How to treat the disease levofloxacin tablets. Levofloxacin: instructions for use, composition, range of therapeutic effectiveness

In this article you can read the instructions for use of the drug Levofloxacin. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of the antibiotic Levofloxacin in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Levofloxacin in the presence of existing structural analogues. Use for the treatment of pneumonia, prostatitis, chlamydia and other infections in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Levofloxacin- a synthetic broad-spectrum antibacterial drug from the group of fluoroquinolones, containing levofloxacin, a levorotatory isomer of ofloxacin, as an active substance. Levofloxacin blocks DNA gyrase, disrupts supercoiling and cross-linking of DNA breaks, inhibits DNA synthesis, and causes profound morphological changes in the cytoplasm, cell wall and membranes.

Levofloxacin is active against most strains of microorganisms (aerobic gram-positive and gram-negative, as well as anaerobic).

Other microorganisms that are sensitive to the antibiotic Levofloxacin are: Bartonella spp, Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp, Mycobacterium spp, Mycobacterium leprae, Micobacterium tuberculosis, Mycoplasma hominis, Mycoplasma pneumoniae, Ricketsia spp, Ureaplasma urealyticum.

Compound

Levofloxacin hemihydrate + excipients.

Pharmacokinetics

Levofloxacin is rapidly and almost completely absorbed after oral administration. Food intake has little effect on the speed and completeness of absorption. Penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, genitourinary organs, bone tissue, cerebrospinal fluid, prostate gland, polymorphonuclear leukocytes, alveolar macrophages. In the liver, a small portion is oxidized and/or deacetylated. It is excreted from the body primarily by the kidneys by glomerular filtration and tubular secretion. After oral administration, approximately 87% of the dose taken is excreted unchanged in the urine within 48 hours, less than 4% in the feces within 72 hours.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

lower respiratory tract infections (exacerbation of chronic bronchitis, community-acquired pneumonia);
ENT infections (acute sinusitis);
urinary tract and kidney infections (including acute pyelonephritis);
genital infections (including bacterial prostatitis);
infections of the skin and soft tissues (festering atheromas, abscess, boils);
intra-abdominal infections;
tuberculosis (complex therapy of drug-resistant forms).

Release forms

Film-coated tablets 250 mg, 500 mg and 750 mg (Hyleflox).

Solution for infusion 5 mg/ml.

Eye drops 0.5%.

Instructions for use and dosage

Orally, during meals or in between meals, without chewing, with a sufficient amount of liquid.

Doses are determined by the nature and severity of the infection, as well as the sensitivity of the suspected pathogen,

For acute sinusitis - 500 mg 1 time per day for 10-14 days;

For exacerbation of chronic bronchitis - from 250 to 500 mg 1 time per day for 7-10 days;

For community-acquired pneumonia - 500 mg 1 or 2 times a day for 7-14 days;

For uncomplicated urinary tract and kidney infections - 250 mg once a day for 3 days;

For complicated urinary tract and kidney infections - 250 mg once a day for 7-10 days;

For bacterial prostatitis - 500 mg 1 time per day for 28 days;

For infections of the skin and soft tissues - 250 mg - 500 mg 1 or 2 times a day for 7-14 days;

Intra-abdominal infections - 250 mg 2 times a day or 500 mg 1 time a day - 7-14 days (in combination with antibacterial drugs acting on anaerobic flora).

Tuberculosis - 500 mg orally 1-2 times a day for up to 3 months.

If liver function is impaired, no special dose adjustment is required, since levofloxacin is only slightly metabolized in the liver and is excreted primarily by the kidneys.

If you miss a dose of the drug, you should take the pill as soon as possible before the time for your next dose approaches. Then continue taking levofloxacin according to the schedule.

The duration of therapy depends on the type of disease. In all cases, treatment should be continued for 48 to 72 hours after the symptoms of the disease disappear.

Side effect

itching and redness of the skin;
general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, constriction of the bronchi and possibly severe suffocation;
swelling of the skin and mucous membranes (for example, in the face and throat);
sudden drop in blood pressure and shock;
increased sensitivity to solar and ultraviolet radiation;
allergic pneumonitis;
vasculitis;
toxic epidermal necrolysis (Lyell's syndrome);
exudative erythema multiforme;
nausea, vomiting;
diarrhea;
loss of appetite;
stomach ache;
pseudomembranous colitis;
a decrease in the concentration of glucose in the blood, which is of particular importance for patients with diabetes (possible signs of hypoglycemia: increased appetite, nervousness, perspiration, trembling);
exacerbation of porphyria in patients already suffering from this disease;
headache;
dizziness and/or stupor;
drowsiness;
sleep disorders;
anxiety;
shiver;
psychotic reactions such as hallucinations and depression;
convulsions;
confusion;
visual and hearing impairments;
disturbances of taste sensitivity and smell;
decreased tactile sensitivity;
increased heart rate;
joint and muscle pain;
tendon rupture (for example, Achilles tendon);
deterioration of kidney function up to acute renal failure;
interstitial nephritis;
increase in the number of eosinophils;
decrease in the number of leukocytes;
neutropenia, thrombocytopenia, which may be accompanied by increased bleeding;
agranulocytosis;
pancytopenia;
fever.

