levofloxacin | apollo +9191 46 950 950...
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Levofloxacin | apollo +9191 46 950 950
Levofloxacin | apollo +9191 46 950 950
Levofloxacin
CAS Number : 100986-85-4
Molecular Formula : C18H20FN3O4
Molecular Weight : 361.3675 g/mol
Systematic (IUPAC) : (2S)-7-fluoro-2-methyl-6-(4-methylpiperazin-1-yl)-10-oxo-4-oxa-1-
azatricyclo[7.3.1.0^{5,13}]trideca-5(13),6,8,11-tetraene-11-carboxylic acid
Type : small molecule
Description : A synthetic fluoroquinolone (fluoroquinolones) antibacterial agent that inhibits the supercoiling activity of bacterial DNAgyrase, halting
DNA replication.
Categories
Anti-Bacterial Agents
Quinolones
Nucleic Acid Synthesis Inhibitors
Anti-Infective Agents, Urinary
Taxonomy
Kingdom : Organic
Classes
Fluoroquinolones and Quinolones
Aminoquinolines and Derivatives
Hydroxyquinolines
Substructures
Hydroxy Compounds
Acetates
Phenols and Derivatives
Aliphatic and Aryl Amines
Pyridines and Derivatives
Piperazines
Fluoroquinolones and Quinolones
Ethers
Benzene and Derivatives
Oxazines
Aminoquinolines and Derivatives
Carboxylic Acids and Derivatives
Hydroxyquinolines
Halobenzenes
Heterocyclic compounds
Aromatic compounds
Anisoles
(Iso)quinolines and Derivatives
Aryl Halides
Phenyl Esters
Anilines
Pharmacology
Indication : For the treatment of bacterial
conjunctivitis caused by susceptible strains of the following organisms: Corynebacteriumspecies,
Staphylococus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus (Groups C/F/G), Viridans group streptococci, Acinetobacter
lwoffii, Haemophilus influenzae, Serratia marcescens.
Pharmacodynamics : Levofloxacin, a fluoroquinolone
antiinfective, is the optically active L-isomer of ofloxacin. Levofloxacin is used to treat bacterial
conjunctivitis, sinusitis, chronic bronchitis, community-acquired pneumonia and pneumonia caused by
penicillin-resistant strains of Streptococcus pneumoniae, skin and skin structure infections, complicated urinary tract infections and acute
pyelonephritis.
Mechanism of action : Levofloxacin inhibits bacterial type II topoisomerases, topoisomerase IV and DNA gyrase. Levofloxacin, like other fluoroquinolones,
inhibits the A subunits of DNA gyrase, two subunits encoded by the gyrA gene. This results in strand
breakage on a bacterial chromosome, supercoiling, and resealing; DNA replication and transcription is
inhibited.
Absorption : Absorption of ofloxacin after single or
multiple doses of 200 to 400 mg is predictable, and the amount of drug absorbed increases proportionately with
the dose.
Protein binding : 24-38% (to plasma proteins)
Metabolism : Mainly excreted as unchanged drug (87%); undergoes limited metabolism in humans.
Route of elimination : Mainly excreted as unchanged
drug in the urine.
Half life : 6-8 hours
Toxicity : Side effects include disorientation, dizziness,
drowsiness, hot and cold flashes, nausea, slurring of speech, swelling and numbness in the face
Affected organisms : Enteric bacteria and other
eubacteria
Drug Class And Mechanisms
Levofloxacin is an antibiotic for treating bacterial infections. Many common infections in humans are caused by bacteria. Bacteria can grow and multiply,
infecting different parts of the body. Drugs that control and eradicate these bacteria are called antibiotics.
Levofloxacin is an antibiotic that stops multiplication of bacteria by preventing the reproduction and repair of
their genetic material, DNA. It is in a class of antibiotics called fluoroquinolones, a class that
includesciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin), trovafloxacin(Trovan), and lomefloxacin (Maxaquin). The FDA approved
levofloxacin in December 1996.
Dosing
The usual dose is 250-750 mg given once daily for 5-60 days depending on the type of infection. It is important to take oral formulations at least 2 hours before or 2
hours after any antacid or mineral supplement containing iron, calcium, zinc, or magnesium since these
bind levofloxacin and prevent its absorption into the body.
