Fact Checked

What Is the Drug Levofloxacin Used For?

What happens when your doctor prescribes an antibiotic for a minor infection and it doesn’t work, or you come down with a serious case of pneumonia that won’t go away? While most doctors prescribe broad-based antibiotics as the first line of treatment for bacterial infections, many species of bacteria are becoming increasingly drug-resistant. One powerful fluoroquinolone antibiotic, levofloxacin, is used to treat and prevent a number of serious infections that cannot be treated with other medications. As the improper use of antibiotics continues, the number of drug-resistant bacteria species continues to grow, making levofloxacin more important; the medication was prescribed 3,777,117 times in 2017 in the United States alone. So, what is the drug levofloxacin used for and how can it help you?

What Is Levofloxacin?

Levofloxacin is an antibiotic used to treat bacterial infections that is sold under the brand name Levaquin. The brand name medication was first approved by the U.S. Food and Drug Administration (FDA) in 1996 for the treatment of acute bacterial sinusitis, bacterial bronchitis, pneumonia, skin infections, severe urinary tract infections, and acute kidney infections. Levofloxacin belongs to a class of drugs called quinolone antibiotics, and like other antibiotics, it works by stopping the growth of bacteria in the body. Levofloxacin is not effective when used against viral infections such as most upper respiratory infections or the common cold, although antibiotics like it are often incorrectly prescribed for these illnesses.

What Is the Drug Levofloxacin Used For?

Levofloxacin is a powerful antibiotic that is used to treat a number of different bacterial conditions. The drug has many different treatment applications, including community-acquired pneumonia, sinus infection, exacerbation of chronic bronchitis, skin infections, chronic prostate infections, urinary tract infections, kidney infections, inhalation of anthrax, and plague. Levofloxacin carries the risk of a number of serious side effects and is therefore not used for the treatment of common bacterial infections that can be addressed with lower strength broad-spectrum antibiotics, including most urinary tract infections, sexually transmitted diseases, and acne. The medication is sometimes taken with other medications in a strategy called combination therapy. Other similar antibiotics include ciprofloxacin and moxifloxacin. 

What Causes Bacterial Infections?

Our bodies are made up of trillions of living organisms that comprise our microbiome, including trillions of bacteria. The bacteria in our bodies can be good, bad, or neutral depending on the size of their population within our bodies and their location. Good bacteria are called probiotics, and you’ve no doubt heard them referenced in yogurt commercials and other advertisements lately. Probiotics fight off disease and are responsible for carrying out important functions, like digesting food. Harmful bacteria, called pathobiotics, cause disease, and eubiotics are species of bacteria that can be harmful or helpful depending on the size of the colony and their location. If the pathobiotics in our bodies or a specific part of the body outnumber the probiotics, we can end up with a bacterial infection.  Antibiotics are commonly used to treat bacterial infections because they work by killing the pathobiotic bacteria that are causing the infection.

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How Much Does Levofloxacin Cost?

Levofloxacin can be purchased in both tablet form and as an ophthalmic solution used for eye infections at your local pharmacy. Healthcare providers have access to an injectable form of levofloxacin, but it is not available for consumer purchase. As the generic form of Levaquin, levofloxacin is an inexpensive medication that is available in 250 mg, 500 mg, and 750 mg strengths. An average prescription of levofloxacin will cost approximately ten dollars to fill regardless of the strength or even the number of pills prescribed. By contrast, the brand name form of the medication, Levaquin, is available at only the 500 mg and 750 strength and will set you back anywhere from 300 - 600 dollars for ten tablets. Brand name medications are often significantly more expensive than the generic forms of the drug, so it is recommended that patients looking to save money purchase the generic medication if their medical history allows them to do so. Levofloxacin is covered by most insurance plans, including Medicare and Medicaid, as well as most commercial insurance programs. However, insurance may not always offer the best prices on prescription drugs. Pharmacy discount card programs like USA Rx also offer savings on all FDA-approved brand name and generic medications, including omeprazole, and patients can sign up for free. 

