Levofloxacin In 5% Dextrose + Antacids Containing MagnesiumContraindicated
Do not co-administer intravenous levofloxacin in the same IV line with magnesium or other multivalent cations due to chelation risk.
Source: NLP:levofloxacin in 5% dextrose
Levofloxacin In 5% Dextrose Interactions
Brand names: Levofloxacin
Fluoroquinolone Antibacterial
Route: Intravenous
FDA Black Box Warning
WARNING: SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS Fluoroquinolones, including levofloxacin, have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together [see Warnings and Precautions (5.1) ] , including: Tendinitis and tendon rupture [see Warnings and Precautions (5.2) ] Peripheral neuropathy [see Warnings and Precautions (5.3) ] Central nervous system effects [see Warnings and Precautions (5.4) ] Discontinue levofloxacin immediately and avoid the use of fluoroquinolones, including levofloxacin, in patients who experience any of these serious adverse reactions [see Warnings and Precautions (5.1) ] Fluoroquinolones, including levofloxacin, may exacerbate muscle weakness in patients with myasthenia gravis. Avoid levofloxacin in patients with a known history of myasthenia gravis [see Warnings and Precautions (5.5) ] . Because fluoroquinolones, including levofloxacin, have been associated with serious adverse reactions [see Warnings and Precautions ( 5.1 to 5.15) ] , reserve levofloxacin for use in patients who have no alternative treatment options for the following indications: Uncomplicated urinary tract infection [see Indications and Usage (1.12) ] Acute bacterial exacerbation of chronic bronchitis [see Indications and Usage (1.13) ] Acute bacterial sinusitis [see Indications and Usage (1.14) ] . WARNING: SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS See full prescribing information for complete boxed warning . Fluoroquinolones, including levofloxacin, have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together ( 5.1 ), including: Tendinitis and tendon rupture ( 5.2 ) Peripheral neuropathy ( 5.3 ) Central nervous system effects ( 5
Contraindications
4 CONTRAINDICATIONS Levofloxacin injection is contraindicated in persons with known hypersensitivity to levofloxacin, or other quinolone antibacterials [see Warnings and Precautions (5.3) ]. Known hypersensitivity to levofloxacin injection or other quinolones (4 , 5.7 )
Pregnancy & Breastfeeding
8.1 Pregnancy Pregnancy Category C. Levofloxacin was not teratogenic in rats at oral doses as high as 810 mg/kg/day which corresponds to 9.4 times the highest recommended human dose based upon relative body surface area, or at intravenous doses as high as 160 mg/kg/day corresponding to 1.9 times the highest recommended human dose based upon relative body surface area. The oral dose of 810 mg/kg/day to rats caused decreased fetal body weight and increased fetal mortality. No teratogenicity was observed when rabbits were dosed orally as high as 50 mg/kg/day which corresponds to 1.1 times the highest recommended human dose based upon relative body surface area, or when dosed intravenously as high as 25 mg/kg/day, corresponding to 0.5 times the highest recommended human dose based upon relative body surface area. There are, however, no adequate and well-controlled studies in pregnant women. Levofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
6 interactions on record
NSAIDs may increase risk of CNS stimulation and convulsive seizures when combined with levofloxacin.
Source: NLP:levofloxacin in 5% dextrose
Levofloxacin may enhance warfarin effects, elevating prothrombin time and increasing bleeding risk. Monitor INR and prothrombin time closely.
Source: NLP:levofloxacin in 5% dextrose
Concomitant use may cause blood glucose disturbances including hyperglycemia and hypoglycemia. Careful monitoring of blood glucose is recommended.
Source: NLP:levofloxacin in 5% dextrose
Monitor prothrombin time, INR, watch for bleeding (7.2) Antidiabetic agents Carefully monitor blood glucose ( 5.13 , 7.3) 7.1 Chelation Agents: Antacids, Sucralfate, Metal Cations, Multivitamins Levofloxacin Injection There are no data concerning an interaction of intravenous fluoroquinolones with oral antacids, sucralfate, multivitamins, didanosine, or metal cations. 7.2 Warfarin No significant effect of levofloxacin on the peak plasma concentrations, AUC, and other disposition parameters for R- and S-warfarin was detected in a clinical study involving healthy volunteers. Similarly, no apparent effect of warfarin on levofloxacin absorption and disposition was observed.
Source: FDA drug label - levofloxacin in 5% dextrose
Other fluoroquinolones have resulted in prolonged theophylline elimination, elevated serum levels, and increased risk of adverse reactions.
Source: NLP:levofloxacin in 5% dextrose