Contraindications

hypersensitivity to levofloxacin or other quinolones;
renal failure (with creatinine clearance less than 20 ml/min - due to the impossibility of dosing this dosage form);
epilepsy;
tendon lesions due to previous treatment with quinolones;
childhood and adolescence (up to 18 years);
pregnancy and lactation period.

Use during pregnancy and breastfeeding

Contraindicated during pregnancy and lactation.

Use in children

Levofloxacin should not be used to treat children and adolescents (under 18 years of age) due to the likelihood of damage to articular cartilage.

special instructions

In severe pneumonia caused by pneumococci, levofloxacin may not provide an optimal therapeutic effect. Hospital-acquired infections caused by certain pathogens (P. aeruginosa) may require combination treatment.

During treatment with Levofloxacin, seizures may develop in patients with previous brain damage caused, for example, by stroke or severe trauma.

If pseudomembranous colitis is suspected, levofloxacin should be discontinued immediately and appropriate treatment should be initiated. In such cases, drugs that inhibit intestinal motility should not be used.

The consumption of alcohol and alcoholic beverages during treatment with Levofloxacin is prohibited.

Rarely observed with the use of the drug Levofloxacin, tendonitis (primarily inflammation of the Achilles tendon) can lead to tendon rupture. Elderly patients are more prone to tendinitis. Treatment with glucocorticosteroids appears to increase the risk of tendon rupture. If tendonitis is suspected, treatment with Levofloxacin should be stopped immediately and appropriate treatment of the affected tendon should be initiated.

Patients with glucose-6-phosphate dehydrogenase deficiency (an inherited metabolic disorder) may respond to fluoroquinolones by destroying red blood cells (hemolysis). In this regard, treatment of such patients with levofloxacin should be carried out with great caution.

Impact on the ability to drive vehicles and operate machinery

Side effects of Levofloxacin, such as dizziness or drowsiness, drowsiness and visual disturbances, may impair reactivity and ability to concentrate. This may pose a risk in situations where these abilities are of particular importance (for example, when driving a car, when servicing machinery, when performing work in an unstable position).

Drug interactions

The effect of Levofloxacin is significantly weakened when used simultaneously with sucralfate. The same thing happens with the simultaneous use of magnesium or aluminum containing antacids, as well as iron salts. Levofloxacin should be taken at least 2 hours before or 2 hours after taking these medications. No interaction was detected with calcium carbonate.

When using vitamin K antagonists simultaneously, monitoring of the blood coagulation system is necessary.

The elimination (renal clearance) of levofloxacin is slightly slowed down by the action of cimetidine and probenecid. It should be noted that this interaction has virtually no clinical significance. However, with the simultaneous use of drugs such as probenecid and cimetidine, which block a certain excretion pathway (tubular secretion), treatment with levofloxacin should be carried out with caution. This applies primarily to patients with limited renal function.

Levofloxacin slightly increases the half-life of cyclosporine.

Taking glucocorticosteroids increases the risk of tendon rupture.

Analogues of the drug Levofloxacin

Structural analogues of the active substance:

Glevo;
Ivacin;
Lebel;
Levolet R;
Levotek;
Levoflox;
Levofloxabol;
Levofloxacin STADA;
Levofloxacin Teva;
Levofloxacin hemihydrate;
Levofloxacin hemihydrate;
Leobag;
Leflobact;
Lefoccin;
Maklevo;
OD Levox;
Oftaquix;
Remedia;
Signicef;
Tavanik;
Tanflomed;
Flexid;
Floracid;
Hyleflox;
Ecolevid;
Eleflox.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Name:

Levofloxacin

Pharmacological
action:

Antibiotic, belonging to the group of fluoroquinolones.
Levofloxacin - synthetic antibacterial drug broad spectrum of action from the group of fluoroquinolones, containing levofloxacin as an active substance - the levorotatory isomer of ofloxacin.
Levofloxacin blocks DNA gyrase, disrupts supercoiling and cross-linking of DNA breaks, inhibits DNA synthesis, and causes profound morphological changes in the cytoplasm, cell wall and membranes.
Levofloxacin is active against most strains of microorganisms both in vitro and in vivo.
Aerobic gram-positive microorganisms: Corynebacterium diphtheriae, Enterococcus faecalis, Enterococcus spp, Listeria monocytogenes, Staphylococcus coagulase-negative methi-S(I), Staphylococcus aureus methi-S, Staphylococcus epidermidis methi-S, Staphylococcus spp(CNS), Streptococci groups C and G, Streptococcus agalactiae , Streptococcus pneumoniae peni I/S/R, Streptococcus pyogenes, Viridans streptococci peni-S/R.

Aerobic gram-negative microorganisms: Acinetobacter baumannil, Acinetobacter spp, Actinobacillus actinomycetemcomitans, Citrobacter freundii, Eikenella corrodens, Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter cloacae, Enterobacter spp, Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae ampi-S/R, Haem ophilus parainfluenzae, Helicobacter pylori , Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella spp, Moraxela catarrhalis (3+/p-, Morganella morganii, Neisseria gonorrhoeae non PPNG/PPNG, Neisseria meningitidis, Pasteurella conis, Pasteurella dagmatis, Pasteurella multocida, Pasteurella spp, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Providencia spp, Pseudomonas aeruginosa, Pseudomonas spp, Salmonella spp, Serratia marcescens, Serratia spp.
Anaerobic microorganisms: Bacteroides fragilis, Bifidobacterium spp, Clostridium perfringens, Fusobacterium spp, Peptostreptococcus, Propionibacterum spp, Veilonella spp.
Other microorganisms: Bartonella spp, Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp, Mycobacterium spp, Mycobacterium leprae, Micobacterium tuberculosis, Mycoplasma hominis, Mycoplasma pneumoniae, Ricketsia spp, Ureaplasma urealyticum.