What Are the Benefits of Using Levofloxacin?

One of the major benefits of levofloxacin is that this powerful antibiotic can effectively treat bacterial infections that other antibiotics have failed to treat. Levofloxacin is used as the first line of treatment for serious skin, sinus, kidney, bladder, and prostate infections caused by bacteria, and it is used as a second treatment for urinary tract infections, chronic bronchitis, and sinusitis when other treatments are not effective. Levofloxacin is sometimes used for the treatment of lung infections and is also given as a preventative treatment to people who have been exposed to anthrax through inhalation. One of the most significant benefits of the drug is that it is capable of killing many different types of pathobiotic bacteria, including some species that have become resistant to treatment by other medications. Both a generic and brand name form of the drug are available, so you are likely to have one of the forms of the medication covered by your insurance company. If you do not have health insurance, levofloxacin and Levaquin are eligible for discounts under any pharmacy discount card program, including USA Rx. 

How Do I Know What Dose of Levofloxacin to Take?

Levofloxacin is a powerful antibiotic that can only be obtained by prescription from your doctor. Therefore, your doctor will consider your age, medical history, the condition being treated, and other medications that you are taking when prescribing a specific dose. Levofloxacin is available in 250 mg, 500 mg, and 750 mg tablets and is also available as an ophthalmic solution and an injection given only by healthcare providers and not over-the-counter. A typical dose of levofloxacin for serious infections in adults is 500 mg or 750 mg taken once per day. Some conditions, including more minor infections that have not responded to other antibiotics,  may be treated by the 250 mg dose. It’s imperative that you follow your doctor’s orders directly and do not take the medication for more or less time than prescribed, even if your symptoms have improved. Skipping doses or extending the length of your prescription can increase your risk of further infection by unnecessarily exposing your body to antibiotics, allowing them to become drug-resistant. Follow your doctor’s orders exactly, read the drug information thoroughly, and store it at room temperature.
It is best to take levofloxacin with a full glass of water. Some people may experience an upset stomach when taking levofloxacin; if this occurs, talk to your doctor about taking the medication with food. Levofloxacin is generally not prescribed for children ages 17 and under except for the treatment of plague or inhalation of anthrax due to the risks associated with the medication. Senior citizens and people with kidney damage or disease may need to take a lower dosage of the drug to treat their infection, as these groups often have reduced kidney function that causes the drug to build up in their systems in higher quantities, causing an increased risk of side effects.

Are There Any Side Effects I Should Be Aware of?

Levofloxacin can cause both mild and serious side effects. Common side effects associated with levofloxacin that usually do not require medical help include:

  • Headache
  • Insomnia (trouble sleeping)
  • Dizziness
  • Nausea
  • Diarrhea
  • Constipation

If these common side effects do not subside within a few days or weeks or become more severe, get medical advice from your doctor. 
Rarely, some people may experience adverse effects from levofloxacin that can affect many different parts of the body. In the event of a serious drug reaction, you should seek treatment from a medical professional. Symptoms of an allergic reaction may include:

  • Skin rash
  • Trouble breathing or swallowing
  • Throat tightness or hoarseness
  • Fainting
  • Hives
  • Swelling of the face, lips, and tongue
  • Fast heart rate

Experiencing any of the following is a sign of a medical emergency and treatment should be sought at once:

  • Central nervous system effects, including:
    • Hallucinations
    • Anxiety
    • Depression
    • Nightmares
    • Paranoia
    • A headache that will not go away, with or without blurred vision
    • Seizures
    • Restlessness
    • Tremors
    • Confusion
    • Trouble sleeping
    • Lightheadedness
    • Suicidal thoughts or actions
  • Peripheral neuropathy, including pain, numbness, or weakness in the hands, feet, arms, or legs
  • Tendon damage and inflammation, including pain and reduced ability to move
  • Joint and muscle pain
  • Severe diarrhea caused by Clostridium difficile
    • Watery and bloody stools
    • Fever
    • Abdominal pain
  • Liver damage, which can sometimes be fatal. Symptoms include:
    • Loss of appetite
    • Vomiting and stomach pain
    • Weakness
    • Itching
    • Light-colored bowel movements
    • Dark-colored urine
    • Nausea
    • Fever
    • Tiredness
    • Bruising
    • Yellowing of the skin or whites of the eyes
    • Pain in the abdomen
  • Heart rhythm problems, including prolongation of the QT interval
    • Loss of consciousness
    • Irregular heartbeat
  • Increased sensitivity to the sun (photosensitivity) that leads to severe sunburns
  • Low blood sugar

Are There Any Risks Associated With Levofloxacin?

