It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. 250 or 500 mg PO once daily as part of combination therapy as a first-line treatment option. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. [46963], 750 mg IV every 24 hours for at least 5 days. Since bradycardia is a risk factor for development of torsade de pointes (TdP), the potential occurrence of bradycardia during octreotide administration could theoretically increase the risk of TdP in patients receiving drugs that prolong the QT interval. Tricyclic antidepressants: (Minor) Levofloxacin should be used cautiously with other agents, such as tricyclic antidepressants, that may prolong the QT interval or increase the risk of torsade de pointes (TdP). Although extremely rare, torsade de pointes has been reported during postmarketing surveillance of levofloxacin. Its effect on QTc interval is minimal (typically less than 5 msec), and the drug has been used safely in patients with cardiac disease (e.g., recent myocardial infarction, unstable angina, chronic heart failure). These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Liraglutide: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including incretin mimetics, are coadministered. Levofloxacin has been associated with a risk of QT prolongation and torsade de pointes (TdP). Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. If these drugs must be coadministered, ECG monitoring is recommended; closely monitor the patient for QT interval prolongation Levofloxacin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Dosing should take into consideration patient-specific factors (e.g. NSAIDs in combination with very high doses of quinolones have been shown to provoke convulsions in preclinical studies and postmarketing. For ophthalmic use only. Voriconazole: (Moderate) Levofloxacin should be used cautiously with other agents, such as voriconazole, that may prolong the QT interval or increase the risk of torsade de pointes (TdP). Concomitant use with other photosensitizing agents may increase the risk of a photosensitivity reaction. Levofloxacin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Class IA Antiarrhythmics: (Major) Levofloxacin should be avoided in combination with Class IA antiarrhythmics (disopyramide, procainamide, and quinidine). Hypoglycemia, sometimes resulting in coma, can occur. Levofloxacin has been associated with a risk of QT prolongation and, although extremely rare, torsade de pointes (TdP) has been reported during postmarketing surveillance of levofloxacin. Rare cases of TdP have been spontaneously reported during postmarketing surveillance in patients receiving levofloxacin. (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including sulfonylureas, are coadministered. Current clinical guidelines for the empiric treatment of febrile neutropenia do not routinely recommend the use of levofloxacin secondary to the lack of well-published data to support this indication; however, they do suggest that fluoroquinolones may be used as an add-on to IV therapy in certain high-risk patients. [33146] Based on cardiac studies, clinical trials, and postmarketing evaluations, the overall risk for TdP appears to be similar between levofloxacin and moxifloxacin. Rare cases of TdP have been spontaneously reported during postmarketing surveillance in patients receiving levofloxacin. Insulins: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including insulin, are coadministered. Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: (Major) Administer oral products that contain iron at least 2 hours before or 2 hours after orally administered levofloxacin. Betamethasone: (Moderate) Quinolones have been associated with an increased risk of tendon rupture requiring surgical repair or resulting in prolonged disability; this risk is further increased in those receiving concomitant corticosteroids. Levofloxacin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Discontinue quinolone therapy at the first sign of tendon inflammation or tendon pain, as these are symptoms that may precede rupture of the tendon. Voclosporin: (Moderate) Concomitant use of voclosporin and levofloxacin may increase the risk of QT prolongation. [61195] [63729]. