Levofloxacin instructions for use indications, contraindications, side effects

Respiratory tract diseases are predominantly infectious and inflammatory in nature. And they are often caused by bacterial pathogens. Therefore, effective treatment is impossible without affecting the source of pathology, i.e., the microbial factor. For this purpose, medications such as Levofloxacin are used. For those who are encountering the drug for the first time, the following questions are relevant: is it an antibiotic or not, which group does it belong to, what does it have, when and how is it used, does it have side effects and contraindications. You can get answers to them from your doctor or from the official instructions.

Levofloxacin analogs

Level 4 ATX code matches:

Syphlox
Hyleflox
Faktiv
Leflobakt
Lefoccin
Gatifloxacin
Lebel
Ofloxacin
Tigeron
Lomefloxacin
Zanotsin
Eleflox
Tsiprobay
Lomflox
Sparflo
Pefloxacin
Tariwid
Zoflox
Abaktal
Moxifloxacin

Levofloxacin analogues are medicines that have as an active ingredient another antibiotic that is similar in antibacterial activity. For eye drops, these are the following drugs:

Tsipromed;
Betaciprol;
Vitabact;
Decamethoxin;
Lofox;
Okatsin;
Ofloxacin;
Ophthalmol;
Phloxal;
Tsiprolet;
Ciprofloxacin;
Ciprofloxacin-AKOS;
Ciprofloxacin Bufus;
Oftocipro;
Vigamox;
Dancil;
Zimar;
Normax ;
Okomistin;
Oftadek;
Uniflox;
Ciloxane;
Ciprolone;
Moxifur.

Analogs of Levofloxacin in the form of tablets and solution for internal administration are as follows:

tablets – Zarquin, Xenaquin, Lomacin, Lomflox, Nolicin, Norilet, Norfacin, Oflocid, Oflocid forte, Sparflo, Tariferid, Faktiv, Ciprex, Ciprodox, Cipropane, Ecotsifol, Gatispan, Loxon-400, Lomefloxacin, Lofox, Moximac, Norbactin, Normax , Norfloxacin, Oflox, Oflomak, Plevilox, Sparbakt, Taritsin, Tseprova, Tsipraz, Tsifloksinal;
tablets and solution for internal administration - Abactal, Geoflox, Ificipro, Oflo, Ofloxin, Pefloxacin, Procipro, Tsiplox, Tsiprobay, Tsiprolet, Ciprofloxacin, Tsifran, Avelox, Zanotsin, Zoflox, Quintor, Ofloxacin, Tarivid, Tsiprobid, Unikpef;
solution for internal administration - Basijen, Ofloxabol, Ciprolacare, Cipronate, Ciprofloxabol, Cifracid;
solution and powder for internal administration – Pefloxabol;
tablets, solution and concentrate for internal administration - Tsiprinol.

All of these drugs have their own characteristics and regimen of use. You should not use them without a doctor's prescription. The price of analogues also varies greatly. Ciprofloxacin is considered one of the cheapest, and Avelox is one of the most expensive.

Levofloxacin price, where to buy

The price of eye drops, a special IV solution and tablets in Russia and Ukraine may vary slightly. This remedy is found quite often in pharmacies. However, due to its popularity, fakes are often found.

The approximate price of Levofloxacin in the form of eye drops for 1 ml is about 30 rubles, and for 5 ml – about 110 rubles. Kharkov and other large cities of Ukraine offer this product for approximately 6 UAH, respectively. and 25 UAH.

The price of Levofloxacin 500 mg in the form of a solution for internal administration is approximately 175-995 rubles or 40-46 UAH. in Ukraine.

In turn, the price for Levofloxacin tablets may be as follows:

250 mg in a package of 5 pieces - on average 280 rubles or 55 hryvnia;
250 mg in a package of 10 pieces - on average 400 rubles or 45 hryvnia;
500 mg in a package of 14 pieces - on average 650 rubles or 130 hryvnia;
500 mg in a package of 10 pieces - on average 550 rubles or 90 hryvnia;
500 mg in a package of 5 pieces - on average 370 rubles or 50 hryvnia.