Pharmacokinetics
Levofloxacin is rapidly and almost completely absorbed after oral administration. Food intake has little effect on the speed and completeness of absorption.
The bioavailability of 500 mg levofloxacin after oral administration is almost 100%. After taking a single dose of 500 mg of levofloxacin, Cmax is 5.2-6.9 mcg/ml, the time to reach Cmax is 1.3 hours, T1/2 is 6-8 hours.
Communication with plasma proteins is 30-40%.
Penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, genitourinary system organs, bone tissue, cerebrospinal fluid, prostate gland, polymorphonuclear leukocytes, alveolar macrophages.
In the liver, a small portion is oxidized and/or deacetylated.
It is excreted from the body primarily by the kidneys by glomerular filtration and tubular secretion. After oral administration, approximately 87% of the dose taken is excreted unchanged in the urine within 48 hours, less than 4% in the feces within 72 hours.

Indications for
application:

Infectious and inflammatory diseases caused by sensitive microorganisms:
- acute sinusitis;
- exacerbation of chronic bronchitis;
- community-acquired pneumonia;
- complicated urinary tract infections (including pyelonephritis);
- uncomplicated urinary tract infections;
- prostatitis;
- infections of the skin and soft tissues;
- septicemia/bacteremia associated with the above indications;
- intra-abdominal infection.
Levofloxacin as 0.5% eye drops indicated for the treatment of superficial bacterial eye infections caused by susceptible microorganisms in adults and children over 1 year of age.

Mode of application:

Pills Levofloxacin should be taken orally between meals or before meals. The daily dosage can be divided into 2 doses. Pills cannot be chewed. Take with 0.5-1 glasses of water.
Levofloxacin as an infusion used intravenously (depending on the severity of symptoms - 0.5 g/2 times a day).

The regimen for using the drug depends on the severity of the disease, the sensitivity of microorganisms and the course of the pathological process.
With normal or slightly reduced renal function (creatinine clearance ≤50 ml/minute), the following treatment regimens are used for adults:
- sinusitis – 0.5 g once a day, course of treatment – from 10 to 14 days;
- community-acquired pneumonia - -.5 g 1 or 2 times a day; duration of therapy – from 7 to 14 days;
- chronic bronchitis (exacerbation) - 0.5-0.25 g 1 time per day, course of treatment - from 7 to 14 days;
- prostatitis – 28 days, 0.5 g once a day;
- complicated urinary tract infections (including pyelonephritis) - 0.25 g once a day, course of treatment - from 7 to 10 days;
- uncomplicated urinary tract infections - 3 days, 0.25 g once a day;
- bacteremia or septicemia - treatment begins with an intravenous infusion of Levofloxacin, and then continues with the tablet form of Levofloxacin 0.5 or 0.25 g 1 or 2 times a day, the course of treatment is 1-2 weeks;
- skin and soft tissue infections - 0.25 g once a day for 1-2 weeks or 0.5 g 1 or 2 times a day for 1-2 weeks;
- abdominal infections 0.5 or 0.25 g 1 time per day, course of treatment – 1-2 weeks; treatment must be supplemented with other antimicrobial agents with activity against anaerobic pathogens.

When taking the drug, you should adhere to the rule that applies to all antibacterial agents: taking tablets must be continued after reliable elimination of the pathogen or no less than 48-72 hours after normalization of body temperature.
If the patient has impaired renal function, the dosage of the drug is changed:
- with creatinine clearance from 20 to 50 ml/min: when using a daily dose of 0.25 g in 1 dose, the starting dosage is 0.25 g, subsequently - 125 mg; when using a daily dose of 0.5 g in 1 dose, the starting dosage is 0.5 g, subsequently - 0.25 g; when using a daily dose of 1 g in 2 doses, the starting dosage is 0.5 g, subsequently - 0.25 g;
- with creatinine clearance from 10 to 19 ml/min: when using a daily dose of 0.25 g in 1 dose, the starting dosage is 0.25 g, subsequently - 125 mg every 48 hours; when using a daily dose of 0.5 g in 1 dose, the starting dosage is 0.5 g, subsequently - 125 mg 1 time per day; when using a daily dose of 1 g in 2 doses, the starting dosage is 0.5 g, subsequently - 125 mg every 12 hours;
- with creatinine clearance up to 10, as well as for dialysis patients (including outpatient continuous peritoneal dialysis): when using a daily dose of 0.25 g in 1 dose, the starting dosage is 0.25 g, subsequently - 125 mg every 48 hours; when using a daily dose of 0.5 g in 1 dose, the starting dosage is 0.5 g, subsequently - 125 mg 1 time per day; when using a daily dose of 1 g in 2 doses, the starting dosage is 0.5 g, subsequently - 125 mg 1 time per day.

After continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis, additional doses of Levofloxacin are not required.
For elderly patients No change in the usual dosage regimen of Levofloxacin is required, except in cases with low creatinine clearance.
In case of liver dysfunction special selection of the dose and dosage regimen of the drug is not required, since levofloxacin hemihydrate undergoes hepatic metabolism only to a small extent.

