What disease to treat with levofloxacin tablets. Levofloxacin: instructions for use, composition, spectrum of therapeutic efficacy

In this article, you can read the instructions for using the drug Levofloxacin. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of the antibiotic Levofloxacin in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared 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. The composition and interaction of the drug with alcohol.

Levofloxacin- a synthetic broad-spectrum antibacterial drug from the group of fluoroquinolones, containing as an active substance levofloxacin - a 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 (aerobic gram-positive and gram-negative, as well as anaerobic).

Sensitive to the antibiotic Levofloxacin and other microorganisms: Bartonella spp, Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp, Mycobacterium spp, Mycobacterium leprae, Mycobacterium 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 rate and completeness of absorption. It penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, organs of the genitourinary system, bone tissue, cerebrospinal fluid, prostate gland, polymorphonuclear leukocytes, alveolar macrophages. In the liver, a small part is oxidized and/or deacetylated. It is excreted from the body mainly by the kidneys by glomerular filtration and tubular secretion. After oral administration, approximately 87% of the dose taken is excreted in the urine unchanged within 48 hours, less than 4% in the feces within 72 hours.

Indications

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

infections of the lower respiratory tract (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 form

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

Solution for infusions 5 mg/ml.

Eye drops 0.5%.

Instructions for use and dosage

Inside, during meals or between meals, without chewing, drinking plenty of fluids.

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

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

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

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

With uncomplicated infections of the urinary tract and kidneys - 250 mg 1 time per day for 3 days;

With complicated infections of the urinary tract and kidneys - 250 mg 1 time per day for 7-10 days;

With 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 the anaerobic flora).

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

In case of impaired liver function, special dose selection is not required, since levofloxacin is only slightly metabolized in the liver and excreted mainly by the kidneys.

If you miss taking the drug, you should take the pill as soon as possible, until the time of the next dose is approaching. Then continue to take levofloxacin according to the scheme.

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

Side effect

itching and redness of the skin;
general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, bronchial constriction 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 mellitus (possible signs of hypoglycemia: increased appetite, nervousness, perspiration, trembling);
exacerbation of porphyria in patients already suffering from this disease;
headache;
dizziness and/or numbness;
drowsiness;
sleep disorders;
anxiety;
shiver;
psychotic reactions such as hallucinations and depressions;
convulsions;
confusion;
visual and hearing impairments;
violations of taste sensitivity and smell;
decreased tactile sensitivity;
increased heartbeat;
joint and muscle pain;
tendon rupture (for example, Achilles tendon);
deterioration of kidney function up to acute renal failure;
interstitial nephritis;
an 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 in previous treatment with quinolones;
children and adolescents (up to 18 years);
pregnancy and lactation.

Use during pregnancy and lactation

Contraindicated in 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 the articular cartilage.

special instructions

In severe pneumonia caused by pneumococci, levofloxacin may not give the optimal therapeutic effect. Hospital infections caused by certain pathogens (P. aeruginosa) may require combined treatment.

During treatment with Levofloxacin, seizures may develop in patients with previous brain damage, such as a stroke or severe trauma.

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

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

Rarely observed with the use of the drug Levofloxacin, tendinitis (primarily inflammation of the Achilles tendon) can lead to tendon rupture. Elderly patients are more prone to tendinitis. Treatment with glucocorticosteroids likely increases 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 started.

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

Influence on the ability to drive vehicles and control mechanisms

Side effects of Levofloxacin, such as dizziness or stupor, drowsiness and visual disturbances, may impair reactivity and the ability to concentrate. This may represent a certain risk in situations where these abilities are of particular importance (for example, when driving a car, when servicing machines and mechanisms, when working in an unstable position).

drug interaction

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 drugs. No interaction was found with calcium carbonate.

With the simultaneous use of vitamin K antagonists, monitoring of the blood coagulation system is necessary.

Elimination (renal clearance) of levofloxacin is slightly slowed down by cimetidine and probenecid. It should be noted that this interaction has practically no clinical significance. However, with the simultaneous use of drugs such as probenecid and cimetidine, blocking a certain route of excretion (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 for the active substance:

Glevo;
Ivacin;
Lebel;
Levolet R;
Levotek;
Levoflox;
Levofloxabol;
Levofloxacin STADA;
Levofloxacin Teva;
Levofloxacin hemihydrate;
Levofloxacin hemihydrate;
Leobag;
Leflobact;
Lefoktsin;
Maklevo;
OD Levox;
Oftaquix;
Remedia;
Significef;
Tavanic;
Tanflomed;
Flexid;
Floracid;
Hyleflox;
Ecovid;
Elefloks.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Name:

Levofloxacin (Levofloxacin)

Pharmacological
action:

Antibiotic, belonging to the group of fluoroquinolones.
Levofloxacin - synthetic antibacterial drug a wide spectrum of action from the group of fluoroquinolones, containing as an active substance levofloxacin - a 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 organisms: 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), Group C and G Streptococci, Streptococcus agalactiae , Streptococcus pneumoniae peni I/S/R, Streptococcus pyogenes, Viridans streptococci peni-S/R.