Drug Interactions
Iron, calcium, zinc, or magnesium can attach to levofloxacin and other fluoroquinolones and prevent their absorption from the intestine into the blood.
Therefore, products (for example, antacids) that contain iron, calcium, zinc or magnesium should be taken at
least 2 hours before or 2 hours after levofloxacin. Other drugs that contain these minerals and can similarly
interact with levofloxacin include sucralfate (Carafate) anddidanosine (Videx, Videx EC).
Taking nonsteroidal antiinflammatory drugs (NSAIDs) with levofloxacin may increase the risk of CNS
stimulation, resulting in over-excitation. There have been reports of changes in blood sugar (increases and
decreases) in patients treated with fluoroquinolones and antidiabetic agents. Fluoroquinolones may increase blood levels of theophylline (Theodur), cyclosporine (Sandimmune, Neoral), and the effect of warfarin
(Coumadin).
Uses
This medication is used to treat a wide variety of bacterial infections. Levofloxacin belongs to a class of
drugs called quinolone antibiotics. It works by stopping the growth of bacteria.This medication will not work for viral infections (such as common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased
effectiveness.
How To Use?
Read the Medication Guide provided by your pharmacist before you start taking levofloxacin and each time you
get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth as
directed by your doctor, usually once daily with or without food. Drink plenty of fluids while taking this
medication unless otherwise directed by your doctor.The dosage and length of treatment is based on your kidney
function, medical condition, and response to treatment.Antibiotics work best when the amount of
medicine in your body is kept at a constant level.
Therefore, take this drug at the same time each day.Continue to take this medication until the full prescribed amount is finished, even if symptoms
disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.Take this medication at
least 2 hours before or 2 hours after taking other products that may bind to it, decreasing its effectiveness. Ask your pharmacist about the other products you take. Some examples include:quinapril, vitamins/minerals (including iron and zinc supplements), and products
containing magnesium, aluminum, or calcium (such as antacids,didanosine solution, calcium supplements).Tell
your doctor if your condition does not improve.
Why is this medication prescribed?
Levofloxacin is used to treat certain infections such as pneumonia chronic bronchitis and sinus, urinary tract, kidney, prostate (a male reproductive gland), and skin infections. Levofloxacin is also used to prevent anthrax (a serious infection that may be spread on purpose as
part of a bioterror attack) in people who may have been exposed to anthrax germs in the air. Levofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. Antibiotics will not
work for colds, flu, or other viral infections.
How should this medicine be used?
Levofloxacin comes as a tablet and a solution (liquid) to take by mouth. It is usually taken once a day. The length of your treatment depends on the type of infection you
have. Your doctor will tell you how long to take levofloxacin. The tablet may be taken with or without
food. The solution should be taken 1 hour before or 2 hours after eating. Take levofloxacin at around the same
time every day. Follow the directions on your prescription label carefully, and ask your doctor or
pharmacist to explain any part you do not understand. Take levofloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your
doctor.
You should begin to feel better during the first few days of treatment with levofloxacin. If your symptoms do not
improve or if they get worse, call your doctor.
Take levofloxacin until you finish the prescription, even if you feel better. Do not stop taking levofloxacin unless you experience the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING
section or the symptoms of allergic reaction described in the SIDE EFFECTS section. If you stop taking
levofloxacin too soon or skip doses, your infection may not be completely treated and the bacteria may become
resistant to antibiotics.