The drug is in the form of eye drops instill 1-2 drops of solution into the conjunctival sac into one or both affected eyes every 2 hours (up to 8 times a day) during the first 2 days.
Then every 4 hours (up to 4 times a day) for 3-7 days. The duration of treatment is 5-7 days.
When using several ophthalmic drugs for topical use simultaneously, a 15-minute interval between instillations must be observed.
To avoid contamination of the solution, the tip of the dropper should not touch the eyelids or tissues around the eye.
Safety and effectiveness in the treatment of corneal ulcers and gonococcal conjunctivitis in neonates have not been studied. No change in dosage regimen is required in the elderly.

Side effects:

Allergic reactions: sometimes – itching and redness of the skin; rarely - general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, constriction of the bronchi and possibly severe suffocation; very rarely - swelling of the skin and mucous membranes (for example, in the face and throat), sudden drop in blood pressure and shock, increased sensitivity to solar and ultraviolet radiation (see "Special Instructions"), allergic pneumonitis, vasculitis; in some cases - severe skin rashes with blistering, for example, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's syndrome) and exudative erythema multiforme. General hypersensitivity reactions may sometimes be preceded by milder skin reactions. The above reactions can develop after the first dose, a few minutes or hours after administration of the drug.

From the digestive system: often - nausea, diarrhea, increased activity of liver enzymes (for example, alanine aminotransferase and aspartate aminotransferase); sometimes - loss of appetite, vomiting, abdominal pain, digestive disorders; rarely - diarrhea mixed with blood, which in very rare cases may be a sign of intestinal inflammation and even pseudomembranous colitis (see "Special Instructions").
Metabolism: very rarely - a decrease in blood glucose concentration, which is of particular importance for patients with diabetes (possible signs of hypoglycemia: increased appetite, nervousness, perspiration, trembling). Experience with the use of other quinolones suggests that they can cause exacerbation of porphyria in patients already suffering from this disease. A similar effect cannot be excluded when using the drug levofloxacin.
From the nervous system: sometimes - headache, dizziness and/or stupor, drowsiness, sleep disturbances; rarely - anxiety, paresthesia in the hands, trembling, psychotic reactions such as hallucinations and depression, agitation, convulsions and confusion; very rarely - visual and hearing impairment , disturbances in taste and smell, decreased tactile sensitivity.

From the cardiovascular system: rarely - increased heartbeat, decreased blood pressure; very rarely - vascular (shock-like) collapse; in some cases - prolongation of the Q-T interval.
From the musculoskeletal system: rarely - tendon lesions (including tendinitis), joint and muscle pain; very rarely - tendon rupture (for example, Achilles tendon); this side effect can be observed within 48 hours after the start of treatment and can be bilateral (see "Special Instructions"), muscle weakness, which is of particular importance for patients with bulbar syndrome; in some cases - muscle damage (rhabdomyolysis).
From the urinary system: rarely - increased levels of bilirubin and creatinine in the blood serum; very rarely - deterioration of kidney function up to acute renal failure, interstitial nephritis.

From the hematopoietic organs: sometimes - an increase in the number of eosinophils, a decrease in the number of leukocytes; rarely – neutropenia, thrombocytopenia, which may be accompanied by increased bleeding; very rarely - agranulocytosis and the development of severe infections (persistent or recurrent increase in body temperature, deterioration in health); in some cases - hemolytic anemia; pancytopenia.
Others: sometimes - general weakness; very rarely - fever.
Any antibiotic therapy can cause changes in the microflora that is normally present in humans. For this reason, increased proliferation of bacteria and fungi resistant to the antibiotic used may occur, which in rare cases may require additional treatment.

Contraindications:

Hypersensitivity to levofloxacin or other quinolones;
- renal failure (with creatinine clearance less than 20 ml/min. - due to the impossibility of dosing this dosage form);
- epilepsy;
- tendon damage due to previous treatment with quinolones;
- childhood and adolescence (up to 18 years);
- pregnancy and lactation period.

Carefully should be used in elderly people due to the high likelihood of a concomitant decrease in renal function, as well as in cases of glucose-6-phosphate dehydrogenase deficiency.
Prescribed with caution when:
- high risk of renal failure in geriatric patients;
- deficiency of glucose-6-phosphate dehydrogenase.

Levofloxacin cannot be used to treat children and adolescents due to the likelihood of damage to articular cartilage.
When treating elderly patients, it should be borne in mind that patients in this group often suffer from impaired renal function (see section “Method of administration and dosage”).
In severe pneumonia caused by pneumococci, levofloxacin may not provide an optimal therapeutic effect. Hospital-acquired infections caused by certain pathogens (P. aeruginosa) may require combination treatment.
During treatment with Levofloxacin, seizures may develop in patients with previous brain damage caused, for example, by stroke or severe trauma.

Despite the fact that photosensitivity is observed very rarely with the use of levofloxacin, in order to avoid it, patients are not recommended to be exposed to strong solar or artificial ultraviolet irradiation unnecessarily.
If pseudomembranous colitis is suspected Levofloxacin should be discontinued immediately and appropriate treatment should be initiated. In such cases, drugs that inhibit intestinal motility should not be used.
Rarely observed with the use of the drug Levofloxacin, tendonitis (primarily inflammation of the Achilles tendon) can lead to tendon rupture. Elderly patients are more prone to tendinitis.
Treatment with glucocorticosteroids appears to increase the risk of tendon rupture. If tendonitis is suspected, treatment with Levofloxacin should be stopped immediately and appropriate treatment of the affected tendon should be initiated.

