Individual generic drug information

levofloxacin

Reference monograph

Part of registered formulation

LEVOFLOXACIN

Reference record: Levofloxacin
Source: BNF 80 (2020–2021)
Printed source pages: 614, 615
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Levofloxacin only.

Indications And Dose

Acute sinusitis ▶BY MOUTH ▶Adult: 500 mg once daily for 10–14 days Acute exacerbation of chronic obstructive pulmonary disease ▶BY MOUTH ▶Adult: 500 mg once daily for 5 days Acute exacerbation of bronchiectasis ▶BY MOUTH ▶Adult: 500 mg 1–2 times a day for 7–14 days ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg 1–2 times a day, to be given over at least 60 minutes Community-acquired pneumonia ▶BY MOUTH ▶Adult: 500 mg twice daily for 5 days ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg twice daily for 5 days, to be given over at least 60 minutes Hospital-acquired pneumonia (administered on expert advice) ▶BY MOUTH ▶Adult: 500 mg 1–2 times a day for 5 days then review ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg 1–2 times a day, to be given over at least 60 minutes, use twice daily if severe infection Urinary-tract infections ▶BY MOUTH ▶Adult: 500 mg once daily for 7–14 days Complicated urinary-tract infections ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg once daily, to be given over at least 60 minutes Prostatitis (initiated under specialist supervision) ▶BY MOUTH ▶Adult: 500 mg once daily for 14 or 28 days based on clinical assessment ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg once daily, to be given over at least 60 minutes Complicated skin infections | Complicated soft-tissue infections ▶BY MOUTH ▶Adult: 500 mg 1–2 times a day for 7–14 days ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg 1–2 times a day, to be given over at least 60 minutes Inhalation of anthrax (treatment and post-exposure prophylaxis) ▶BY MOUTH ▶Adult: 500 mg once daily for 8 weeks ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg once daily, to be given over at least 60 minutes Chronic pulmonary infections due to Pseudomonas aeruginosa in cystic fibrosis ▶BY INHALATION OF NEBULISED SOLUTION ▶Adult: 240 mg twice daily for 28 days, subsequent courses repeated after 28-day interval without levoﬂoxacin nebuliser solution Helicobacter pylori eradication [in combination with other drugs (see Helicobacter pylori infection p. 89)] ▶BY MOUTH ▶Adult: 250 mg twice daily for 7 days for second-line eradication therapy; 10 days for third-line eradication therapy l UNLICENSED USE Levoﬂoxacin may be used as detailed below, although these situations are considered unlicensed: . g treatment of acute exacerbation of bronchiectasis . treatment of hospital-acquired pneumonia . duration of treatment for acute exacerbation of chronic obstructive pulmonary disease . duration of treatment for community-acquired pneumonia . eradication of Helicobacter pylori h

Source page 614

Cautions

Risk factors for QT interval prolongation (e.g. electrolyte disturbances, acute myocardial infarction, heart failure with reduced left ventricular ejection fraction, bradycardia, congenital long QT syndrome, history of symptomatic arrhythmias)

Source page 614

National Funding Access Decisions

Scottish Medicines Consortium (SMC) decisions ▶When used by inhalation The Scottish Medicines Consortium has advised (August 2016) that levoﬂoxacin (Quinsair ®) is accepted for restricted use within NHS Scotland for the management of chronic pulmonary infections due to Pseudomonas aeruginosa in patients with cystic ﬁbrosis, as a third-line treatment option after colistimethate sodium (ﬁrst line) and tobramycin (second line). This advice is contingent upon the continuing availability of the Patient Access Scheme in NHS Scotland or a list price that is equivalent or lower. All Wales Medicines Strategy Group (AWMSG) decisions ▶When used by inhalation The All Wales Medicines Strategy Group has advised (November 2016) that levoﬂoxacin (Quinsair ®) is recommended as an option for restricted use within NHS Wales as third-line therapy for the management of chronic pulmonary infections due to Pseudomonas aeruginosa in patients with cystic ﬁbrosis, who do not respond to, or are intolerant of, second-line treatment with tobramycin, only if the approved Wales Patient Access Scheme (WPAS) is used or where the list price is equivalent or lower.

Source page 615

Safety

Extracted information for Levofloxacin only.