Levofloxacin-Teva is even more expensive in many pharmacies, but it is believed that this drug has the lowest severity of negative side reactions.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine

ZdravCity

Levofloxacin tablets p.p.o. 500 mg No. 5 VertexVertex JSC
Levofloxacin tablets p.p.o. 500 mg No. 10 VertexVertex JSC
Levofloxacin tablets p.p.o. 500 mg No. 5 PharmstandardPharmstandard-Tomskkhimpharm/Pharmstandard-Leksredstva OJSC
Levofloxacin tablets p.p.o. 500 mg No. 5 OzonOzon LLC
Levofloxacin tablets p.p.o. 500 mg No. 10 Rapharma JSC "Rafarma"

Pharmacy Dialogue* discount 100 rub. using promo code medside (for orders over 1000 rubles)

Levofloxacin (tab.p.p./vol. 250 mg No. 5)
Levofloxacin (tab.pl/vol.500mg No. 5)
Levofloxacin-Teva tablets 500 mg No. 7
Levofloxacin-Teva tablets 500 mg No. 14
Levofloxacin (vial 0.5% 100ml)

Europharm* 4% discount using promo code medside11

Levofloxacin-Vertex 250 mg 5 tabletsVertex Joint Stock Company
Levofloxacin-vertex 500 mg 5 tabOzon LLC
Levofloxacin-Vertex 250 mg 10 tabletsVertex JSC
Levofloxacin-teva 500 mg 14 tabletsTeva Pharmaceutical Enterprises Ltd
Levofloxacin-Vertex 500 mg 10 tabletsVertex JSC

Pharmacy IFC

Levofloxacin EcolevidAVVA RUS OJSC, Russia
LevofloxacinVertex JSC, Russia
Levofloxacin-TevaTeva, Israel
Levofloxacin-TevaTeva, Israel

Pharmacy24

Levofloxacin Aurobindo 5 mg/ml 100 ml No. 1 Aurobindo Pharma Ltd., India
Levofloxacin 0.5% 150ml solution for infusion ZAT"Infusion", Ukraine
Levofloxacin 250 mg No. 10 tablets PrAT "Technolog", Uman, Cherkasy region, Ukraine
Levofloxacin-Astrapharm 500 mg No. 7 tablets TOV Astrapharm, Ukraine
Levofloxacin-Astrapharm 500 mg No. 14 tablets TOV Astrapharm, Ukraine

PaniPharmacy

LEVOFLOXACIN tablets Levofloxacin film-coated tablets 500 mg No. 10 Ukraine, Health LLC
LEVOFLOXACIN tablets Levofloxacin film-coated tablets 500 mg No. 10 Ukraine, Tekhnolog ChAO
LEVOFLOXACIN infusion Levofloxacin rn d/inf. 500mg 100ml India, Eurolife Healthcare
LEVOFLOXACIN infusion Levofloxacin solution 0.5% 100ml Ukraine, Infusion JSC
LEVOFLOXACIN tablets Levofloxacin film-coated tablets 250 mg No. 10 Ukraine, Tekhnolog ChAO

The drug is inexpensive. On average, it is 70-100 rubles per package, depending on the manufacturer and region.

Method of treatment

The drip solution is contained in 5-10 ml cans, the concentration of the beneficial substance is 0.5%. Physical characteristics: transparent, odorless, homogeneous.

The medicine has contraindications:

for children under 12 months;
pregnant and lactating women;
with an allergic reaction to fluoroquinolone.

In case of hypersensitivity to fluoroquinolones, the medicine is discontinued after a single use.

Therapeutic purpose:

bacterial damage to the conjunctiva, cornea and eyelids;
chlamydia of eye tissues;
gonorrheal infection.

The maximum duration of therapy is 5-7 days. The daily dose is reduced throughout the entire treatment period from 8-16 drops per day to 3-4. Single injection under the lower eyelid – 1-2 drops.

Features of application: only conjunctivally, without affecting the corneal layer.

If the prescribed dose is exceeded, symptoms of overdose are possible:

corneal erosion;
This is what corneal erosion looks like
conjunctivitis;
dizziness.

For treatment, you need to rinse your eyes with water. If signs of overdose persist, you should consult a doctor.

Types of complications during treatment with Levofloxacin:

Side effects for the mucous membrane:

conjunctivitis;
the appearance of follicles (nodules of lymphoid tissue on the conjunctiva);
chemosis (swelling of the mucous membrane).

Corneal reactivity:

redness, itching and burning;
mucous cords (impaired properties of the tear film);
decreased visual acuity;
photophobia (soreness and lacrimation in bright light).