Patients with glucose-6-phosphate dehydrogenase deficiency(hereditary metabolic disorder) may react to fluoroquinolones by destroying red blood cells (hemolysis). In this regard, treatment of such patients with levofloxacin should be carried out with great caution.
Impact on the ability to drive vehicles and operate machinery
Side effects of Levofloxacin, such as dizziness or drowsiness, drowsiness and visual disturbances (see also Side Effects section), may impair reactivity and concentration. This may pose a risk in situations where these abilities are particularly important. (for example, when driving a car, when servicing machines and mechanisms, when performing work in an unstable position).

Interaction
other medicinal
by other means:

There are reports of a pronounced decrease in the threshold of convulsive readiness with the simultaneous use of quinolones and substances that can, in turn, reduce the cerebral threshold of convulsive readiness. This also applies equally to the simultaneous use of quinolones and theophylline.
The effect of the drug Levofloxacin is significantly weakened when used simultaneously with sucralfate. The same thing happens with the simultaneous use of magnesium or aluminum containing antacids, as well as iron salts.
Levofloxacin should be taken at least 2 hours before or 2 hours after taking these medications.
No interaction was detected with calcium carbonate.

With simultaneous use of vitamin K antagonists monitoring of the blood coagulation system is necessary.
The elimination (renal clearance) of levofloxacin is slightly slowed down by the action of cimetidine and probenecid. It should be noted that this interaction has virtually no clinical significance. However, with the simultaneous use of drugs such as probenecid and cimetidine, which block a certain excretion pathway (tubular secretion), treatment with levofloxacin should be carried out with caution. This applies primarily to patients with limited renal function.
Levofloxacin slightly increases the half-life of cyclosporine.
Taking glucocorticosteroids increases the risk of tendon rupture.

Pregnancy:

Contraindicated during pregnancy and lactation.

Overdose:

Symptoms: manifest themselves at the level of the central nervous system (confusion, dizziness, disturbances of consciousness and seizures of the epileptic type). In addition, gastrointestinal disorders (for example, nausea) and erosive lesions of the mucous membranes, and prolongation of the QT interval may occur.
Treatment: Must be symptomatic. Levofloxacin is not eliminated by dialysis (hemodialysis, peritoneal dialysis and continuous peritoneal dialysis). There is no specific antidote.

Overdose of Levofloxacin in the form of drops:
- symptoms: tissue irritation (burning, redness, swelling, pain, lacrimation);
- treatment: Rinse with clean (tap) water at room temperature; if there are severe side effects, consult a doctor.

Release form:

Levofloxacin solution for infusion- 100 mg bottles containing 0.5 g of active ingredient. The solution in the bottle is yellow-green or yellow in color, transparent.
Levofloxacin tablets 250 mg- white or almost white, round in shape, covered with a shell. There are 5 or 10 pieces in a package.
Levofloxacin tablets 500 mg- white or almost white, scored on one side, covered with a shell, capsule-shaped. There are 5 or 10 pieces in a package.
Levofloxacin eye drops 0.5%- 1 ml in a dropper tube, 5 ml or 10 ml in a bottle.

Storage conditions:

Store out of reach of children, dry and protected from light, at a temperature not exceeding 25 °C.
Shelf life - 2 years. Do not use after expiration date.

1 tablet Levofloxacin 500 mg contains:
- active ingredient: levofloxacin hemihydrate - 512.46 mg, which corresponds to the content of levofloxacin - 500 mg;
- excipients: microcrystalline cellulose, hypromellose (hydroxypropyl methylcellulose), primellose (croscarmellose sodium), calcium stearate.

100 ml Levofloxacin solution for infusion contains:
- active ingredient: levofloxacin hemihydrate - 500 mg;
- excipients: anhydrous glucose, hydrochloric acid, water for injection, sodium edetate.

Levofloxacin eye drops contain: 1 pack
- active ingredient: levofloxacin - 0.5%.

Antimicrobials - naphthyridine derivatives, quinolones, fluoroquinolones, piperazines.

Compound

The active ingredient is levofloxacin.

Manufacturers

Vertex CJSC (Russia), Dalkhimfarm (Russia), Ozon LLC (Russia), Hetero Drugs Limited, packaged by Makis-Pharma (India), Hetero Drugs Limited, packaged by Skopinsky Pharmaceutical Plant (India)

pharmachologic effect

Broad spectrum antibacterial, bactericidal effect.

Effective against gram-positive aerobes - Enterococcus faecalis, Stapnylococcus aureus, Staphylococcus saprophyticus, Streptococcus pneumonias (including penicillin-resistant strains), Streptococcus pyogenes, gram-negative aerobes - Enterobacter cloacae, Escherichia coli, Haemophilus influenzas, Haemophilus parainfluenzae, Klebs iella pneumoniae, Legionella pneumophila , Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa and other microorganisms - Chlamydia pneumoniae, Mycoplasma pneumoniae.

May be effective against microorganisms resistant to aminoglycosides, macrolides and beta-lactam antibiotics (including penicillin).