Aerobic gram-negative organisms: 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 am pi-S/R, Haemophilus 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 vulgar is, 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, Mycobacterium 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 rate 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 μg / ml, the time to reach Cmax is 1.3 hours, T1 / 2 is 6-8 hours.
Communication with plasma proteins - 30-40%.
Penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, organs of the genitourinary system, bone tissue, cerebrospinal fluid, prostate gland, polymorphonuclear leukocytes, alveolar macrophages.
In the liver, a small part is oxidized and/or deacetylated.
It is excreted from the body mainly by the kidneys by glomerular filtration and tubular secretion. After oral administration, approximately 87% of the dose taken is excreted in the urine unchanged within 48 hours, less than 4% in the feces within 72 hours.

Indications for
application:

Infectious and inflammatory diseases caused by susceptible 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 is indicated for the treatment of superficial bacterial eye infections caused by susceptible organisms in adults and children over 1 year of age.

Mode of application:

Pills Levofloxacin is taken orally between meals or before meals. The daily dosage can be divided into 2 doses. Pills can't be chewed. Drink 0.5-1 glass of water.
Levofloxacin in the form of an infusion apply drip intravenously (depending on the severity of symptoms - 0.5 g / 2 times a day).

The scheme of application of 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 kidney function (with creatinine clearance ≤50 ml / minute), the following therapy regimens are used for adults:
- sinusitis - 0.5 g once a day, the course of treatment - from 10 to 14 days;
- community-acquired pneumonia - 0.5 g 1 or 2 times a day; the duration of the course of therapy is 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, the course of treatment is 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 a tablet form of Levofloxacin 0.5 or 0.25 g 1 or 2 times a day, the course of treatment is 1-2 weeks;
- infections of the skin and soft tissues - 0.25 g once a day for 1-2 weeks or 0.5 g 1 or 2 times a day for 1-2 weeks;
- infections of the abdominal cavity, 0.5 or 0.25 g 1 time per day, the course of treatment is 1-2 weeks; treatment must be supplemented with other antimicrobial agents with activity against anaerobic pathogens.

When taking the drug, you should follow the rule that applies to all antibacterial agents: taking tablets should 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, then 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, followed by 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 each; when using a daily dose of 1 g in 2 doses, the starting dosage is 0.5 g, subsequently - 0.25 g each;
- 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 permanent 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, followed by 125 mg 1 time per day.

After continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis, additional doses of Levofloxacin are not required.
For elderly patients changes in the usual dosing regimen of Levofloxacin are not required, except in cases with low creatinine clearance.
In violation of liver function special selection of the dose and dosing regimen of the drug is not required, since levofloxacin hemihydrate is only slightly metabolized by the liver.

The drug in the form of eye drops 1-2 drops of the solution are instilled into the conjunctival sac in 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.
With the simultaneous use of several topical ophthalmic preparations, 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 and tissues around the eye.
Safety and efficacy in the treatment of corneal ulcers and gonococcal conjunctivitis in neonates have not been studied. Changing the dosage regimen in the elderly is not required.

Side effects:

allergic reactions: sometimes - itching and redness of the skin; rarely - general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, bronchial constriction and possibly severe suffocation; very rarely - swelling of the skin and mucous membranes (for example, in the face and pharynx), a sudden drop in blood pressure and shock, increased sensitivity to sunlight and ultraviolet radiation (see "Special Instructions"), allergic pneumonitis, vasculitis; in some cases, severe rashes on the skin with the formation of blisters, 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 the 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, indigestion; rarely - diarrhea mixed with blood, which in very rare cases can be a sign of intestinal inflammation and even pseudomembranous colitis (see "Special instructions").
From the side of metabolism: very rarely - a decrease in the concentration of glucose in the blood, which is of particular importance for patients with diabetes mellitus (possible signs of hypoglycemia: increased appetite, nervousness, perspiration, trembling). Experience with other quinolones indicates that they can exacerbate porphyria in patients already suffering from this disease. A similar effect is not excluded when using the drug levofloxacin.
From the side of the nervous system: sometimes - headache, dizziness and / or numbness, 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 impairments , violations of taste sensitivity and smell, decrease in tactile sensitivity.