Eyelid irritation:

dermatitis (inflammatory skin reaction);
blepharitis (inflammation of the edges of the eyelids);
edema.

Ocular side effects include headache and swelling of the nasopharynx.

When installing Levofloxacin, the following is prohibited:

use contact lenses (remove while taking medication);
use other antibacterial drugs at the same time (no earlier than after 15 minutes);
drive vehicles (due to the effect on visual acuity).

Soft contact lenses are not used during treatment with Levofloxacin due to eye irritation.

The drug is good for 28 days after opening. Dispensed with a doctor's prescription.

Characteristics

Levofloxacin is a synthetic substance. According to its chemical structure, it is the L-isomer of ofloxacin, due to which it has a more pronounced effectiveness compared to it. It is a crystalline powder with a whitish-yellow tint, highly soluble in aqueous media. Able to form stable compounds with many metals. The pharmaceutical industry widely produces the drug in tablets or solution for infusion. But there are also dosage forms for topical use, for example, eye drops.

Action

Levofloxacin is an antibiotic from the fluoroquinolone group. It has a broad spectrum of antimicrobial activity. Due to the inhibition of a special enzyme (DNA gyrase), it disrupts the processes of spiralization of nucleic chains in the nucleus of a microbial cell. This entails severe structural disturbances in the cytoplasm, organelles and membrane. Many gram-negative and gram-positive bacteria with aerobic metabolism are sensitive to Levofloxacin:

Streptococci.
Pneumococcus.
Staphylococci.
Haemophilus influenzae.
Moraxella.
Klebsiella.
Neisseria.
Mycobacteria.
Corynebacteria.

In addition, the drug is effective against intracellular microbes (chlamydia, mycoplasma). As you can see, all of these pathogens can cause respiratory disease. Levofloxacin also affects Escherichia coli and Pseudomonas aeruginosa, Salmonella, Proteus, enterococci and other microbes, including strains resistant to penicillin drugs, macrolides or other fluoroquinolones. This makes the antibiotic extremely popular and effective.

Levofloxacin acts bactericidal, causing structural disturbances in the microbial cell. It is active against most pathogens, especially those involved in the pathology of the respiratory tract.

Distribution in the body

After oral administration, the drug is quickly and almost completely absorbed from the gastrointestinal tract. The bioavailability of the active substance is close to one hundred percent, and ingestion of food or other medications has little effect on it. The maximum plasma concentration is reached after 80 minutes, and the half-life extends to 8 hours. About a third of Levofloxacin that enters the blood binds to protein molecules. It penetrates well into the tissues of the bronchopulmonary system, gland secretions and alveolar macrophages. The drug is partially metabolized in the liver, but the main part is excreted unchanged through the kidneys. This occurs within 2 days after oral or parenteral administration.

Adverse reactions and overdose

According to the instructions for use of Levofloxacin at a dosage of 500 mg, undesirable reactions may develop during treatment. If such effects occur, the drug should be discontinued and consult your doctor. Adverse reactions include:

Allergies - skin itching and redness, urticaria, spasm and swelling of bronchial smooth muscles, swelling of the mucous membrane of the nasopharynx, anaphylactic shock, allergic vasculitis and pneumonitis, increased sensitivity to ultraviolet radiation.
Skin manifestations - exudative erythema multiforme, Lyell's syndrome, Stevens-Johnson syndrome.
Digestive disorders - increased levels of liver enzymes, nausea, diarrhea, vomiting, epigastric pain, rarely - pseudomembranous colitis.
Metabolic disorders - hypoglycemia and porphyria in patients with diabetes mellitus.
Neurological and mental disorders - dizziness and headache, sleep disorders, motor restlessness and agitation, tremor, paresthesia in the limbs, acute psychotic disorders, depression, convulsions, impaired consciousness.
Impaired functioning of the sense organs - disorders of vision and hearing, as well as taste and tactile sensitivity.
Cardiovascular manifestations - tachycardia, arterial hypotension, vascular collapse.
Musculoskeletal disorders - tendinitis, myalgia, arthralgia, bilateral Achilles tendon ruptures, rhabdomyolysis.
From the urinary system, hypercreatinemia, interstitial nephritis, decreased renal function up to the development of acute failure are possible.
Disorders of the hematopoietic organs - a decrease in the number of blood cells up to pancytopenia, hemolytic anemia.

