Precautions and Warnings With Levofloxacin
Talk to your healthcare provider about the precautions and warnings with levofloxacin to help ensure safe use of the drug. Before starting treatment, let your healthcare provider know if you have kidney disease, hypokalemia, or any allergies. You should avoid taking levofloxacin altogether if you are allergic to any components of the medication or have had an allergic reaction to any other quinolone antibiotic.
- Had a heart, liver, or lung transplant
- Rheumatoid arthritis
- Kidney disease, such as kidney failure (renal failure)
- Seizures or epilepsy
- Cerebral arteriosclerosis (hardening and thickening of the arteries of the brain)
- Low potassium levels in the blood (hypokalemia)
- Any other allergies, including allergies to food, dyes, or preservatives
- Myasthenia gravis.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Some warnings and precautions to be aware of with levofloxacin include the following:
- Levofloxacin can cause severe allergic reactions. Seek immediate medical attention if you develop any signs of an allergic reaction, such as a rash or hives, itching, swelling of the lips or throat, wheezing, or difficulty breathing.
- There have been reports of liver damage possibly caused by levofloxacin. Let your healthcare provider know if you develop any signs of a liver problem, such as upper right abdominal pain, yellow eyes or skin (jaundice), dark urine, or light-colored stools.
- Levofloxacin and other similar antibiotics can cause rupture of tendons, including shoulder, hand, or Achilles tendons. This can be disabling and can require surgical repair. Let your healthcare provider know right away if you develop tendon soreness or pain.
Do not exercise until your healthcare provider makes sure you do not have a ruptured tendon. This problem can occur while you are taking the medication or even months later.
- People who are over 60 years old, who have had liver, lung, or heart transplants, or who take corticosteroid drugs are at an increased risk for tendon rupture. People with kidney disease, those who exercise vigorously, and people with rheumatoid arthritis (or other tendon disorders) may also be at a higher risk.
- Levofloxacin can cause central nervous system problems, such as seizures, tremors, restlessness, anxiety, lightheadedness, confusion, hallucinations, paranoia, depression, nightmares, insomnia, and suicidal thoughts or acts. Certain conditions (including epilepsy, cerebral arteriosclerosis, and kidney disease) may increase the risk of these problems.
- Pseudotumor cerebri, a condition involving high pressure inside the cranium, has been reported rarely in people taking this medication. Let your healthcare provider know if you develop signs of this condition, such as:
- Vision changes.
- Let your healthcare provider know if you experience bloody or watery diarrhea. While diarrhea is a common side effect of levofloxacin, bloody or watery diarrhea may be a sign of a serious reaction to levofloxacin that can occur when certain bacteria (Clostridium difficile) overgrow in the colon. This severe reaction can occur long after you stop taking levofloxacin and can be life-threatening.
- Levofloxacin can cause nerve problems. Be sure to tell your healthcare provider if you develop any unusual sensations (such as numbness, burning, or tingling) while taking levofloxacin.
- Levofloxacin can cause a change in the heart rhythm known as QT prolongation. This can be dangerous and may be more common in people with low blood potassium and in those taking certain arrhythmia medications (see Drug Interactions With Levofloxacin).
- Levofloxacin (as well as all other fluoroquinolone antibiotics) can cause worsening of myasthenia gravis symptoms, such as muscle weakness and breathing problems. This is a serious occurrence, which can be life-threatening. In severe cases, this can result in the need to be put on a ventilator, or even death. Levofloxacin should be avoided in people with a known history of myasthenia gravis.
- This medication can cause muscle, joint, or tendon problems in children. Levofloxacin is not approved to be used in children except to prevent infection after anthrax exposure or to treat or prevent plague.
- Levofloxacin can cause changes in blood sugar (both high and low) in people with diabetes. If you have diabetes, you may need to monitor your blood sugar more closely while taking levofloxacin.
- This drug can cause sensitivity to the sun. Try to avoid excessive sun exposure while taking it.
- Levofloxacin can cause false positives for opiates on some drug tests.
- Overuse of antibiotics (including levofloxacin) increases the risk for developing antibiotic-resistant bacteria. Your healthcare provider should prescribe antibiotics only when necessary (and only to treat bacterial infections). Antibiotics are not effective for treating viral infections, such as the common cold or the flu.
- Make sure your healthcare provider knows if you have kidney disease, as you may need a lower levofloxacin dosage.
- Sometimes, antibiotics (including levofloxacin) can cause yeast infections, since they can get rid of "good" bacteria that help protect against yeast infections. Let your healthcare provider know if you develop a vaginal yeast infection or thrush (a yeast infection of the mouth) while taking levofloxacin.
- It is very important to take levofloxacin exactly as prescribed. Skipping doses or stopping levofloxacin too early (even if you feel better) can lead to bacterial resistance to levofloxacin.
- Levofloxacin can interact with other medications (see Drug Interactions With Levofloxacin).
- Levofloxacin is considered a pregnancy Category C medication. This means that the drug may not be safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using levofloxacin during pregnancy (see Levaquin and Pregnancy for more information).
- Levofloxacin passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider about using levofloxacin (see Levaquin and Breastfeeding for more information).