Tell your doctor if you have or have ever had seizures, epilepsy, cerebral arteriosclerosis (narrowing of blood vessels in or near the brain that can lead to stroke or ministroke), stroke, changed brain structure, or kidney disease. The QTc interval then decreased to 437 msec 2 days after discontinuing this drug. flushing or redness of the skin, especially on the face and neck. Enter multiple addresses on separate lines or separate them with commas. Cardiology 120 (2011): 103-110, 47. Once a quinolone-induced tendonopathy is suspected, a patient should not be rechallenged with quinolones.10, The pathologic mechanisms responsible for quinolone-induced tendonopathy seem to be multifactorial. Call your doctor right away if you have a rash, itching, hives, hoarseness, lightheadedness or fainting, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you or your child take this medicine. Check with your doctor right away if you or your child start having nausea or vomiting, dark urine, light-colored stools, stomach pain, or yellow eyes or skin while using this medicine. The tablet may be taken with or without food. Due to the possibility that this may have been an allergic reaction, rechallenge was not attempted. Blood glucose levels subsequently ranged between 40 to 159 mg/dL with dextrose doses and infusions; however, he did not regain consciousness and expired 2 days later. Different people may feel different symptoms of low blood sugar. the unsubscribe link in the e-mail. You may report side effects to FDA at 1-800-FDA-1088. Drugs 63 (2003): 2769-2802, 5. CMAJ 184 (2012): 1565-70, 28. 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. Because the patient was not a good surgical candidate, a below-the-knee ankle-foot orthosis was applied for 3 months. Make sure you drink plenty of water or other fluids every day while you are taking levofloxacin. J Urol 174 (2005): 165, 44. Ann Pharmacother 35 (2001): 1540-7, 13. Copyright 2023 Elsevier Inc. All Rights Reserved. http://www.upandaway.org. Your prescription is probably not refillable. Coban S, Ceydilek B, Ekiz F, Erden E, Soykan I "Levofloxacin-induced acute fulminant hepatic failure in a patient with chronic hepatitis B infection." Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Do not take other medicines unless they have been discussed with your doctor. A 74-year-old female developed hepatotoxicity and significantly increased AST (4962 units/L), ALT (7071 units/L), alkaline phosphatase (90 units/L), and total bilirubin (2.5 mg/dL) after starting this drug. Available for Android and iOS devices. Drug class: quinolones and fluoroquinolones, diarrhea (watery and severe) which may also be bloody, feeling that others can hear your thoughts or control your behavior, seeing, hearing, or feeling things that are not there, difficulty with chewing, talking, or swallowing. Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. Bird SB, Orr PG, Mazzola JL, Brush DE, Boyer EW "Levofloxacin-Related Seizure Activity in a Patient With Alzheimer's Disease: Assessment of Potential Risk Factors." The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (eg, dexamethasone, prednisolone, prednisone, or Medrol), have severe kidney problems, have a history of tendon problems (eg, rheumatoid arthritis), or have received an organ (eg, heart, kidney, or lung) transplant. Ramakrishnan K, Scheid DC "Diagnosis and management of acute pyelonephritis in adults." Check with your doctor right away if you have sudden chest, stomach, or back pain, trouble breathing, cough, or hoarseness. The American Society of Health-System Pharmacists, 4500 East-West Highway, Suite 900, Bethesda, Maryland. Tendon rupture, whether surgically or conservatively treated, requires casting and prolonged rest. The rash initially manifested as an erythematous rash, blistering, and mucosal sloughing but progressed to exfoliation involving three-quarters of the patient's body surface area including mucosa. sinus infection worsening of chronic bronchitis skin infections chronic prostate infection urinary tract infections pyelonephritis (kidney infection) inhalational anthrax plague Levofloxacin may. The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (eg, dexamethasone . The patient usually presents with a positive Thompson sign (absence of plantar flexion on squeezing the calf muscle in the prone position).1,10 Pain diminishes after tendon rupture occurs. Ann Pharmacother 34 (2000): 453-8, 20. Symptoms of a kidney infection include one-sided or bilateral flank or lower back pain, nausea, fever, and chills. Pharmacotherapy 24 (2004): 1807-12, 29. A 65-year-old woman with hypokalemia (2.8 mEq/L), hypomagnesemia (1.5 mEq/L), and renal insufficiency (serum creatinine 7.7 mg/dL, BUN 34 mg/dL) developed a QTc interval of 605 ms (baseline 435 to 485 ms), several episodes of torsade de pointes, and cardiac arrest after 3 days of this drug (250 mg/day IV). A direct relationship exists between severity and the length of treatment; there is a predilection for the Achilles tendon, but shoulder and hand involvement has been reported as well.2,6,12 The injury may be bilateral, partial, or complete and is usually located 2 to 3 cm above a poorly vascularized area.1,13 On examination, substantial swelling is frequently noted, and the presentation may mimic phlebitis. Finally, an emphasis on patient awareness can further reduce the morbidity associated with quinolone-induced tendonitis and/or rupture by prompting earlier presentation, evaluation, and intervention. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. You may get drowsy or dizzy. They can happen within hours to weeks after starting this drug. An MRI of a new rupture shows evidence of edema, hemorrhage and fiber discontinuity.1,7,10, Treatment consists of immediate discontinuation of quinolone therapy at the earliest suspicion of tendonopathy.7,12 For mild tendonitis, weight-bearing restriction ranges from 2 to 6 weeks. Friedrich LV, Dougherty R "Fatal hypoglycemia associated with levofloxacin." Information is also available online at https://www.poisonhelp.org/help. Levofloxacin may lower the number of some types of blood cells in your body. Your doctor may order certain lab tests to check your body's response to levofloxacin. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Brush and floss your teeth gently. These can happen alone or at the same time. Keep all appointments with your doctor and the laboratory. This can occur after the first dose of levofloxacin. Do not skip doses or stop your medication early. Do not take a double dose to make up for a missed one. Do not let anyone else take your medication. Call your doctor if your child develops joint problems, such as pain or swelling, while taking levofloxacin or after treatment with levofloxacin. Medically reviewed by Drugs.com. Do not take more or less of it or take it more often than prescribed by your doctor. Mayo Clinic on Incontinence - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. Clin Nephrol 54 (2000): 356, 58. [Ref], Uncommon (0.1% to 1%): Genital moniliasis, Frequency not reported: Dysmenorrhea, hematuria, dysuria, oliguria, urinary incontinence, urinary retention, leukorrhea, genital pruritus, ejaculation failure, impotence, albuminuria, candiduria, crystalluria, cylindruria, vaginal candidiasis, urinary tract infection, -Common (1% to 10%): Vulvovaginal mycotic infection[Ref]. Taking levofloxacin may affect your brain or nervous system and cause serious side effects. The condition resolved within 4 weeks after discontinuation of this drug. Wash your hands often. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. MRI confirmed the diagnosis of tendon rupture 3 weeks later. Tendon disorder (eg, rheumatoid arthritis), history ofUse with caution. Cough/productive cough, dysgeusia, and fatigue/asthenia were reported most often with the nebulizer solution formulation. Applies to levofloxacin: oral solution, oral tablet. These problems may affect tendons in your shoulder, your hand, the back of your ankle, or in other parts of your body. The most common side effects leading to discontinuation were gastrointestinal (primarily nausea, vomiting), dizziness, and headache. Clin Infect Dis 55 (2012): 1457-65, 49. Do not share this medicine with others. [Ref], Rare (0.01% to 0.1%): Visual disturbances (e.g., blurred vision), Frequency not reported: Ophthalmologic abnormalities (including cataracts, multiple punctate lenticular opacities), abnormal vision, eye pain, nystagmus, conjunctivitis, transient vision loss, Postmarketing reports: Vision disturbance (including diplopia), reduced visual acuity, blurred vision, scotomata, uveitis, -Uncommon (0.1% to 1%): Visual disturbance[Ref], Rare (0.01% to 0.1%): Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)[Ref]. Sydnor TA, Kopp EJ, Anthony KE, LoCoco JM, Kim SS, Fowler CL "Open-label assessment of levofloxacin for the treatment of acute bacterial sinusitis in adults." Full recovery ensued without any sequelae of tendonopathy. Levofloxacin should not normally be given to children younger than 18 years of age unless they have plague or have been exposed to plague or anthrax in the air. Levofloxacin may cause serious liver problems, including hepatitis. Although not all of these side effects may occur, if they do occur they may need medical attention. It works by killing bacteria that cause infections. Levofloxacin can cause severe allergic reactions. Micheli L, Sbrilli M, Nencini C "Severe hypoglycemia associated with levofloxacin in Type 2 diabetic patients receiving polytherapy: two case reports." Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, History of low levels of potassium in the blood, Tingling of the fingers or toes, or other nerve disorder, An unusual or allergic reaction to levofloxacin, other quinolone antibiotics, foods, dyes, or preservatives, Certain medications for diabetes, like glipizide, glyburide, or insulin, Certain medications that treat or prevent blood clots like warfarin, NSAIDS, medications for pain and inflammation, like ibuprofen or naproxen, Other medications that prolong the QT interval (cause an abnormal heart rhythm) like dofetilide, ziprasidone, Steroid medications like prednisone or cortisone, Allergic reactionsskin rash, itching, hives, swelling of the face, lips, tongue, or throat, Heart rhythm changesfast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing, Increased pressure around the brainsevere headache, blurry vision, change in vision, nausea, vomiting, Joint, muscle, or tendon pain, swelling, or stiffness, Liver injuryright upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue, Mood and behavior changesanxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression, Pain, tingling, or numbness in the hands or feet, Redness, blistering, peeling, or loosening of the skin, including inside the mouth, Sudden or severe chest, back, or stomach pain, Unusual vaginal discharge, itching, or odor. Khaliq Y, Zhanel GG "Fluoroquinolone-Associated Tendinopathy: A Critical Review of the Literature." This can occur while you are taking the medicine or after you finish using it. What side effects can this medication cause? Maunz G, Conzett T, Zimmerli W "Cutaneous vasculitis associated with fluoroquinolones." Confirmed the Diagnosis of tendon rupture, whether surgically or conservatively treated, requires casting and prolonged rest child. With levofloxacin., check interactions and set up your own personal medication...., Conzett T, Zimmerli W `` Cutaneous vasculitis associated with levofloxacin. unconsciousness ( passing out ) ). Chronic prostate infection urinary tract infections pyelonephritis ( kidney infection include one-sided or bilateral flank or levofloxacin side effects tendons levitra soft back,! Infections pyelonephritis ( kidney infection ) inhalational anthrax plague levofloxacin may affect your brain or system... 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