Coslev
Generic Name
Levofloxacin 500 mg Tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| coslev 500 mg tablet | ৳ 14.00 | ৳ 140.00 |
Description
Overview of the medicine
Coslev 500 mg Tablet contains Levofloxacin, a broad-spectrum fluoroquinolone antibiotic used to treat various bacterial infections including respiratory tract infections, urinary tract infections, skin and soft tissue infections, and certain sexually transmitted diseases.
Uses & Indications
Dosage
Adults
Typically 500 mg once daily for 7-14 days depending on the infection. For some infections, 250 mg once daily or 750 mg once daily may be prescribed.
Elderly
No specific dose adjustment is needed based on age alone; adjust based on renal function.
Renal_impairment
Dose adjustment required based on creatinine clearance. For CrCl 20-49 mL/min, 250 mg every 24 hours. For CrCl 10-19 mL/min, 250 mg every 48 hours.
How to Take
Take orally, with or without food. Do not take with antacids containing magnesium or aluminum, sucralfate, iron, or zinc supplements. Maintain adequate hydration.
Mechanism of Action
Levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes involved in DNA replication, transcription, repair, and recombination. This leads to bacterial cell death.
Pharmacokinetics
Onset
Within hours for susceptible pathogens.
Excretion
Primarily excreted unchanged in urine, mainly via glomerular filtration and tubular secretion. Renal clearance is substantial.
Half life
Approximately 6-8 hours.
Absorption
Rapid and complete absorption from the gastrointestinal tract after oral administration. Bioavailability is approximately 99%. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Minimally metabolized in the liver; primarily excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to levofloxacin, other quinolones, or any excipients
- History of tendon disorders related to fluoroquinolone administration
- Epilepsy
- Pregnancy and lactation (generally not recommended)
- Children or adolescents (under 18 years of age) due to risk of arthropathy
Drug Interactions
NSAIDs
May increase the risk of CNS stimulation and convulsive seizures.
Warfarin
May enhance the anticoagulant effect of warfarin, requiring INR monitoring.
Corticosteroids
Increased risk of tendinitis and tendon rupture.
Insulin/Oral Hypoglycemics
May cause dysglycemia (hypoglycemia or hyperglycemia), especially in diabetic patients. Monitor blood glucose.
Antacids (Mg/Al), Sucralfate, Iron, Zinc
Reduced absorption of levofloxacin. Take levofloxacin at least 2 hours before or 2 hours after these agents.
QTc-prolonging drugs (e.g., Class IA and III antiarrhythmics, tricyclic antidepressants)
Increased risk of QTc prolongation and arrhythmias.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include central nervous system effects such as confusion, dizziness, impaired consciousness, convulsive seizures, and gastrointestinal reactions. Management involves symptomatic treatment and supportive measures. Gastric lavage and hydration are important. Hemodialysis or peritoneal dialysis are not effective.
Pregnancy & Lactation
Levofloxacin is generally contraindicated in pregnancy and lactation due to potential risks of arthropathy in the fetus/infant. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to levofloxacin, other quinolones, or any excipients
- History of tendon disorders related to fluoroquinolone administration
- Epilepsy
- Pregnancy and lactation (generally not recommended)
- Children or adolescents (under 18 years of age) due to risk of arthropathy
Drug Interactions
NSAIDs
May increase the risk of CNS stimulation and convulsive seizures.
Warfarin
May enhance the anticoagulant effect of warfarin, requiring INR monitoring.
Corticosteroids
Increased risk of tendinitis and tendon rupture.
Insulin/Oral Hypoglycemics
May cause dysglycemia (hypoglycemia or hyperglycemia), especially in diabetic patients. Monitor blood glucose.
Antacids (Mg/Al), Sucralfate, Iron, Zinc
Reduced absorption of levofloxacin. Take levofloxacin at least 2 hours before or 2 hours after these agents.
QTc-prolonging drugs (e.g., Class IA and III antiarrhythmics, tricyclic antidepressants)
Increased risk of QTc prolongation and arrhythmias.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include central nervous system effects such as confusion, dizziness, impaired consciousness, convulsive seizures, and gastrointestinal reactions. Management involves symptomatic treatment and supportive measures. Gastric lavage and hydration are important. Hemodialysis or peritoneal dialysis are not effective.
Pregnancy & Lactation
Levofloxacin is generally contraindicated in pregnancy and lactation due to potential risks of arthropathy in the fetus/infant. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (DGDA, FDA)
Patent Status
Off-patent (generic available)
WHO Essential Medicine
YesClinical Trials
Levofloxacin has undergone extensive clinical trials demonstrating its efficacy and safety across various bacterial infections. Ongoing post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Renal function tests (e.g., creatinine clearance) in patients with impaired renal function
- Blood glucose monitoring in diabetic patients
- INR monitoring in patients on warfarin
Doctor Notes
- Counsel patients on the black box warnings, especially regarding tendinitis/tendon rupture and peripheral neuropathy.
- Advise caution in elderly patients and those on corticosteroids due to increased risk of musculoskeletal adverse events.
- Monitor for signs of dysglycemia in diabetic patients.
- Ensure appropriate renal dose adjustments.
Patient Guidelines
- Complete the full course of treatment, even if symptoms improve.
- Stay well-hydrated.
- Avoid excessive sun exposure and use sunscreen due to photosensitivity risk.
- Report any joint pain, swelling, or weakness immediately.
- Do not take with antacids, iron, or zinc supplements.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
May cause dizziness, lightheadedness, or visual disturbances. Patients should assess their reaction to the drug before driving or operating machinery.
Lifestyle Advice
- Maintain good hygiene to prevent reinfection.
- Follow a balanced diet and avoid self-medication.
- Consult doctor for persistent symptoms.
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