Adults

Typical dosage is 400 mg once daily for 7-14 days, depending on the type and severity of infection. For example, 400 mg once daily for 10-14 days for community-acquired pneumonia.

Elderly

No specific dose adjustment based on age alone; however, renal function should be assessed, and dosage adjusted accordingly if impaired.

Renal_impairment

Dosage adjustment is necessary for patients with creatinine clearance less than 50 mL/min. For CrCl 20-49 mL/min: Initial dose 400 mg, then 200 mg every 24 hours. For CrCl 10-19 mL/min: Initial dose 400 mg, then 100 mg every 24 hours.

Onset

Within 1-2 hours (for significant plasma levels, clinical effects vary based on infection type and site).

Excretion

Primarily excreted unchanged by the kidneys, with approximately 87% of an oral dose recovered in the urine within 48 hours.

Half life

Approximately 6-8 hours, increasing with renal impairment.

Absorption

Rapid and almost complete absorption after oral administration; bioavailability approximately 99%. Peak plasma concentrations are usually achieved within 1-2 hours.

Metabolism

Minimally metabolized in the liver to inactive metabolites. About 5% of a dose is metabolized.

NSAIDs

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

Warfarin

May enhance the anticoagulant effects of warfarin, requiring close monitoring of INR.

Corticosteroids

Increased risk of tendinitis and tendon rupture when co-administered with fluoroquinolones.

Diabetes medications (e.g., Insulin, oral hypoglycemics)

May cause dysglycemia (hypoglycemia or hyperglycemia), requiring careful blood glucose monitoring.

Antacids containing magnesium or aluminum, Sucralfate, Metal cations (iron, zinc)

Can significantly reduce absorption of levofloxacin. Administer levofloxacin at least 2 hours before or 2 hours after these agents.