth every 12 hours for 60 days (2 months).
- Plague
- Weighing 110 lbs or more: The typical dose is 500 mg by mouth every 24 hours for 10 to 14 days.
- Weighing 66 lbs to less than 110 lbs: The typical dose is 250 mg by mouth every 12 hours for 10 to 14 days.
- Anthrax
Levofloxacin is also available as an injection that's given through a vein by a healthcare professional in the hospital or clinic setting.
More on Levofloxacin dosage
Interactions between Levofloxacin and other drugs
More on Levofloxacin interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bepridil
- Cisapride
- Dronedarone
- Mesoridazine
- Pimozide
- Piperaquine
- Saquinavir
- Sparfloxacin
- Terfenadine
- Thioridazine
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acarbose
- Acecainide
- Acenocoumarol
- Acetohexamide
- Alfuzosin
- Alogliptin
- Amiodarone
- Amisulpride
- Amitriptyline
- Anagrelide
- Apomorphine
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Asenapine
- Astemizole
- Atazanavir
- Azithromycin
- Bedaquiline
- Benfluorex
- Betamethasone
- Bretylium
- Budesonide
- Buprenorphine
- Buserelin
- Canagliflozin
- Ceritinib
- Chloroquine
- Chlorpromazine
- Chlorpropamide
- Cholera Vaccine, Live
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Corticotropin
- Cortisone
- Cosyntropin
- Crizotinib
- Cyclobenzaprine
- Dabrafenib
- Dapagliflozin
- Dasatinib
- Deflazacort
- Degarelix
- Delamanid
- Desipramine
- Deslorelin
- Deutetrabenazine
- Dexamethasone
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Doxepin
- Droperidol
- Ebastine
- Efavirenz
- Encorafenib
- Entrectinib
- Eribulin
- Ertugliflozin
- Erythromycin
- Escitalopram
- Exenatide
- Famotidine
- Felbamate
- Fingolimod
- Flecainide
- Fluconazole
- Fludrocortisone
- Fluocortolone
- Fluoxetine
- Formoterol
- Foscarnet
- Fosphenytoin
- Fostemsavir
- Galantamine
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gliclazide
- Glimepiride
- Glipizide
- Gliquidone
- Glyburide
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Histrelin
- Hydrocortisone
- Hydroquinidine
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Inotuzumab Ozogamicin
- Insulin
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Itraconazole
- Ivabradine
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Linagliptin
- Liraglutide
- Lofexidine
- Lumefantrine
- Macimorelin
- Mefloquine
- Metformin
- Methadone
- Methylprednisolone
- Metronidazole
- Mifepristone
- Miglitol
- Mirtazapine
- Mizolastine
- Moricizine
- Moxifloxacin
- Nafarelin
- Nateglinide
- Nelfinavir
- Nilotinib
- Norfloxacin
- Octreotide
- Ofloxacin
- Olanzapine
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Ozanimod
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Perphenazine
- Pimavanserin
- Pioglitazone
- Pipamperone
- Pitolisant
- Ponesimod
- Porfimer
- Posaconazole
- Pramlintide
- Prednisolone
- Prednisone
- Probucol
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Rasagiline
- Repaglinide
- Ribociclib
- Rilpivirine
- Risperidone
- Ritonavir
- Rosiglitazone
- Saxagliptin
- Selpercatinib
- Sertindole
- Sertraline
- Sevoflurane
- Siponimod
- Sitagliptin
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Solifenacin
- Sorafenib
- Sotalol
- Sulpiride
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telaprevir
- Telavancin
- Telithromycin
- Tetrabenazine
- Theophylline
- Tolazamide
- Tolbutamide
- Tolterodine
- Toremifene
- Trazodone
- Triamcinolone
- Triclabendazole
- Trimipramine
- Triptorelin
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Vilanterol
- Vildagliptin
- Vinflunine
- Voclosporin
- Voriconazole
- Vorinostat
- Warfarin
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aluminum Carbonate, Basic
- Aluminum Hydroxide
- Aluminum Phosphate
- Aminolevulinic Acid
- Calcium
- Dihydroxyaluminum Aminoacetate
- Dihydroxyaluminum Sodium Carbonate
- Iron
- Lanthanum Carbonate
- Magaldrate
- Magnesium Carbonate
- Magnesium Hydroxide
- Magnesium Oxide
- Magnesium Trisilicate
- Phenytoin
How much does Levofloxacin cost?
$9.88
Levofloxacin contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Levofloxacin will not be safe for you to take.
- Allergy to another quinolone antibiotic
What are alternatives to Levofloxacin?
News about Levofloxacin