Interactions

→Appendix 1: quinolones

Source page 614

Side Effects

▶Common or very common ▶When used by inhalation Bronchial secretion changes. dysphonia. haemoptysis. weight decreased ▶Uncommon ▶When used by inhalation Costochondritis. hyperbilirubinaemia. joint stiffness ▶Rare or very rare ▶With intravenous or oral use Paranoia ▶Frequency not known ▶With intravenous or oral use Diarrhoea haemorrhagic SIDE-EFFECTS, FURTHER INFORMATION Systemic side- effects may occur with nebulised levoﬂoxacin. Bronchospasm Manufacturer advises if acute symptomatic bronchospasm occurs after receiving nebulised levoﬂoxacin, patients may beneﬁt from the use of a short-acting inhaled bronchodilator at least 15 minutes to 4 hours prior to subsequent doses.

Source page 614

Breast Feeding

Manufacturer advises avoid.

Source page 614

Renal Impairment

Dose adjustments ▶With intravenous use or oral use Usual initial dose, then use half normal dose if eGFR 20–50 mL/minute/1.73 m2; consult product literature if eGFR less than 20 mL/minute/1.73 m2. ▶When used by inhalation Manufacturer advises avoid if creatinine clearance less than 20 mL/minute.

Source page 614

Dose and formulations

Extracted information for Levofloxacin only.

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 6, 9, 25 ▶Levofloxacin (Non-proprietary) Levofloxacin (as Levofloxacin hemihydrate) 250 mg Levofloxacin 250mg tablets | 5 tablet P £5.47–£5.74 | 10 tablet P £11.48 DT = £11.10 Levofloxacin (as Levofloxacin hemihydrate) 500 mg Levofloxacin 500mg tablets | 5 tablet P £7.90–£12.93 | 10 tablet P £25.85 DT = £24.42 Solution for infusion ELECTROLYTES: May contain Sodium ▶Levofloxacin (Non-proprietary) Levofloxacin (as Levofloxacin hemihydrate) 5 mg per 1 ml Levofloxacin 500mg/100ml solution for infusion vials | 1 vial P £25.00 (Hospital only) Levofloxacin 500mg/100ml solution for infusion bottles | 1 bottle P £12.00 | 10 bottle P £273.00 Nebuliser liquid ▶Quinsair (Chiesi Ltd) A Levofloxacin (as Levofloxacin hemihydrate) 100 mg per 1 ml Quinsair 240mg nebuliser solution ampoules | 56 ampoule P £2,181.53 Infusion ▶Levofloxacin (Non-proprietary) Levofloxacin (as Levofloxacin hemihydrate) 5 mg per 1 ml Levofloxacin 500mg/100ml infusion bags | 1 bag P £4.00 | 10 bag P £250.00 (Hospital only) | 20 bag P £502.00 (Hospital only) eiiii F 589

Source page 615

Clinical care

Extracted information for Levofloxacin only.

Patient And Carer Advice

▶When used by inhalation Manufacturer advises patients and carers should be given advice on how to administer levoﬂoxacin. Missed doses ▶When used by inhalation Manufacturer advises if a dose is more than 4 hours late, the missed dose should not be taken and the next dose should be taken at the normal time. Driving and skilled tasks May impair performance of skilled tasks (e.g. driving).

Source page 614

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 10–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 5 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day for 7–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg twice daily for 5 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg twice daily for 5 days, to be given over at

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day for 5 days then review

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 7–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 14 or 28 days based on

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day for 7–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 8 weeks

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

240 mg twice daily for 28 days, subsequent

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

250 mg twice daily for 7 days for second-line

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.

Individual generic drug information

levofloxacin

Reference monograph

Part of registered formulation

LEVOFLOXACIN

Reference record: Levofloxacin
Source: BNF 80 (2020–2021)
Printed source pages: 614, 615
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Levofloxacin only.

Indications And Dose

Source page 614

Cautions

Source page 614

National Funding Access Decisions

Source page 615

Safety

Extracted information for Levofloxacin only.

Interactions

→Appendix 1: quinolones

Source page 614

Side Effects

Source page 614

Breast Feeding

Manufacturer advises avoid.

Source page 614

Renal Impairment

Source page 614

Dose and formulations

Extracted information for Levofloxacin only.

Medicinal Forms

Source page 615

Clinical care

Extracted information for Levofloxacin only.

Patient And Carer Advice

Source page 614

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 10–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 5 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day for 7–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg twice daily for 5 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg twice daily for 5 days, to be given over at

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day for 5 days then review

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 7–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 14 or 28 days based on

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day for 7–14 days

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg 1–2 times a day, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily for 8 weeks

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

500 mg once daily, to be given over at least

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

240 mg twice daily for 28 days, subsequent

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Adults

First line only; read the complete Indications and dose section above.

250 mg twice daily for 7 days for second-line

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 614

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.