From the side of the cardiovascular system: rarely - increased heart rate, lowering blood pressure; very rarely - vascular (shock-like) collapse; in some cases - prolongation of the Q-T interval.
From the side of the musculoskeletal system: rarely - tendon lesions (including tendinitis), joint and muscle pain; very rarely - tendon rupture (eg, Achilles tendon); this side effect can be observed within 48 hours after the start of treatment and may 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 side of 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 fever, deterioration of health); in some cases - hemolytic anemia; pancytopenia.
Other: sometimes - general weakness; very rarely - fever.
Any antibiotic therapy can cause changes in the microflora, which is normally present in humans. For this reason, increased reproduction 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 lesions in previous treatment with quinolones;
- children's and adolescence (up to 18 years);
- pregnancy and lactation.

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

Levofloxacin should not be used to treat children and adolescents due to the likelihood of damage to the 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 application and doses").
In severe pneumonia caused by pneumococci, levofloxacin may not give the optimal therapeutic effect. Hospital infections caused by certain pathogens (P. aeruginosa) may require combined treatment.
During treatment with Levofloxacin, seizures may develop in patients with previous brain damage, such as a 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 radiation without special need.
If pseudomembranous colitis is suspected Levofloxacin should be discontinued immediately and appropriate treatment initiated. In such cases, drugs that inhibit intestinal motility should not be used.
Rarely observed with the use of the drug Levofloxacin, tendinitis (primarily inflammation of the Achilles tendon) can lead to tendon rupture. Elderly patients are more prone to tendinitis.
Treatment with glucocorticosteroids likely increases 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 started.

Patients with glucose-6-phosphate dehydrogenase deficiency(hereditary metabolic disorder) may respond to fluoroquinolones by destroying red blood cells (hemolysis). In this regard, the treatment of such patients with levofloxacin should be carried out with great caution.
Influence on the ability to drive vehicles and control mechanisms
Such side effects of the drug Levofloxacin as dizziness or numbness, drowsiness and visual disturbances (see also the section "Side Effects") may impair reactivity and the ability to concentrate. This may represent a certain risk in situations where these abilities are of particular importance (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 for convulsive readiness with the simultaneous use of quinolones and substances that can, in turn, reduce the cerebral threshold for convulsive readiness. Equally, this also applies to the simultaneous use of quinolones and theophylline.
The effect of the drug Levofloxacin is significantly weakened when used concomitantly 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 drugs.
No interaction was found with calcium carbonate.

Concomitant use of vitamin K antagonists necessary to control the blood coagulation system.
Elimination (renal clearance) of levofloxacin is slightly slowed down by cimetidine and probenecid. It should be noted that this interaction has practically no clinical significance. However, with the simultaneous use of drugs such as probenecid and cimetidine, blocking a certain route of excretion (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 in pregnancy and lactation.

Overdose:

Symptoms: manifested at the level of the central nervous system (confusion, dizziness, impaired consciousness and seizures of the type of epileptic seizures). In addition, gastrointestinal disturbances (eg, nausea) and erosive lesions of the mucous membranes, prolongation of the Q-T interval may be noted.
Treatment: should be symptomatic. Levofloxacin is not excreted by dialysis (hemodialysis, peritoneal dialysis and permanent peritoneal dialysis). There is no specific antidote.

Overdose with 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 pronounced side effects, consult a doctor.

Release form:

Levofloxacin solution for infusion- vials of 100 mg containing 0.5 g of the active substance. The solution in the vial is yellow-green or yellow, transparent.
Levofloxacin tablets 250 mg- white or almost white, round, coated. The package contains 5 or 10 pieces.
Levofloxacin tablets 500 mg- white or almost white, on one side they are at risk, coated, capsule-shaped. The package contains 5 or 10 pieces.
Levofloxacin eye drops 0.5%- 1 ml in a dropper tube, 5 ml or 10 ml in a vial.

Storage conditions:

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

1 tablet Levofloxacin 500 mg contains:
- active substance: 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 substance: levofloxacin hemihydrate - 500 mg;
- excipients: anhydrous glucose, hydrochloric acid, water for injection, sodium edetate.

Eye drops Levofloxacin contain: 1 pack
- active substance: levofloxacin - 0.5%.

Antimicrobial - naphthyridine derivatives, quinolones, fluoroquinolones, piperazines.

