Medicine Information

Leo

Tablet250 mgAntibioticsATC: J01MA12

Generic Name

Levofloxacin

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
leo 250 mg tablet	৳ 8.06	৳ 32.25

Description

Overview of the medicine

Levofloxacin is a fluoroquinolone antibiotic used to treat a wide range of bacterial infections including respiratory tract infections, urinary tract infections, and skin and soft tissue infections.

Uses & Indications

Community-acquired pneumonia (CAP)

Acute bacterial sinusitis (ABS)

Acute bacterial exacerbation of chronic bronchitis (ABECB)

Uncomplicated and complicated urinary tract infections (UTI)

Pyelonephritis

Skin and skin structure infections (SSSI)

Chronic bacterial prostatitis

Dosage

Adults

For most infections, 250 mg once daily for 7-14 days. Dosing varies based on infection type and severity.

Elderly

No specific dose adjustment is needed for the elderly unless renal function is impaired. Monitor renal function.

Renal_impairment

Adjust dose based on creatinine clearance (CrCl). For CrCl 20-49 mL/min: 250 mg every 48 hours. For CrCl <20 mL/min: 250 mg initial dose, then 125 mg every 48 hours.

How to Take

Take orally with or without food. Ensure adequate hydration during treatment. Do not crush or chew the tablet.

Mechanism of Action

Levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes involved in bacterial DNA replication, transcription, repair, and recombination. This leads to disruption of bacterial DNA and cell death.

Pharmacokinetics

Onset

Within 1-2 hours

Excretion

Primarily excreted unchanged in the urine (approximately 87% within 48 hours), indicating renal elimination.

Half life

6-8 hours

Absorption

Rapidly and almost completely absorbed after oral administration, with peak plasma concentrations typically occurring 1-2 hours post-dose. Bioavailability is approximately 99%.

Metabolism

Minimally metabolized in the liver; less than 5% of an administered dose is recovered in urine as metabolites.

Side Effects

Contraindications

Hypersensitivity to levofloxacin or other fluoroquinolones.
History of tendinitis or tendon rupture associated with fluoroquinolone use.
Epilepsy or other seizure disorders.
Children and adolescents below 18 years of age.
Pregnancy and breastfeeding.

Drug Interactions

Warfarin

May enhance the anticoagulant effects of warfarin, increasing the risk of bleeding. Monitor INR closely.

Corticosteroids

Concomitant use with corticosteroids increases the risk of tendinitis and tendon rupture.

Antiarrhythmics (Class IA and III)

Increased risk of QT interval prolongation and torsades de pointes.

Insulin and Oral Hypoglycemic Agents

Can cause dysglycemia (both hypoglycemia and hyperglycemia); monitor blood glucose levels.

NSAIDs (Nonsteroidal anti-inflammatory drugs)

May increase the risk of CNS stimulation and convulsive seizures when co-administered with fluoroquinolones.

Antacids (containing Mg or Al), Sucralfate, Iron/Zinc supplements

May significantly reduce the absorption of levofloxacin if taken concurrently. Administer levofloxacin at least 2 hours before or 2 hours after these agents.

Storage

Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.

Overdose

In case of overdose, symptoms may include confusion, dizziness, seizures, QT prolongation, and gastrointestinal disturbances. Management involves gastric lavage, symptomatic and supportive treatment, and monitoring of ECG and vital signs. Hemodialysis or peritoneal dialysis is not effective in removing levofloxacin.

Pregnancy & Lactation

Levofloxacin is generally avoided during pregnancy and breastfeeding due to potential risks to the fetus/infant, including effects on cartilage development. It is classified as Pregnancy Category C. Consult a doctor to weigh the benefits against risks.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 Tablets (Blister pack)

Shelf Life

24 to 36 months from manufacturing date, check specific packaging.

Availability

Pharmacies, Hospitals

Approval Status

Approved by FDA/DGDA

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have demonstrated the efficacy and safety of levofloxacin in treating various bacterial infections, leading to its widespread approval and use globally.

Lab Monitoring

Renal function tests (e.g., serum creatinine, BUN) in patients with impaired renal function or elderly.
Blood glucose levels, especially in diabetic patients on insulin or oral hypoglycemic agents.
Liver function tests if hepatotoxicity is suspected.

Doctor Notes

Emphasize the importance of completing the full course of therapy to prevent resistance and recurrence.
Advise patients about the black box warnings, particularly regarding tendon rupture, peripheral neuropathy, and CNS effects. Instruct them to seek immediate medical attention if these symptoms occur.
Consider alternative antibiotics in patients with a history of myasthenia gravis, or if no other options are available, closely monitor for exacerbation of symptoms.

Patient Guidelines

Complete the entire course of medication, even if symptoms improve, to prevent antibiotic resistance.
Stay well-hydrated during treatment by drinking plenty of fluids.
Avoid excessive sun exposure and use sunscreen, as levofloxacin can increase photosensitivity.
Report any new pain, tingling, numbness, or weakness in your limbs, or any tendon pain or swelling immediately to your doctor.
Do not take antacids, sucralfate, or mineral supplements within 2 hours of taking this medicine.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double doses.

Driving Precautions

Levofloxacin may cause dizziness, lightheadedness, or visual disturbances. Patients should assess their reaction to the drug before driving or operating machinery.

Lifestyle Advice

Maintain a balanced diet and healthy lifestyle. Avoid alcohol during treatment if it exacerbates side effects. Practice good hygiene to prevent further infections.