Levofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

IV-$14/d PO-$3/d

Dosing

500-750 mg IV/PO q24h

8-10 mg/kg/dose IV/PO q24h
Maximum: 750 mg/dose
5 + Years

8-10 mg/kg/dose IV/PO q12h
6 Months - 5 Years

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

General Information

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

  • Dizziness

  • Insomnia

  • Rash

  • Nausea & Vomiting

  • Abdominal pain

  • Tendinopathy and rupture have been reported

  • QTc prolongation have been reported

Major Interactions

  • Increased risk when combined with other QTc prolonging agents.

  • AVOID concomitant administration with antacids, multivitamin & mineral supplements. Space doses by 2 hours.

  • Increased risk of tendon rupture especially with concomitant use of corticosteroids.

  • Monitor INR with warfarin.

Oral Liquids

Not available

Tablet/Capsule Strengths

500 mg tablet (very bitter when crushed)
Tablets and capsules are preferred especially over an unpleasant tasting liquid.
Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary.

Additional Information

Dosing for oral and IV levofloxacin is identical
Not to be given IM or SC administration.

Pharmacology

Antimicrobial class: Fluoroquinolone

Average serum half life:

  • Infants ≥6 months to 5 years: ~4 hours.

  • Children 5-16 years: 4.8-6 hours.

  • Adults: 6-8 hours

Route of Elimination: 87% excreted unchanged in urine over 48 hours by tubular secretion and glomerular filtration; 4% in feces