After oral administration, it is quickly and completely absorbed from the gastrointestinal tract.

The maximum concentration is reached after 1-2 hours.

Levofloxacin can be prescribed without regard to meals.

The half-life is 6-8 hours after single or repeated oral or intravenous administration.

Side effect

Headache, dizziness and/or stiffness, drowsiness, sleep disturbances, paresthesia in the hands, trembling, anxiety, states of fear, seizures and confusion, visual and hearing impairment, disturbances of taste and smell, decreased tactile sensitivity, psychotic reactions such as hallucinations and depression, movement disorders; nausea, diarrhea, loss of appetite, vomiting, abdominal pain, digestive disorders, bloody diarrhea; tachycardia, drop in blood pressure, vascular collapse; photosensitivity; increased activity of ALT, AST, increased bilirubin levels in the blood serum, hepatitis; hypoglycemia; tendon damage, joint and muscle pain, Achilles tendon rupture, muscle weakness, rhabdomyolysis; increased serum creatinine levels, deterioration of kidney function up to acute renal failure; eosinophilia, leukopenia, neutropenia, thrombocytopenia, severe agranulocytosis, hemolytic anemia, pancytopenia; asthenia, fever, allergic pneumonitis, vasculitis; allergic reactions:

itching and redness of the skin,
anaphylactic and anaphylactoid reactions (manifesting such symptoms as
like hives,
narrowing of the bronchi and possible severe suffocation,
and also - in rare cases - swelling of the face,
larynx,
sudden drop in blood pressure and sho,
Stevens-Johnson syndrome,
toxic epidermal necrolysis (Lyell's syndrome) and exudative erythema multiforme.

Indications for use

Infectious and inflammatory diseases caused by microorganisms sensitive to the drug:

acute sinus,
exacerbation of chronic bronchitis,
community-acquired pneumonia,
skin and soft tissue infections,
kidney and urinary tract infections,
acute pyelonephritis.

Contraindications

Hypersensitivity (including to other quinolones), age under 18 years, epilepsy, severe cerebral atherosclerosis, renal dysfunction, pregnancy, lactation.

Directions for use and dosage

Orally, before meals or between meals, without chewing, with a sufficient amount of liquid.

Overdose

Symptoms:

confusion,
dizziness,
disturbances of consciousness and seizures,
nausea, nausea
damage to the mucous membranes.

Treatment is symptomatic.

Interaction

They weaken the effect by reducing absorption from the gastrointestinal tract and systemic concentration:

sucralf,
magnesium and aluminum containing antacids,
gland salts,
zinc-containing multivitamin,
didanosie,
therefore, it is necessary to maintain an interval of at least 2 hours between taking these drugs and levofloxacin.

When levofloxacin and theophylline are used concomitantly, careful monitoring of theophylline levels and appropriate dose adjustment are necessary.

Careful monitoring of MHO, prothrombin time and other coagulation parameters, monitoring for possible signs of bleeding is necessary when using levofloxacin and warfarin simultaneously.

NSAIDs may increase the risk of CNS stimulation and seizures.

special instructions

It is recommended to continue taking the drug for at least 48–78 hours after the body temperature has normalized or after the pathogen has been effectively destroyed. To avoid photosensitization, patients should not be exposed to strong solar or artificial ultraviolet irradiation.

If pseudomembranous colitis is suspected, the drug should be immediately discontinued and appropriate treatment should be started without using drugs that inhibit intestinal motility.

If tendinitis is suspected, the drug should be discontinued immediately and appropriate treatment should be initiated.

During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Storage conditions

Store in a dry place, protected from light, at a temperature not exceeding 25°C.

Bactericidal action, that is, a drug that destroys microorganisms both adult and developing forms. It belongs to the fluoroquinolones, such as Avelox, Ciprofloxacin and so on. An analogue of this medicine is Tavanik. Levofloxacin is active against a very wide range of bacteria: aerobic, anaerobic, gram-positive and gram-negative. In addition, some other microorganisms are sensitive to it - chlamydia, mycobacteria, rickettsia, uraplasma and so on. Treatment with Levofloxacin is indicated for infectious and inflammatory processes caused by microorganisms sensitive to it. These processes can be localized in the ENT organs, respiratory tract, genitourinary system, skin and soft tissues ( furuncle, abscess and so on).

Levofloxacin is produced in the form of a solution, which is administered in droppers, and in the form of tablets. The instructions for use of the drug must be strictly followed. For various pathologies, it is preferably recommended to take one dose of Levofloxacin per day. The tablets do not need to be chewed; they should be washed down generously, taking them before meals. Levofloxacin drip is compatible with saline solution, Ringer's solution with dextrose, and so on. Five hundred milligrams of the substance, diluted in one hundred milliliters of solution, should be administered slowly - at least an hour. Patients with renal impairment require dose adjustment of this antibiotic, since Levofloxacin is excreted primarily in the urine.

This drug is not used in cases of intolerance, epilepsy, or damage to the musculoskeletal system as a result of previous therapy using fluoroquinolones. Children and adolescents under eighteen years of age (during active growth) are not prescribed Levofloxacin, as this may affect the condition of cartilage tissue. This antibiotic is contraindicated for pregnant and lactating women.