Compound

The active substance is levofloxacin.

Manufacturers

Vertex ZAO (Russia), Dalhimpharm (Russia), Ozon OOO (Russia), Hetero Drugs Limited, packaged by Makiz-Pharma (India), Hetero Drugs Limited, packaged by Skopinsky Pharmaceutical Plant (India)

pharmachologic effect

Antibacterial broad spectrum, bactericidal action.

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, Kleb siella 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 rapidly and completely absorbed from the gastrointestinal tract.

The maximum concentration is reached in 1-2 hours.

Levofloxacin can be administered with or without food.

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

Side effect

Headache, dizziness and / or stiffness, drowsiness, sleep disturbances, paresthesias in the hands, tremors, anxiety, states of fear, seizures and confusion, visual and hearing impairments, taste and smell disorders, decreased tactile sensitivity, psychotic reactions such as hallucinations and depression, movement disorders; nausea, diarrhea, loss of appetite, vomiting, abdominal pain, indigestion, bloody diarrhea; tachycardia, drop in blood pressure, vascular collapse; photosensitivity; increased activity of ALT, AST, increased levels of bilirubin in the blood serum, hepatitis; hypoglycemia; tendon lesions, 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 (manifested by such symptoms,
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, epilepsy, severe cerebral atherosclerosis, impaired renal function, pregnancy, lactation.

Method of application and dosage

Inside, before meals or between meals, without chewing, drinking plenty of fluids.

Overdose

Symptoms:

mental confusion,
dizziness,
disturbances of consciousness and convulsive attacks,
nausea,
mucosal lesions.

Treatment is symptomatic.

Interaction

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

sucralfa,
magnesium and aluminum containing antacids,
iron salts,
zinc-containing multivitamin,
didanosi,
therefore, it is necessary to observe an interval of at least 2 hours between taking these drugs and levofloxacin.

With the simultaneous use of levofloxacin and theophylline, careful monitoring of theophylline levels and appropriate dose adjustment is necessary.

Careful monitoring of MHO, prothrombin time and other indicators of coagulation is necessary, monitoring of possible signs of bleeding while using levofloxacin and warfarin.

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 normalization of body temperature or after reliable destruction of the pathogen. To avoid photosensitivity, patients should not be exposed to strong solar or artificial ultraviolet radiation.

If pseudomembranous colitis is suspected, the drug should be immediately discontinued and appropriate treatment initiated, without the use of drugs that depress intestinal motility.

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

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

Storage conditions

Store in a dry, dark place at a temperature not exceeding 25°C.

Bactericidal action, that is, a drug that destroys microorganisms of both adult and developing forms. It belongs to fluoroquinolones, such as Avelox, Ciprofloxacin, and so on. The analogue of this drug is Tavanic. Levofloxacin is active against a very wide range of bacteria: aerobic, anaerobic, gram-positive and gram-negative. In addition, some other microorganisms are also 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, etc.).

Levofloxacin is produced in the form of a solution, which is administered in droppers, and in the form of tablets. Instructions for the drug in terms of methods of application must be strictly observed. For various pathologies, one dose of Levofloxacin per day is mainly recommended. Tablets do not need to be chewed, should be washed down with plenty, taking them before meals. Levofloxacin drip is compatible with saline, Ringer's solution with dextrose and so on. Five hundred milligrams of the substance, diluted in one hundred milliliters of a solution, should be administered slowly - at least an hour. Patients with impaired renal function require dose adjustment of this antibiotic, since Levofloxacin is excreted mainly in the urine.

Do not use this drug in case of intolerance, epilepsy, damage to the musculoskeletal system as a result of previous therapy with the use of fluoroquinolones. Children and adolescents under eighteen years of age (during active growth) are not prescribed Levofloxacin, as this may affect the condition of the 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 system of the body is able to respond to the action of this drug. Therefore, it is necessary to monitor the patient's condition during therapy, detecting side effects in time and making a decision to continue or stop using Levofloxacin.

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

Reviews about Levofloxacin

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

As a rule, patients do not report side effects. Only in relation to the long course of Levofloxacin for gastric ulcers, some patients report that such therapy is not easily tolerated.

Any antibiotic raises doubts whether it will undermine the health of the whole organism, even ridding a person of certain bacteria. The correct answer to all such questions can be a preliminary study of the sensitivity of pathogens. If it is found that they are sensitive to Levofloxacin, then the treatment is likely to be successful. Also, it is necessary to discuss with the doctor a scheme for maintaining the immune system, intestinal microflora, so that antibiotic therapy does not cause harm.

