Adult Dosing
Nosocomial Pneumonia
- 750 mg PO Daily x 7-14 days
Community Acquired Pneumonia
- 500 mg PO Daily x 7-14 days or 750 mg PO Daily x 5 days
Acute Bacterial Sinusitis
- 750 mg PO Daily x 5 day or 500 mg PO Daily x 10-14 days
Acute Bacterial Exacerbation of Chronic Bronchitis
Skin and Skin Structure Infections
- Complicated: 750 mg PO Daily x 7-14 days
- Uncomplicated: 500 mg PO Daily x 7-10 days
Chronic Bacterial Prostatitis
- 500 mg PO Daily x 28 days
Urinary Tract Infection or Acute Pyelonephritis
- Complicated: 750 mg PO Daily for 5 days or 250 mg PO Daily for 10 days
- Uncomplicated: 250 mg PO Daily for 3 days
Inhalational Anthrax (Post-Exposure)
- 500 mg PO Daily for 60 days
Traveler's Diarrhea [Not FDA Approved]
Bronchiectasis [Not FDA Approved]
Orbital cellulitis [Non-FDA Approved]
Chlamydia [Non-FDA Approved]
- 500 mg PO daily x 7 days
- Contraindicated in pregnant women
Pediatric Dosing
Inhalational Anthrax (Post-Exposure)
Child >6 mo
- < 50 kg: 8 mg/kg PO bid for 60 days (MAX:250 mg/dose)
- >50 kg: 500 mg PO Daily for 60 days
- The safety has not been studied for dosage more than 14 days
Traveler's Diarrhea[Not FDA Approved]
- 10 mg/kg/dose qd x 3 days; max: 500 mg/day
Bronchiectasis [Not FDA Approved]
- 6 mos-5 yrs: 20 mg/kg/day divided q12 hrs PO [Max 500 mg/day]
- >5 yrs: 10 mg/kg/day q24 hrs PO/IV [Max 500-750 mg/day]
Orbital cellulitis [Non-FDA Approved]
- 20 mg/kg PO qd [Maximum dose 750 mg]
[Outline]
Renal Dose Adjustment (Based on CrCl)
For usual dose of 750 mg PO Daily
- 20-49 (mL/min): 750 mg PO Every other Day
- <20 (mL/min): 750 mg PO as a single dose, then 500 mg PO every other day
- Hemodialysis and continuous peritoneal dialysis: No dose adjustments defined
For usual dose of 500 mg PO Daily
- 20-49 (mL/min): 500 mg PO as a single dose, then 250 mg PO every other day
- <20 (mL/min): 500 mg PO as a single dose, then 250 mg PO every other day
- Hemodialysis and continuous peritoneal dialysis: No dose adjustments defined
For usual dose of 250 mg PO Daily
- 10-19 (mL/min): 250 mg PO every other day
- <10 (mL/min): No dose adjustments defined
- Hemodialysis and continuous peritoneal dialysis: No adjustments defined
Hepatic Dose Adjustment
- Hepatic impairment: No dose adjustments defined
See Supplemental Patient Information
- Administer tablet without regard to meals
- Administer oral soln on an empty stomach, 1 hr before or 2 hrs after eating and maintain adequate hydration
- Increased risk of tendinitis and tendon rupture especially in patients > 60years, or those with kidney, heart or lung transplants. Discontinue if tendon pain, inflammation or rupture occurs
- May exacerbate muscle weakness in patients with myasthenia gravis. Avoid use in these patients
- Serious and occasionally fatal hypersensitivity and/or anaphylactic reactions have been reported in patients receiving therapy with fluoroquinolones, including levofloxacin
- Severe hepatotoxicity has been reported in patients treated with this drug. The majority of fatal cases occurred in patients 65 years of age or older and most were not associated with hypersensitivity
- Discontinue if rash, jaundice, other signs of hypersensitivity, hypoglycemic reactions, phototoxicity, CNS stimulation, or hepatitis occurs
- Clostridium difficile-associated diarrhea (CDAD) has been reported with use of this drug and may range in severity from mild diarrhea to fatal colitis
- An increased incidence of musculoskeletal disorders (arthralgia, arthritis, tendonopathy, and gait abnormality) compared to controls has been observed in pediatric patients treated with this drug
- Prolongation of the QT interval and isolated cases of torsade de pointes have been reported
- Avoid use in patients with known QT prolongation, those with hypokalemia, and with other drugs that prolong the QT interval
- Avoid use in patients with a history of hypersensitivity to levofloxacin
- Reevaluate if peripheral neuropathy occurs. Avoid excessive sun or UV light
- Monitor blood, renal, hepatic, and hematopoietic function
- Cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias and weakness have occurred in patients
- Discontinue therapy if the patient experiences symptoms of neuropathy including pain, burning, tingling, numbness, and/or weakness or other alterations of sensation including light touch, pain, temperature, position sense, and vibratory sensation in order to prevent the development of an irreversible condition
Cautions: Use with caution in
- Renal impairment
- CNS disorders (eg, cerebral arteriosclerosis, epilepsy) that increase seizure risk
- Concurrent use of corticosteroids
- Kidney, heart, or lung transplant patients
- Pediatric patients
- Diabetics
Supplemental Patient Information
- Instruct patient to stop taking drug and contact physican if he/she experiences signs or symptoms of hypersensitivity reaction (rash, hives, or other skin reactions) or severe diarrhea (which may indicate pseudomembranous colitis)
- Instruct patients to take oral soln on an empty stomach, 1 hr before or 2 hrs after eating
- Advise patients to drink fluids liberally while taking this drug to avoid formation of a highly concentrated urine and crystal formation in urine
Pregnancy Category:C
Breastfeeding: Safety unknown; Use with caution; exclusively breastfed infant would receive 1.25 mg daily in breastmilk out of 500 mg daily dose received by mother; which is far below the dose used in children. This information based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 January 2011).
Pricing data from www.DrugStore.com in U.S.A.
- Levaquin 500 MG TABS [Bottle] (JANSSEN)
10 mg = $185.98
30 mg = $532.99 - Levaquin 250 MG TABS [Bottle] (JANSSEN)
10 mg = $168
30 mg = $484.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
