Levofloxacin is an antibiotic that that may be used to treat different types of bacterial infections. Levofloxacin may also be used to treat people who have been exposed to anthrax or certain types of plague.

Levofloxacin is usually only used for bacterial infections that cannot be treated with safer antibiotics. This is because levofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic and fluoroquinolone antibiotics can cause serious or disabling side effects.

Levofloxacin was FDA approved in 1996.

Levofloxacin can cause serious side effects, including tendon problems, nerve damage, serious mood or behavior changes, or low blood sugar.

Stop using levofloxacin and call your doctor at once if you have symptoms such as: headache, hunger, irritability, numbness, tingling, burning pain, confusion, agitation, paranoia, problems with memory or concentration, thoughts of suicide, or sudden pain or movement problems in any of your joints.

In rare cases, levofloxacin may cause damage to your aorta, which could lead to dangerous bleeding or death. Get emergency medical help if you have severe and constant pain in your chest, stomach, or back.

Before taking this medicine

You should not use levofloxacin if you are allergic to it or other fluoroquinolones (such as ciprofloxacin, gemifloxacin, moxifloxacin, norfloxacin, ofloxacin, and others).

Levofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. This can happen during treatment or up to several months after you stop taking levofloxacin. Tendon problems may be more likely in certain people (children and older adults, or people who use steroid medicine or have had an organ transplant).

Tell your doctor if you have ever had:

• tendon problems, bone problems, arthritis or other joint problems (especially in children);

• blood circulation problems, aneurysm, narrowing or hardening of the arteries;

• heart problems, high blood pressure;

• a genetic disease such as Marfan syndrome or Ehler's-Danlos syndrome;

• diabetes;

• a muscle or nerve disorder, such as myasthenia gravis;

• kidney disease;

• seizures or epilepsy;

• a head injury or brain tumor;

• long QT syndrome (in you or a family member); or

• low levels of potassium in your blood (hypokalemia).

Do not give this medicine to a child without medical advice.

It is not known whether levofloxacin will harm an unborn baby. Tell your doctor if you are pregnant or intending to become pregnant.

You should not breast-feed while using levofloxacin.

Levofloxacin comes as a tablet and a solution (liquid) to take by mouth. It is usually taken once a day. The length of your treatment depends on the type of infection you have. Your doctor will tell you how long to take levofloxacin. The tablet may be taken with or without food. The solution should be taken 1 hour before or 2 hours after eating. Take levofloxacin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take levofloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

You should begin to feel better during the first few days of treatment with levofloxacin. If your symptoms do not improve or if they get worse, call your doctor.

Take levofloxacin until you finish the prescription, even if you feel better. Do not stop taking levofloxacin without talking to your doctor unless you experience certain serious side effects listed in the IMPORTANT WARNING or SIDE EFFECTS sections. If you stop taking levofloxacin too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Follow all directions on your prescription label and read all medication guides or instruction sheets about levofloxacin.

Take levofloxacin with water, at the same time each day. Drink extra fluids to keep your kidneys working properly while taking levofloxacin.

You may take levofloxacin tablets with or without food.

Take levofloxacin oral solution (liquid) on an empty stomach, at least 1 hour before or 2 hours after a meal.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Use levofloxacin for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Levofloxacin will not treat a viral infection such as the flu or a common cold.

Do not share levofloxacin with another person.

Levofloxacin may affect a drug-screening urine test and you may have false results. Tell the laboratory staff that you are taking it.

Store levofloxacin at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

You should not use levofloxacin if you are allergic to it or other fluoroquinolones (such as ciprofloxacin, gemifloxacin, moxifloxacin, norfloxacin, ofloxacin, and others).

Levofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. This can happen during treatment or up to several months after you stop taking levofloxacin. Tendon problems may be more likely in certain people (children and older adults, or people who use steroid medicine or have had an organ transplant).

Tell your doctor if you have ever had:

• tendon problems, bone problems, arthritis or other joint problems (especially in children);

• blood circulation problems, aneurysm, narrowing or hardening of the arteries;

• heart problems, high blood pressure;

• a genetic disease such as Marfan syndrome or Ehler's-Danlos syndrome;

• diabetes;

• a muscle or nerve disorder, such as myasthenia gravis;

• kidney disease;

• seizures or epilepsy;

• a head injury or brain tumor;

• long QT syndrome (in you or a family member); or

• low levels of potassium in your blood (hypokalemia).

Do not give this medicine to a child without medical advice.

It is not known whether levofloxacin will harm an unborn baby. Tell your doctor if you are pregnant or intending to become pregnant.

You should not breast-feed while using levofloxacin.

Take levofloxacin as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Make sure you drink plenty of water or other fluids every day while you are taking levofloxacin.

Avoid driving or hazardous activity until you know how levofloxacin will affect you. Your reactions could be impaired.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.

Levofloxacin could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Tell your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

Get emergency medical help if you have signs of an allergic reaction to levofloxacin (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Levofloxacin can cause serious side effects, including tendon problems, side effects on your nerves (which may cause permanent nerve damage), serious mood or behavior changes (after just one dose), or low blood sugar (which can lead to coma).

Stop taking this medicine and call your doctor at once if you have:

• low blood sugar--headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, or feeling anxious or shaky;

• nerve symptoms in your hands, arms, legs, or feet--numbness, weakness, tingling, burning pain;

• serious mood or behavior changes--nervousness, confusion, agitation, paranoia, hallucinations, memory problems, trouble concentrating, thoughts of suicide; or

• signs of tendon rupture--sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints (rest the joint until you receive medical care or instructions).

In rare cases, levofloxacin may cause damage to your aorta, the main blood artery of the body. This could lead to dangerous bleeding or death. Get emergency medical help if you have severe and constant pain in your chest, stomach, or back.

Stop taking levofloxacin and call your doctor at once if you have:

• severe stomach pain, diarrhea that is watery or bloody;

• fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);

• the first sign of any skin rash, no matter how mild;

• muscle weakness, breathing problems;

• seizure (convulsions);

• increased pressure inside the skull--severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes; or

• liver problems--upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of levofloxacin may include:

• nausea, constipation, diarrhea;

• headache, dizziness; or

• trouble sleeping.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Some medicines can make levofloxacin much less effective when taken at the same time. If you take any of the following medicines, take your levofloxacin dose 2 hours before or 2 hours after you take the other medicine.

• antacids that contain magnesium or aluminum (such as Maalox, Mylanta, or Rolaids), or the ulcer medicine sucralfate (Carafate);

• didanosine (Videx) powder or chewable tablets; or

• vitamin or mineral supplements that contain aluminum, iron, magnesium, or zinc.

Tell your doctor about all your other medicines, especially:

• theophylline;

• a diuretic or "water pill";

• heart rhythm medication;

• insulin or oral diabetes medicine (check your blood sugar regularly);

• medicine to treat depression or mental illness;

• steroid medicine (such as prednisone);

• a blood thinner--warfarin, Coumadin, Jantoven; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect levofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to levofloxacin. If you have diabetes, your doctor may ask you to check your blood sugar more often while taking levofloxacin.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking levofloxacin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish taking levofloxacin, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.