Levofloxacin (lee-voe-FLOX-a-sin)

Treats infections and is given to people who have been exposed to anthrax. Also used to treat and prevent plague (including pneumonic and septicemic plague). This medicine is a quinolone antibiotic.

Brand Name(s):

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.
• Drink extra fluids so you will urinate more often and help prevent kidney problems.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Your doctor may give you a few doses of this medicine until your condition improves, and then you may be switched to an oral medicine that works the same way. Talk to your doctor if you have any concerns about this.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how levofloxacin works. Tell your doctor if you are using any of the following:
  • Theophylline
  • Blood thinner (including warfarin)
  • Diabetes medicine
  • Medicine for heart rhythm problems (including amiodarone, procainamide, quinidine, sotalol)
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
  • Steroid medicine (including hydrocortisone, methylprednisolone, prednisone)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, diabetes, heart disease, myasthenia gravis, or a history of heart rhythm problems (including QT prolongation), seizures, brain problems, or mental illness. Tell your doctor if you have ever had tendon or joint problems, including rheumatoid arthritis, or if you have received a transplant.
• This medicine may cause the following problems:
  • Tendinitis and tendon rupture (may happen after treatment ends)
  • Liver problems
  • Nerve damage in the arms or legs, which may become permanent
  • Changes in mood or behavior, seizures, or increased pressure in the head
  • Serious skin reactions
  • Kidney problems
  • Heart rhythm changes
  • Changes in blood sugar levels
• This medicine may make you feel dizzy or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Diarrhea that may contain blood
• Fainting, dizziness, or lightheadedness
• Fast, slow, or uneven heartbeat, chest pain
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Pain, stiffness, swelling, or bruises around your ankle, leg, shoulder, or other joint
• Seizures, severe headache, unusual thoughts or behaviors, trouble sleeping, feeling anxious, confused, or depressed, seeing, hearing, or feeling things that are not there
• Sensitivity of the skin to sunlight, redness or other discoloration of the skin, severe sunburn
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Mild headache or nausea
• Pain, itching, burning, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088