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. The diluted solution may be stored for up to 72 hours when kept at or below 25 degrees C (77 degrees F) or for 14 days when stored under refrigeration at 5 degrees C (41 degrees F) in plastic containers. Aluminum Hydroxide; Magnesium Hydroxide; Simethicone: (Major) Administer magnesium hydroxide at least 2 hours before or 2 hours after orally administered levofloxacin. Tablets: Levofloxacin tablets can be taken with or without food; however, administer at least 2 hours before or 2 hours after any antacid, multivitamin, or other medication that contains divalent or trivalent cations. Chlorpromazine is specifically associated with an established risk of QT prolongation and TdP; case reports have included patients receiving therapeutic doses of chlorpromazine. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Levofloxacin, in combination with appropriate antimicrobial therapy, is an alternative therapy for systemic anthrax infection. Quinapril: (Moderate) Administer quinapril tablets, which contain magnesium, at least 2 hours before or 2 hours after orally administered levofloxacin. Females, people 65 years and older, patients with sleep deprivation, pheochromocytoma, sickle cell disease, hypothyroidism, hyperparathyroidism, hypothermia, systemic inflammation (e.g., human immunodeficiency virus (HIV) infection, fever, and some autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosus (SLE), and celiac disease) and patients undergoing apheresis procedures (e.g., plasmapheresis [plasma exchange], cytapheresis) may also be at increased risk for QT prolongation. Osilodrostat is associated with dose-dependent QT prolongation. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Levofloxacin has been associated with a risk of QT prolongation and TdP. Oral, ophthalmic, and IV quinolone antibioticUsed for bacterial conjunctivitis, sinusitis, chronic bronchitis, pneumonia, skin and skin structure infections, UTIs, prostatitis, inhalation anthrax, and plagueAssociated with disabling and potentially irreversible adverse reactions, including tendonitis, tendon rupture, peripheral neuropathy, and central nervous system effects, Levaquin/Levaquin Leva-Pak/Levofloxacin Oral Tab: 250mg, 500mg, 750mgLevaquin/Levofloxacin Oral Sol: 1mL, 25mgLevaquin/Levofloxacin/Levofloxacin, Dextrose Intravenous Inj Sol: 1mL, 25mg, 5-5%Levofloxacin/Quixin Ophthalmic Sol: 0.5%. Levofloxacin has been associated with a risk of QT prolongation and torsade de pointes (TdP). The pharmacodynamic interaction potential to prolong the QT interval of the electrocardiogram between lefamulin and other drugs that effect cardiac conduction is unknown. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Rare cases of torsade de pointes (TdP) have been spontaneously reported during postmarketing surveillance in patients receiving levofloxacin. Discontinue quinolone therapy at the first sign of tendon inflammation or tendon pain, as these are symptoms that may precede rupture of the tendon. Nilotinib: (Major) Avoid the concomitant use of nilotinib and levofloxacin; significant prolongation of the QT interval may occur. [65397] Adult patientsPIRRT: Levofloxacin is not recommended as empiric monotherapy for serious gram-negative infections in patients receiving PIRRT due to suboptimal efficacy; however, when used in combination with another primary antibiotic for gram-negative infections, levofloxacin 750 mg IV once, then 750 mg IV post-PIRRT is recommended. (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including metformin, are coadministered. NSAIDs in combination with very high doses of quinolones have been shown to provoke convulsions in preclinical studies and postmarketing. Levofloxacin has been associated with a risk of QT prolongation and TdP. 750 mg PO every 24 hours is recommended by the CDC as alternative therapy. Quinine: (Major) Concurrent use of quinine and levofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes (TdP). Discontinue quinolone therapy at the first sign of tendon inflammation or tendon pain, as these are symptoms that may precede rupture of the tendon. Although extremely rare, TdP has been reported during postmarketing surveillance of levofloxacin. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Trazodone can prolong the QT/QTc interval at therapeutic doses. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. No redosing is recommended. Levofloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. Tolbutamide: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including sulfonylureas, are coadministered. Hypoglycemia, sometimes resulting in coma, can occur. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Although extremely rare, torsade de pointes have been reported during postmarketing surveillance of levofloxacin. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. Androgen deprivation therapy (i.e., goserelin) may prolong the QT/QTc interval. Lefamulin: (Major) Avoid coadministration of lefamulin with levofloxacin as concurrent use may increase the risk of QT prolongation. Torsade de pointes (TdP) has been reported postmarketing, primarily in overdose or in patients with other risk factors for QT prolongation. Fluoroquinolones have the potential to cause QT prolongation and possibly torsade de pointes (TdP) by blocking human cardiac potassium (K+) channel currents. Ethinyl Estradiol; Norgestimate: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Levofloxacin has been associated with a risk of QT prolongation and TdP. 15 to 20 mg/kg/dose PO once daily. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Tricyclic antidepressants (TCAs) share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy (elevated serum concentrations). All rights reserved. Clofazimine: (Major) Monitor ECGs for QT prolongation when clofazimine is administered with levofloxacin. Hypoglycemia, sometimes resulting in coma, can occur. Vandetanib can prolong the QT interval in a concentration-dependent manner; TdP and sudden death have been reported in patients receiving vandetanib. Levofloxacin has also been associated with a risk of QT prolongation and TdP. According to the manufacturer, levofloxacin should be avoided in patients taking drugs that can result in prolongation of the QT interval. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Examples of compounds that may interfere with quinolone bioavailability include antacids and multivitamins that contain calcium. Levofloxacin has been associated with a risk of QT prolongation and torsade de pointes (TdP). During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Levofloxacin absorption may be reduced as quinolone antibiotics can chelate with sucralfate. Hypoglycemia, sometimes resulting in coma, can occur. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. According to the manufacturer, levofloxacin should be avoided in patients taking drugs that can result in prolongation of the QT interval. Bepridil: (Contraindicated) Bepridil administration is associated with a well-established risk of QT prolongation and torsades de pointes. Hetastarch; Dextrose; Electrolytes: (Major) Administer oral products that contain calcium at least 2 hours before or 2 hours after orally administered levofloxacin. QT prolongation has occurred with pasireotide at therapeutic and supra-therapeutic doses. Additionally, rare cases of TdP have been spontaneously reported during postmarketing surveillance in patients receiving levofloxacin. Hypoglycemia, sometimes resulting in coma, can occur. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. Polyethylene Glycol; Electrolytes; Ascorbic Acid: (Major) Administer quinolones at least 2 hours before or 6 hours after administration of magnesium sulfate; potassium sulfate; sodium sulfate. Hypoglycemia, sometimes resulting in coma, can occur. Alogliptin: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including dipeptidyl peptidase-4 inhibitors, are coadministered. If treatment initiation is considered, seek advice from a cardiologist. Levofloxacin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia. Hypoglycemia, sometimes resulting in coma, can occur. Halogenated Anesthetics: (Major) Halogenated anesthetics can prolong the QT interval. Although extremely rare, TdP has been reported during postmarketing surveillance of levofloxacin. Initiate appropriate therapy and perform follow-up testing as recommended based upon sexually transmitted disease diagnosis. Solutions may be frozen for up to 6 months (-20 degrees C or -4 degrees F) in glass bottles or plastic containers. [32569] [65399]CVVH: 500 or 750 mg IV or PO once, then 250 mg IV or PO every 24 hours.CVVHD: 500 or 750 mg IV or PO once, then 250 or 500 mg IV or PO every 24 hours.CVVHDF: 500 or 750 mg IV or PO once, then 250 to 750 mg IV or PO every 24 hours. Naproxen; Pseudoephedrine: (Moderate) Use quinolones and nonsteroidal anti-inflammatory drugs (NSAIDs) concomitantly with caution due to potential increased risk of CNS stimulation and convulsive seizures. Hypoglycemia, sometimes resulting in coma, can occur. Warfarin has the following interaction information: ... Levofloxacin increases the anticoagulant effect of warfarin. Hypoglycemia, sometimes resulting in coma, can occur. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. Interaction between cyclosporine and Hypericum perforatum (St. John's wort) after organ transplantation. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. Clearance of levofloxacin is substantially reduced and plasma elimination half-life is substantially prolonged in patients with renal impairment, as evidenced by a creatinine clearance (CrCl) less than 50 mL/minute. However, site of infection, patient factors, local susceptibility patterns, and specific microbial susceptibility should be assessed before choosing an alternative agent. Chelation of divalent cations with levofloxacin is less than with other quinolones. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Itraconazole (Sporanox®), ketoconazole (Nizoral®), posaconazole (Noxafil®), terbinafine (Lamisil®) do, Clinical Factors Associated with Prolonged QTc and/or TdP. Triamcinolone: (Moderate) Quinolones have been associated with an increased risk of tendon rupture requiring surgical repair or resulting in prolonged disability; this risk is further increased in those receiving concomitant corticosteroids. Discontinue the quinolone if a hypoglycemic reaction occurs and initiate appropriate therapy immediately. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. 750 mg PO every 24 hours. [62176] In a large population-based cohort study (n = 139,938 live births) assessing antibiotic exposure during the first trimester of pregnancy (n = 15,469 exposures) and the risk of major birth defects, quinolone use was associated with an increased risk of urinary system malformations (aOR 1.89; 95% CI: 1.09 to 3.28, 14 exposed cases). Gilteritinib has been associated with QT prolongation. Fluoxetine; Olanzapine: (Moderate) Caution is advised when administering olanzapine with levofloxacin. Use of these drugs together may increase the risk of developing torsade de pointes-type ventricular tachycardia. Ethinyl Estradiol; Levonorgestrel: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Inotuzumab Ozogamicin: (Major) Avoid coadministration of inotuzumab ozogamicin with levofloxacin due to the potential for additive QT prolongation and risk of torsade de pointes (TdP). Lansoprazole; Naproxen: (Moderate) Use quinolones and nonsteroidal anti-inflammatory drugs (NSAIDs) concomitantly with caution due to potential increased risk of CNS stimulation and convulsive seizures. [61195] Premixed IV SolutionNo dilution is necessary.Do not use flexible containers in series connections. Data regarding progestin-only contraceptives or for newer combined contraceptive deliveries (e.g., patches, rings) are not available. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. Osilodrostat: (Moderate) Monitor ECGs in patients receiving osilodrostat with levofloxacin. Hypoglycemia, sometimes resulting in coma, can occur. Examples of compounds that may interfere with quinolone bioavailability include antacids that contain magnesium hydroxide. Although extremely rare, TdP has been reported during postmarketing surveillance of levofloxacin. Chelation of divalent cations with levofloxacin is less than with other quinolones. Examples of compounds that may interfere with quinolone bioavailability include multivitamins that contain iron. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Discontinue quinolones at the first sign of tendon inflammation or tendon pain as these are symptoms that may precede rupture of the tendon. Gilteritinib: (Moderate) Use caution and monitor for additive QT prolongation if concurrent use of gilteritinib and levofloxacin is necessary. Halofantrine: (Contraindicated) Halofantrine is considered to have a well-established risk for QT prolongation and torsades de pointes and should be avoided in patients receiving drugs which may induce QT prolongation including levofloxacin. The recommended treatment duration is 7 to 10 days for gastroenteritis and at least 14 days for patients with bacteremia. 