Check out Levofloxacin!

Helped me 547

Didn't help me 210

General impression: (490)

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

Release form and composition

Levofloxacin is produced in the following dosage forms:

Eye drops 0.5%.
250 mg, 500 mg and 750 mg film-coated tablets (Hyleflox).
Solution for infusions 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.

The composition of 1 tablet includes: Levofloxacin - 250 or 500 mg (levofloxacin hemihydrate - 256.23 or 512.46 mg).

The composition of 100 ml 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 helps Levofloxacin? Tablets are used for infectious and inflammatory diseases that are provoked by susceptible 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 tract, kidneys, skin and soft tissues, ENT organs, genital organs.

Instructions for use

Levofloxacin tablets are administered orally, during meals or between meals, without chewing, drinking plenty of liquid. Doses are determined by the nature and severity of the infection, as well as the sensitivity of the suspected pathogen.

The recommended dose of the drug for adults with normal renal function (CC> 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 the anaerobic flora).
With community-acquired pneumonia - 500 mg 1 or 2 times a day for 7-14 days.
For uncomplicated infections of the urinary tract and kidneys - 250 mg 1 time per day for 3 days.
With complicated infections of the urinary tract and kidneys - 250 mg 1 time per day for 7-10 days.
In acute sinusitis - 500 mg once a day for 10-14 days.
Tuberculosis - inside 500 mg 1-2 times a day for up to 3 months.
With bacterial prostatitis - 500 mg 1 time per day for 28 days.
With 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.

In case of impaired liver function, no special dose selection is required, since Levofloxacin is only slightly metabolized in the liver and excreted mainly by the kidneys.

If you miss taking the drug, you should take the pill as soon as possible, until the time of the next dose is approaching. Then continue to take the medicine according to the scheme. The duration of therapy depends on the type of disease. In all cases, treatment should be continued from 48 to 72 hours after the disappearance of the symptoms of the disease.

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, Kleb siella, salmonella , Pseudomonas, Streptococcus, Chlamydia, Mycobacteria, Clostridium, Bifidobacterium, Listeria, etc.

The use of Levofloxacin has an effective effect on microorganisms resistant to macroliths, 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.

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

Extended Q-T interval (infusion solution.
Simultaneous use with antiarrhythmic drugs of class IA (quinidine, procainamide) or class III (amiodarone, sotalol) (infusion solution).
Tendon lesions in 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 kidney 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 numbness;
nausea, vomiting;
violations of taste sensitivity and smell;
a decrease in the concentration of glucose in the blood, which is of particular importance for patients with diabetes mellitus (possible signs of hypoglycemia: increased appetite, nervousness, perspiration, trembling);
decrease in the number of leukocytes;
allergic pneumonitis;
increased heartbeat;
pancytopenia;
decreased tactile sensitivity;
headache;
anxiety;
general hypersensitivity reactions (anaphylactic and anaphylactoid reactions) with symptoms such as urticaria, bronchial constriction and possibly severe suffocation;
exacerbation of porphyria in patients already suffering from this disease;
vasculitis;
shiver;
interstitial nephritis;
psychotic reactions such as hallucinations and depressions;
tendon rupture (for example, Achilles tendon);
itching and redness of the skin;
confusion;
fever;
increased sensitivity to solar and ultraviolet radiation;
an 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, during pregnancy and lactation

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 the period of use of the drug, ultraviolet rays should be avoided to avoid damage to the skin.

Diabetic patients 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 an increased concentration of attention and speed of psychomotor reactions.

drug interaction

Cimetidine and Probenicid to some extent slow down the excretion of the active substance Levofloxacin. So therapy with this combination of drugs is desirable to be carried out with caution.

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

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

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 oral solutions:

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

It is forbidden to mix the medicine with a solution of heparin or sodium bicarbonate. Clinically significant drug interactions of eye drops with other agents are unlikely.

Analogues of the drug Levofloxacin

According to the structure, analogues are determined:

Levotek.
Flexid.
Hyleflox.
Lebel.
Glevo.
Levofloxacin hemihydrate.
Maklevo.
Significef.
Levolet R.
Levoflox.
Levofloxacin hemihydrate.
Leobag.
Elefloks.
Remedia.
Lefoktsin.
Floracid.
Tanflomed.
Levofloxacin STADA or Teva.
Ecological.
Levofloxabol.
Leflobact.
Oftaquix.
OD Levox.
Ivacin.

Holiday conditions and price

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

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

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

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

Post Views: 256