Side effects and overdose of Levofloxacin

As with every powerful antibiotic, Levofloxacin has an extensive list of unwanted symptoms that may occur during treatment with it. Any body system can respond to the action of this medicine. Therefore, it is necessary to monitor the patient's condition during therapy, detecting side effects in a timely manner and deciding whether to continue or discontinue the use of Levofloxacin.

An overdose of this drug affects the functions of the central nervous system and is expressed in confusion, convulsions, dizziness, and so on. Digestion and heart problems are also possible. Therapy should be focused on the symptoms of overdose.

Reviews of Levofloxacin

A large number of patients with various pathologies take this antibiotic. Often reviews of Levofloxacin talk about the treatment of genitourinary infections - ureaplasmosis, mycoplasmosis, prostatitis. There are treatment regimens for stomach ulcers, namely, destruction Helicobacter pylori using Levofloxacin. This drug is often used for acute respiratory diseases.

As a rule, patients do not report side effects. Only with regard to a long course of Levofloxacin for gastric ulcers, some patients report that such therapy is not easy to tolerate.

Any antibiotic raises doubts whether it will undermine the health of the entire body, even if it rids a person of certain bacteria. The correct answer to all such questions can be a preliminary study of the sensitivity of pathogenic microorganisms. If it is determined that they are sensitive to Levofloxacin, then treatment is most likely to be successful. Also, it is necessary to discuss with your doctor a plan for maintaining the immune system and intestinal microflora so that antibiotic therapy does not cause harm.

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Levofloxacin is a broad-spectrum antibacterial drug with pronounced antimicrobial and bactericidal properties. Instructions for use prescribe taking 250 mg, 500 mg and 750 mg tablets of Hyleflox, solution for infusion, 0.5% antibiotic eye drops for the treatment of infectious pathologies: bronchitis, conjunctivitis, furunculosis, etc.

Release form and composition

Levofloxacin is available in the following dosage forms:

Eye drops 0.5%.
Film-coated tablets 250 mg, 500 mg and 750 mg (Hyleflox).
Solution for infusion 5 mg/ml.

The composition of 1 ml of eye drops includes: active substance - levofloxacin - 5 mg (in the form of hemihydrate) and auxiliary components: benzalkonium chloride - 0.04 mg, sodium chloride - 9 mg, disodium edetate - 0.1 mg, hydrochloric acid solution 1 M – up to pH 6.4, water for injection – up to 1 ml.

1 tablet contains: Levofloxacin – 250 or 500 mg (levofloxacin hemihydrate – 256.23 or 512.46 mg).

The composition of 100 ml of solution for infusion includes: active substance - levofloxacin - 500 mg (in the form of hemihydrate) and auxiliary components: sodium chloride - 900 mg, water for injection - up to 100 ml.

Indications for use

What does Levofloxacin help with? Tablets are used for infectious and inflammatory diseases that are provoked by sensitive microorganisms:

uncomplicated urinary tract infections;
septicemia or bacteremia;
community-acquired pneumonia;
prostatitis;
acute sinusitis;
infections of the skin and soft tissues;
exacerbation of chronic bronchitis;
complicated urinary tract infections;
intra-abdominal infection.

Levofloxacin eye drops are prescribed for superficial eye infections of bacterial origin.

The solution for internal administration is used for infections of the lower respiratory and urinary tracts, kidneys, skin and soft tissues, ENT organs, and genitals.

Instructions for use

Levofloxacin tablets are prescribed orally, during meals or between meals, without chewing, with a sufficient amount of liquid. Doses are determined by the nature and severity of the infection, as well as the sensitivity of the suspected pathogen.

Recommended dose of the drug for adults with normal renal function (creatinine clearance >50 ml/min):

Intra-abdominal infections - 250 mg 2 times a day or 500 mg 1 time a day - 7-14 days (in combination with antibacterial drugs acting on anaerobic flora).
For community-acquired pneumonia - 500 mg 1 or 2 times a day for 7-14 days.
For uncomplicated urinary tract and kidney infections - 250 mg once a day for 3 days.
For complicated urinary tract and kidney infections - 250 mg once a day for 7-10 days.
For acute sinusitis - 500 mg once a day for 10-14 days.
Tuberculosis - 500 mg orally 1-2 times a day for up to 3 months.
For bacterial prostatitis - 500 mg once a day for 28 days.
For exacerbation of chronic bronchitis - from 250 to 500 mg 1 time per day for 7-10 days.
For infections of the skin and soft tissues - 250 mg - 500 mg 1 or 2 times a day for 7-14 days.

If liver function is impaired, no special dose selection is required, since Levofloxacin is only slightly metabolized in the liver and is excreted primarily by the kidneys.

If you miss a dose of the drug, you should take the pill as soon as possible before the time for your next dose approaches. Then continue taking the medicine according to the schedule. The duration of therapy depends on the type of disease. In all cases, treatment should be continued for 48 to 72 hours after the symptoms of the disease disappear.

pharmachologic effect

The drug inhibits type II topoisomerases - enzymes that are necessary for transcription, replication, recombination, and repair of bacterial DNA. In equivalent concentrations it has a bactericidal effect. Due to its chemical formula, Levofloxacin is much more effective than ofloxacin.

The drug exhibits pronounced activity against infections caused by Haemophilus influenzae, Helicobacter, Enterobacter, Citrocacter freundi, Gardnella vaginalis, Gonococcus, meningococcus, Proteus vulgaris, Serration, Staphylococcus, Enterococcus, Mycoplasma, Legionella, ureaplasmosis, Escherichia coli, Klebsiella, salmonella , pseudomonas, streptococcus, chlamydia, mycobacteria, clostridia, bifidobacterium, listeria, etc.