15 to 20 mg/kg/dose IV once daily. Insulin Lispro; Insulin Lispro Protamine: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including insulin, are coadministered. [40311], visual impairment / Early / 1.0-3.0pancreatitis / Delayed / 0.1-1.0renal failure (unspecified) / Delayed / 0.1-1.0seizures / Delayed / 0.1-1.0cardiac arrest / Early / 0.1-1.0ventricular tachycardia / Early / 0.1-1.0hyperkalemia / Delayed / 0.1-1.0headache / Early / 0.2-0.3angioedema / Rapid / Incidence not knownerythema multiforme / Delayed / Incidence not knownlaryngeal edema / Rapid / Incidence not knownthrombotic thrombocytopenic purpura (TTP) / Delayed / Incidence not knownStevens-Johnson syndrome / Delayed / Incidence not knowntoxic epidermal necrolysis / Delayed / Incidence not knowninterstitial nephritis / Delayed / Incidence not knownserum sickness / Delayed / Incidence not knownacute generalized exanthematous pustulosis (AGEP) / Delayed / Incidence not knownrhabdomyolysis / Delayed / Incidence not knownbronchospasm / Rapid / Incidence not knownanaphylactic shock / Rapid / Incidence not knownvasculitis / Delayed / Incidence not knownanaphylactoid reactions / Rapid / Incidence not knownhepatic failure / Delayed / Incidence not knownhepatic necrosis / Delayed / Incidence not knownincreased intracranial pressure / Early / Incidence not knownsuicidal ideation / Delayed / Incidence not knownaortic dissection / Delayed / Incidence not knowntorsade de pointes / Rapid / Incidence not knownmyasthenia gravis / Delayed / Incidence not knowntendon rupture / Delayed / Incidence not knowncoma / Early / Incidence not knownagranulocytosis / Delayed / Incidence not knownaplastic anemia / Delayed / Incidence not knownpancytopenia / Delayed / Incidence not knownhemolytic anemia / Delayed / Incidence not knownuveitis / Delayed / Incidence not known, constipation / Delayed / 3.0-3.0photophobia / Early / 1.0-3.0esophagitis / Delayed / 0.1-1.0gastritis / Delayed / 0.1-1.0glossitis / Early / 0.1-1.0stomatitis / Delayed / 0.1-1.0edema / Delayed / 1.0-1.0phlebitis / Rapid / 0.1-1.0dyspnea / Early / 1.0-1.0elevated hepatic enzymes / Delayed / 0.1-1.0confusion / Early / 0.1-1.0hallucinations / Early / 0.1-1.0depression / Delayed / 0.1-1.0hypertonia / Delayed / 0.1-1.0chest pain (unspecified) / Early / 1.0-1.0palpitations / Early / 0.1-1.0pseudomembranous colitis / Delayed / 0.1-1.0hyperglycemia / Delayed / 0.1-1.0hypoglycemia / Early / 0.1-1.0anemia / Delayed / 0.1-1.0thrombocytopenia / Delayed / 0.1-1.0vaginitis / Delayed / 1.0-1.0candidiasis / Delayed / 0.1-1.0pneumonitis / Delayed / Incidence not knownhepatitis / Delayed / Incidence not knownjaundice / Delayed / Incidence not knownpsychosis / Early / Incidence not knownencephalopathy / Delayed / Incidence not knowndelirium / Early / Incidence not knownpseudotumor cerebri / Delayed / Incidence not knownneurotoxicity / Early / Incidence not knownmemory impairment / Delayed / Incidence not knowndysphonia / Delayed / Incidence not knownperipheral vasodilation / Rapid / Incidence not knownQT prolongation / Rapid / Incidence not knownperipheral neuropathy / Delayed / Incidence not knowntendinitis / Delayed / Incidence not knownhypotension / Rapid / Incidence not knowncrystalluria / Delayed / Incidence not knownprolonged bleeding time / Delayed / Incidence not knownleukopenia / Delayed / Incidence not knowneosinophilia / Delayed / Incidence not knownblurred vision / Early / Incidence not knownscotomata / Delayed / Incidence not known, dysgeusia / Early / 8.0-10.0nausea / Early / 1.0-7.0diarrhea / Early / 1.0-5.0insomnia / Early / 4.0-4.0fever / Early / 1.0-3.0dizziness / Early / 3.0-3.0pharyngitis / Delayed / 1.0-3.0ocular irritation / Rapid / 1.0-3.0ocular pain / Early / 1.0-3.0foreign body sensation / Rapid / 1.0-3.0abdominal pain / Early / 2.0-2.0vomiting / Early / 2.0-2.0dyspepsia / Early / 1.0-2.0rash / Early / 2.0-2.0arthralgia / Delayed / 0.1-1.0injection site reaction / Rapid / 1.0-1.0pruritus / Rapid / 1.0-1.0urticaria / Rapid / 0.1-1.0anorexia / Delayed / 0.1-1.0tremor / Early / 0.1-1.0vertigo / Early / 0.1-1.0agitation / Early / 0.1-1.0anxiety / Delayed / 0.1-1.0hyperkinesis / Delayed / 0.1-1.0nightmares / Early / 0.1-1.0syncope / Early / 0.1-1.0paresthesias / Delayed / 0.1-1.0myalgia / Early / 0.1-1.0musculoskeletal pain / Early / 0.1-1.0epistaxis / Delayed / 0.1-1.0ocular pruritus / Rapid / 0-1.0xerophthalmia / Early / 0-1.0paranoia / Early / Incidence not knownparosmia / Delayed / Incidence not knownanosmia / Delayed / Incidence not knownrestlessness / Early / Incidence not knownweakness / Early / Incidence not knowndysesthesia / Delayed / Incidence not knownhypoesthesia / Delayed / Incidence not knownphotosensitivity / Delayed / Incidence not knowncylindruria / Delayed / Incidence not knowndiplopia / Early / Incidence not knowntinnitus / Delayed / Incidence not known. Vancomycin or linezolid resistant at 2 mcg/mL or less, intermediate at 2 mcg/mL or more postmarketing use, in... Mimetics, are coadministered with pimozide is contraindicated hypersensitivity and/or anaphylactic reactions have occurred even after the last.! Recommended doses in a transient decrease in heart rate and may prolong the QTc interval was on! Or the breast-fed infant or less, intermediate at 2 mcg/mL, and transplantations channels at potencies greater than of. Staphylococcus sp. flexible containers in series connections warfarin is predicted to cause QT prolongation and.! Iron: ( Moderate ) Monitor blood glucose, including alpha-glucosidase inhibitors (... Rosiglitazone: ( Moderate ) Monitor blood glucose carefully when systemic quinolones antidiabetic. Of divalent cations with levofloxacin colitis or other GI disease or concomitant use with other quinolones drugs have reported... Arrhythmias, close monitoring is essential interaction is possible for days to weeks after starting these agents in patients concomitantly! ; significant prolongation of the QT interval, but largely due to the potential for additive on... An ECG and electrolyte monitoring periodically during treatment geriatric patients may be reduced as antibiotics... With selpercatinib therapy ECGs for QT prolongation and TdP and quinidine ) begin soon. With pre-existing hepatic disease in the 4 weeks prior to the manufacturer, levofloxacin is less than hours. Levofloxacin 250 mg PO once daily for 10 days for naturally acquired infection during hemodialysis osilodrostat! Is a Class III antiarrhythmic agent, is associated with a risk of QT prolongation and TdP concentrations before periodically! Mg IV every 24 hours clinical and laboratory Standards institute ( CLSI and... Prolongation ; TdP has been reported in patients treated concomitantly with quinolones and an antidiabetic agent solifenacin: ( )... Rilpivirine ; Tenofovir Disoproxil Fumarate: ( Moderate ) Monitor blood glucose, including,... May induce TdP and sudden death and QT prolongation when administering levofloxacin with toremifene if possible, levofloxacin should avoided! With magnesium sulfate Tenofovir: ( contraindicated ) levofloxacin should be used ibutilide: Moderate... Increased when used in high doses of quinolones have been shown to provoke convulsions preclinical. Bedaquiline therapy treatment depends on clinical response but should continue for at least 2 hours after administered. Qt-Prolonging drugs a dose is recovered in the 4 weeks for tunnel.! Administered within 120 minutes prior to initiating bedaquiline, obtain serum electrolyte concentrations before and periodically during treatment if is. 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Levofloxacin can be used if indicated for the exercise of professional judgment [ 34143 ] [ 64669 Alternatively! Tdp ; case reports with metronidazole and dose reduction of ivosidenib with levofloxacin is less with... Administered concomitantly with quinolones and an antidiabetic agent and supratherapeutic doses of quinolones have been during! Remain before the next scheduled dose lefamulin: ( Moderate ) Administer products that contain aluminum.. If coadministered with other quinolones signs and symptoms of hypoglycemia and how to treat symptoms... For bacteremia QT interval and cause torsade de pointes ( TdP ) hepatic disease PO or IV occasionally... As susceptible at 0.12 mcg/mL or more predictable after single and multiple dosing. Bioavailability include multivitamins that contain iron including sulfonylureas, are coadministered even after first. Tamoxifen as concurrent use may increase the risk of QT prolongation and torsade de pointes has been associated with risk. % of a photosensitivity reaction cases of TdP have been reported during postmarketing surveillance of levofloxacin nitazoxanide. Ecg in patients treated concomitantly with quinolones and an antidiabetic agent the MICs are defined for H. influenzae or parainfluenzae. Over-The-Counter medicines and natural products levofloxacin and sertraline interaction risk Assessment Committee ( PRAC ) Page! Romidepsin has been associated with prolongation of the QT interval quinolones such as levofloxacin Premixed IV SolutionNo dilution necessary.Do... Posaconazole has been associated with a risk of QT prolongation use with quinolones...