Other uses for this medicine
Levofloxacin is also sometimes used to treat endocarditis (infection of the heart lining and valves), certain sexually transmitted diseases, and tuberculosis (TB). Levofloxacin is also sometimes used to prevent or treat travelers' diarrhea and plague (a serious infection that may be spread on purpose as part of a bioterror
attack). Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking levofloxacin,
tell your doctor and pharmacist if you are allergic or have had a severe reaction to levofloxacin; any other
quinolone or fluoroquinolone antibiotic such as ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive),
lomefloxacin (Maxaquin) (not available in the U.S.), moxifloxacin (Avelox), nalidixic acid (NegGram),
norfloxacin (Noroxin), ofloxacin (Floxin), and sparfloxacin (Zagam) (not available in the U.S.): or any other medications, or if you are allergic to any of the
ingredients in levofloxacin tablets or solution. Ask your pharmacist or check the Medication Guide for a list of
the ingredients.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the
IMPORTANT WARNING section and any of the following: anticoagulants ('blood thinners') such as
warfarin (Coumadin, Jantoven); certain antidepressants; antipsychotics (medications to treat
mental illness); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); insulin; oral
medications for diabetes such as glyburide (DiaBeta, in Glucovance, Micronase, others); certain medications for
irregular heartbeat such as amiodarone (Cordarone), procainamide (Procanbid), quinidine, and sotalol
(Betapace, Betapace AF, Sorine); nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others);
tacrolimus (Prograf); or theophylline (Elixophyllin, Theo-24, Uniphyl, others). Your doctor may need to
change the doses of your medications or monitor you carefully for side effects.
if you are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta,
Tums, others), didanosine (Videx), sucralfate (Carafate), or vitamin or mineral supplements that contain iron or zinc, take these medications 2 hours before or after you
take levofloxacin.
tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart
problem that may cause irregular heartbeat, fainting, or sudden death) or an irregular heartbeat, and if you have
or have ever had nerve problems; a low level of potassium in your blood; a slow heartbeat; cerebral
arteriosclerosis (narrowing of blood vessels in or near the brain that can lead to stroke or mini-stroke);
seizures; chest pain; or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant
while taking levofloxacin, call your doctor.
you should know that levofloxacin may cause confusion, dizziness, lightheadedness, and tiredness. Do not drive a
car, operate machinery, or participate in activities requiring alertness or coordination until you know how
this medication affects you.
plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds and sunlamps)
and to wear protective clothing, sunglasses, and sunscreen. Levofloxacin may make your skin sensitive to
sunlight or ultraviolet light. If your skin becomes reddened, swollen, or blistered, like a bad sunburn, call
your doctor.
What special dietary instructions should I follow?
Make sure you drink plenty of water or other fluids every day while you are taking levofloxacin.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Levofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
nausea
vomiting
diarrhea
stomach pain
constipation
heartburn
headache
vaginal itching and/or discharge
Some side effects can be serious. If you experience any of these symptoms, or those mentioned in the
IMPORTANT WARNING section, stop taking levofloxacin, and call your doctor immediately:
severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur
up to 2 months or more after your treatment)
skin rash or blisters
itching
hives
tingling or swelling of the face, neck, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
difficulty breathing or swallowing
hoarseness or throat tightness
fainting
rapid, irregular, or pounding heartbeat
chest pain
joint or muscle pain
fever
unusual bruising or bleeding
extreme tiredness
lack of energy
loss of appetite
pain in the upper right part of the stomach
yellowing of the skin or eyes
dark urine
pale stools
flu-like symptoms
seizures
dizziness
confusion
nervousness
restlessness
anxiety
not trusting others or feeling that others want to hurt you
difficulty falling asleep or staying asleep
nightmares or abnormal dreams
hallucinations (seeing things or hearing voices that do not exist)
depression
thoughts about dying or killing yourself
uncontrollable shaking of a part of the body
pain, burning, tingling, numbness, and/or weakness in a part of the body
Levofloxacin may cause problems with bones, joints, and tissues around joints in children. Levofloxacin should
not normally be given to children younger than 18 years of age unless they have been exposed to anthrax in the
air. If your doctor prescribes levofloxacin for your child, be sure to tell the doctor if your child has or has ever had
joint-related problems. Call your doctor if your child develops joint problems, such as pain or swelling, while taking levofloxacin or after treatment with levofloxacin.
Talk to your child's doctor about the risks of giving levofloxacin to your child.
Levofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking
this medication.
What storage conditions are needed for this
medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room
temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist
about the proper disposal of your medication.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to
check your body's response to levofloxacin.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking
levofloxacin.
Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have
symptoms of infection after you finish taking levofloxacin, call your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter)
medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You
should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of
emergencies.
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