The use of Levofloxacin has an effective effect on microorganisms that are resistant to macrolites, aminoglycosides and beta-lactam antibiotics, which also include penicillin. After oral administration, levofloxacin is completely absorbed from the digestive tract, the absolute bioavailability of the drug is 99%.

The maximum concentration of the substance is observed in plasma after 1-2 hours; the presence of food does not affect absorption. It is practically not metabolized in the body and is excreted unchanged in the urine. The half-life of the substance is 6-8 hours.

Contraindications

Hypersensitivity to the components of the drug or to other quinolones.
Age up to 1 year (eye drops), up to 18 years (tablets and infusion solution).
Pregnancy and lactation period.

Additional contraindications to the use of Levofloxacin in the form of tablets and infusion solution are:

Prolonged QT interval (infusion solution.
Concomitant use with antiarrhythmic drugs of class IA (quinidine, procainamide) or class III (amiodarone, sotalol) (infusion solution).
Tendon lesions due to previous treatment with quinolones.
Renal failure with creatinine clearance less than 20 ml per minute (tablets).
Epilepsy.

Levofloxacin in these dosage forms should be used with caution in elderly patients (due to the high likelihood of a concomitant decrease in renal function), as well as in patients with glucose-6-phosphate dehydrogenase deficiency.

Side effects

loss of appetite;
stomach ache;
drowsiness;
joint and muscle pain;
pseudomembranous colitis;
neutropenia, thrombocytopenia, which may be accompanied by increased bleeding;
agranulocytosis;
dizziness and/or stupor;
nausea, vomiting;
disturbances of taste sensitivity and smell;
a decrease in the concentration of glucose in the blood, which is of particular importance for patients with diabetes (possible signs of hypoglycemia: increased appetite, nervousness, perspiration, trembling);
decrease in the number of leukocytes;
allergic pneumonitis;
increased heart rate;
pancytopenia;
decreased tactile sensitivity;
headache;
anxiety;
general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, constriction of the bronchi and possibly severe suffocation;
exacerbation of porphyria in patients already suffering from this disease;
vasculitis;
shiver;
interstitial nephritis;
psychotic reactions such as hallucinations and depression;
tendon rupture (for example, Achilles tendon);
itching and redness of the skin;
confusion;
fever;
increased sensitivity to solar and ultraviolet radiation;
increase in the number of eosinophils;
toxic epidermal necrolysis (Lyell's syndrome);
convulsions;
visual and hearing impairments;
sudden drop in blood pressure and shock;
sleep disorders;
diarrhea;
swelling of the skin and mucous membranes (for example, in the face and throat);
exudative erythema multiforme;
deterioration of kidney function up to acute renal failure.

Children, pregnancy and breastfeeding

Contraindicated during pregnancy and breastfeeding.

special instructions

Treatment with Levofloxacin is recommended to continue for at least 48-78 hours after normalization of body temperature or after laboratory confirmed recovery. During use of the drug, ultraviolet rays should be avoided to avoid skin damage.

Patients with diabetes mellitus taking Levofloxacin should regularly monitor their blood glucose levels. During treatment, it is recommended to be careful when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Drug interactions

Cimetidine and Probenicid slow down the elimination of the active substance Levofloxacin to some extent. So it is advisable to carry out therapy with this combination of drugs with caution.

The effectiveness of the drug is significantly reduced when combined with Sucralfate, as well as with antacid drugs that contain aluminum, magnesium and iron salts. Thus, there should be an interval of at least two hours between doses of these drugs.

And if simultaneous use with vitamin K antagonists is necessary, the blood coagulation system should be monitored.

To a small extent, the drug also increases the half-life of Cyclosporine. And the combination with glucocorticosteroids increases the likelihood of tendon rupture. When interacting with NSAIDs and Theophylline, convulsive readiness increases.

Levofloxacin for infusion is combined with the following solutions for internal administration:

saline;
solutions for parenteral nutrition;
Ringer's solution with dextrose (concentration 2.5%);
dextrose solution (2.5% concentration).

Do not mix the medicine with heparin or sodium bicarbonate solution. Clinically significant drug interactions between eye drops and other drugs are unlikely.

Analogues of the drug Levofloxacin

Analogues are determined by structure:

Levotek.
Flexid.
Hyleflox.
Lebel.
Glevo.
Levofloxacin hemihydrate.
Maklevo.
Signicef.
Levolet R.
Levoflox.
Levofloxacin hemihydrate.
Leobag.
Eleflox.
Remedia.
Lefoccin.
Floracid.
Tanflomed.
Levofloxacin STADA or Teva.
Ecolevid.
Levofloxabol.
Leflobakt.
Oftaquix.
OD Levox.
Ivacin.

Vacation conditions and price

The average cost of Levofloxacin (500 mg tablets No. 5) in Moscow is 305 rubles. The price of the infusion solution is 122 rubles per 100 ml bottle. Dispensed by prescription.

Store in a dry place, protected from light, out of reach of children, at temperatures up to 25 C. Shelf life:

Tablets, infusion solution – 2 years;
Eye drops – 3 years.

After opening the bottle of drops, Levofloxacin can be used for 4 weeks.

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