levofloxacin hemihydrate at a glance
Medicine class
Fluoroquinolone antibacterial.
Available routes
Oral, intravenous, inhaled and ocular formulations have different uses and precautions.
What is levofloxacin hemihydrate used for?
Licensed uses depend on the formulation. Systemic and inhaled levofloxacin should only be selected when other commonly recommended antibiotics are inappropriate.
Tablets: susceptible bacterial sinusitis, community-acquired pneumonia, exacerbations of chronic obstructive pulmonary disease including bronchitis, urinary-tract and kidney infections, chronic bacterial prostatitis, complicated skin and soft-tissue infections, and inhalational anthrax management.
Intravenous infusion: susceptible community-acquired pneumonia, complicated skin and soft-tissue infections, acute kidney and complicated urinary-tract infections, chronic bacterial prostatitis, and inhalational anthrax management.
Inhaled Quinsair: chronic pulmonary infection caused by Pseudomonas aeruginosa in adults with cystic fibrosis.
Eye drops: external bacterial eye infections caused by susceptible organisms in adults and children aged at least one year.
How does levofloxacin hemihydrate work?
Levofloxacin blocks bacterial DNA gyrase and topoisomerase IV, enzymes needed to copy and repair bacterial DNA. This stops susceptible bacteria multiplying and leads to their death.
levofloxacin hemihydrate preparations and strengths
Inhaled preparation
Route: Inhaled
Strengths: 240 mg
Solution for infusion
Route: Intravenous
Strengths: 5 mg/mL
Eye drops
Route: Ophthalmic
Strengths: 5 mg/mL
Tablet
Route: Oral
Strengths: 250 mg, 500 mg
How to take levofloxacin hemihydrate
Follow the instructions for your particular formulation; formulations are not interchangeable.
Swallow tablets with water, without crushing. They may be taken with or without food.
Keep tablets separate from iron or zinc supplements, magnesium- or aluminium-containing antacids, sucralfate and buffered didanosine because these can reduce absorption.
Quinsair must be inhaled only through its specified Zirela nebuliser system. Use an opened ampoule immediately, do not swallow it or mix it with other nebulised medicines, and clean the equipment as instructed.
For eye drops, wash your hands and avoid touching the dropper tip to the eye, eyelids, skin or fingers. Do not wear contact lenses while an external bacterial eye infection is present.
Use single-dose Oxalux containers immediately after opening, then discard them. Healthcare professionals prepare and administer intravenous levofloxacin.
levofloxacin hemihydrate side effects
Common or expected effects
- Tablets or infusion: nausea, vomiting, diarrhoea, headache, dizziness, insomnia and increased liver enzymes.
- Quinsair: altered taste, cough, breathlessness, sputum changes, coughing blood, reduced exercise tolerance and fatigue; headache, nausea and diarrhoea can also occur.
- Eye drops: temporary burning, reduced vision or mucus strands in the eye.
Get urgent medical advice
- Severe allergic reaction.
- Tendinitis or tendon rupture; persistent muscle or joint pain or weakness.
- Peripheral neuropathy, including burning, tingling, numbness or weakness.
- Severe psychiatric or neurological effects, including marked anxiety, depression, confusion, hallucinations, suicidal thoughts or seizures.
- Serious heart-rhythm disturbance, severe liver injury, major blood-glucose disturbance or severe antibiotic-associated diarrhoea.
- Sudden severe chest, abdominal or back pain, or new severe breathlessness, palpitations or swelling that could indicate an aortic or heart-valve complication.
- Bronchospasm or substantial worsening of breathing after inhaled treatment.
levofloxacin hemihydrate in pregnancy
The selected oral, intravenous and inhaled products are contraindicated during pregnancy. Eye drops may be considered only when the expected benefit justifies the potential risk. Discuss treatment or accidental exposure with the prescriber rather than changing treatment without advice.
levofloxacin hemihydrate interactions
Important interactions mainly concern systemic and inhaled exposure. Eye-drop interactions are unlikely because systemic absorption is very low.
Iron, zinc and magnesium- or aluminium-containing antacids
They reduce oral absorption and must be separated from tablets as directed.
Sucralfate or buffered didanosine
These can reduce oral absorption, so administration must be separated as directed.
Warfarin and other vitamin K antagonists
Levofloxacin may increase clotting-test results and bleeding risk; closer monitoring may be needed.
Common questions about levofloxacin hemihydrate
Answers are fully visible for fast scanning and source review.
Why is levofloxacin reserved for certain infections?
Systemic and inhaled fluoroquinolones can rarely cause disabling, long-lasting or irreversible reactions. They should be used only when commonly recommended alternatives are inappropriate.
What does levofloxacin hemihydrate mean?
It is the hydrated salt form used in the formulation. Product strengths state the equivalent amount of active levofloxacin.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.