The most frequently reported side events are nausea or vomiting, diarrhea, headache, and constipation. Less common side effects include difficulty sleeping, dizziness, abdominal pain, rash, abdominal gas, and itching.
Rare allergic reactions have been described, such as hives and anaphylaxis (shock). Levofloxacin should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving levofloxacin. Levofloxacin should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.
Levofloxacin as well as other antibiotics in the fluoroquinolone class of antibiotics, has been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon. Many antibiotics, including levofloxacin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting levofloxacin (diarrhea, fever, abdominal pain, and possibly shock) should contact their physician immediately. Patients taking levofloxacin can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.
Cautions and Warnings
You should not use Levaquin if you are allergic to levofloxacin or other fluoroquinolones such as ciprofloxacin (Cipro), moxifloxacin (Avelox), ofloxacin (Floxin), norfloxacin (Noroxin), lomefloxacin (Maxaquin), and others.
Before taking Levaquin, tell your doctor if you have a heart rhythm disorder, especially if you are being treated with one of these medications: quinidine (Cardioquin, Quinidex, Quinaglute), disopyramide (Norpace), bretylium (Bretylol), procainamide (Pronestyl, Procan SR), amiodarone (Cordarone, Pacerone), or sotalol (Betapace).
Drug Interactions
Before taking Levaquin, tell your doctor if you are also using any of the following drugs:
a blood thinner such as warfarin (Coumadin);
insulin or diabetes medication you take by mouth, such as glyburide (Micronase, Diabeta, Glynase);
a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), etodolac (Lodine), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), nabumetone (Relafen), meloxicam (Mobic), naproxen (Aleve, Naprosyn, Anaprox), piroxicam (Feldene), and others; or
an oral steroid medication such as betamethasone (Celestone), dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), prednisolone (Orapred), prednisone (Meticorten, Sterapred), and others.
This list is not complete and there may be other drugs that can interact with Levaquin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