Levofloxacin is associated with serious side effects that can be permanent and fatal, so the medication guide has numerous black box warnings from the FDA, which are the most serious warnings that the agency offers. Although it is a highly effective and powerful antibiotic, this is the reason that levofloxacin is used only to treat serious medical conditions or infections that have not responded to other types of treatment. Black box warnings associated with levofloxacin include:

  • Restricted use: Due to the potential for serious side effects, some of which may be permanent, levofloxacin should only be taken for certain conditions when no other treatment options exist. 
  • Myasthenia gravis: Levofloxacin can cause a worsening of muscle weakness in patients with myasthenia gravis. These patients should not take levofloxacin.
  • Tendon rupture and tendonitis: Levofloxacin is associated with an increased risk of tendon problems regarding things like the Achilles tendon regardless of the age of the patient. However, risks of tendon disorders and tendinitis are higher for patients over the age of 60, those taking corticosteroids or people who have had heart, kidney, or lung transplants.
  • Central nervous system: Levofloxacin can impact your central nervous system and cause convulsions, increased pressure in the head, nerve damage, psychosis, hallucinations, tremors, agitation, anxiety, confusion, and other mental issues. It can also increase suicidal thoughts or actions. 
  • Peripheral neuropathy: Levofloxacin can cause damage to the nerves in your hands, arms, feet, and legs, called peripheral neuropathy, that can be permanent.

Who Should Not Take Levofloxacin?

People who are allergic to levofloxacin or other quinolone antibiotics should not take levofloxacin. Also, make sure to inform your doctor about potential drug interactions from all medications that you currently take including multivitamins, nonsteroidal antiinflammatory drugs (NSAIDs), opiates, antacids like Carafate, People who have a history of any of the following conditions should make sure to give their health care professional a complete medical and family history:

  • History of depression or mental illness
  • Heart problems
  • Liver problems
  • Diabetes
  • Kidney problems
  • Myasthenia gravis

Is Levofloxacin Safe for Pregnant and Nursing Women?

The FDA categorizes levofloxacin as a Category C drug for pregnant women, which means that not enough studies have been done on humans to know how the drug might impact a developing fetus. Research in animals has shown that the drug may cause adverse effects, but definitive human impacts are unknown. However, a serious bacterial infection can also be potentially harmful to the developing fetus, so pregnant women should consult with their doctors about whether the benefits outweigh the risks of using the medication.  Levofloxacin does pass into breast milk and cause harmful side effects to a nursing infant, so nursing mothers should talk to their doctors and decide whether to continue taking the drug or whether to stop breastfeeding. 

How Do I Know If Levofloxacin Is Right for Me?

Levofloxacin may be right for you if you are suffering from a bacterial infection, are eighteen years of age older, and do not fall into any of the categories considered at higher risk of side effects from levofloxacin. The medication is affordable and comes in several different strengths, making it highly accessible. However, there are serious risks associated with taking levofloxacin, so it is important to give your doctor a complete medical history. Because levofloxacin is only effective against bacterial, rather than viral, infections, it is critical that you speak to your doctor to ensure that your condition is bacterial prior to starting the medication. Taking levofloxacin incorrectly by skipping doses or not finishing the prescribed course of treatment can have a lasting effect on your body’s response to antibiotics, so only take levofloxacin if you are confident that you will follow the prescription instructions.
 
 

Published July 14th, 2020 by Bridget Reed
Fact Checked by Chris Riley

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