In addition, weakness and fever, dysbacteriosis and the development of superinfection due to the activation of the growth of resistant microflora may be observed.

When instilling drops into the conjunctival sac, undesirable manifestations may develop:

burning, itching and pain in the eyes, sensation of sand or foreign body;
decreased visual acuity;
increased mucus production, its secretion in the form of dense strands;
inflammation of the eyelid - blepharitis;
papillary conjunctival reaction;
dryness and redness of the conjunctiva of the eye;
swelling and redness of the eyelid;
photophobia.

If the recommended therapeutic dose has been exceeded, the patient may experience characteristic symptoms mainly from the brain: impaired consciousness, convulsions, epileptiform seizure, dizziness. In addition, gastrointestinal disorders are possible.

Treatment for overdose is symptomatic; there is no antidote to the drug. The use of peritoneal dialysis for poisoning is ineffective. 24-hour ECG monitoring is mandatory so as not to miss QT interval prolongation.

Possible adverse reactions from Levofloxacin tablets:

Vomiting and nausea, severe diarrhea, possible diarrhea with blood, disruption of the gastrointestinal tract, stomach pain, decreased appetite, increased activity of liver transaminases, acute inflammation of the walls of the large intestine, hepatitis, increased levels of bilirubin in the blood, various forms dysbacteriosis.
Heart failure, low blood pressure, risk of gastric tachycardia and cardiac tachycardia, cardiac arrhythmia.
Severe dizziness, migraine, lack of concentration and weakness, tremors of the limbs, sleep disturbances, burning and tingling of the skin, unreasonable fear, anxiety, confusion, hallucinations, musculoskeletal disorders, decreased mood, sudden muscle contractions.
Hearing problems, distortions in the level of smell, deterioration in the level of vision, loss of tactile sensations, loss of taste sensitivity.
Decreased muscle strength, joint pain, tendon ruptures, muscle pain, destruction of muscle tissue cells, inflammation of tendon tissue.
Interstitial nephritis, bacterial inflammation of interstitial tissue and renal tubules, acute renal failure.
Destruction of red blood cells, increased number of eosinophils, decreased level of neutrophil granulocytes, decreased level of leukocytes in the blood, insufficiency of blood cells, increased bleeding and decreased level of blood clotting (difficulty stopping bleeding).
Strong increase in appetite, profuse sweating.
Quincke's edema, severe itching, allergic redness of the skin, Lyell's syndrome, Stevens-Johnson syndrome, narrowing of the airways, obstruction of the bronchi, anaphylactic shock, immunopathological vascular inflammation, allergic-based pneumonia.
Pigmentation disorders, neuropsychic weakness, persistent fever, increased sensitivity of the body, development of additional infections based on what is already present.

Levofloxacin tablets are included in Russian and foreign clinical guidelines, such as the Infectious Diseases Society of the USA, the Russian Society of Pulmonologists, the Alliance of Clinical Chemotherapists and Microbiologists and others.

INSTRUCTIONS FOR USE OF THE MEDICINE FOR MEDICAL USE Registration number: LSR-005589/10 Trade name of the drug: Ecolevid® International nonproprietary name: levofloxacin Dosage form: film-coated tablets. Composition One tablet contains:

Active substance:
levofloxacin hemihydrate (in terms of levofloxacin)	250.0 mg	500.0 mg
Excipients:
Lactulose	300.0 mg	600.0 mg
Crospovidone	32.5 mg	65.0 mg
Povidone - K17	10.0 mg	20.0 mg
Sodium stearyl fumarate	9.75 mg	19.5 mg
Talc	6.5 mg	13.0 mg
Microcrystalline cellulose to obtain a tablet weight	650.0 mg	1300.0 mg
Shell excipients	until you get a tablet weighing
Shell excipients	670.0 mg	1340.0 mg
Hypromellose	9.52 mg	19.04 mg
Titanium dioxide	5.22 mg	10.44 mg
Macrogol-4000	4.16 mg	8.32 mg
Talc	1.10 mg	2.20 mg

Description. Film-coated tablets, white or almost white, capsule-shaped, biconvex in shape. On a cross section, two layers are visible, the inner layer is from light yellow to yellow, white inclusions are allowed. Pharmacotherapeutic group. Antimicrobial agent, fluoroquinolone. ATX code. J01MA12 Pharmacological properties. Pharmacodynamics. Levofloxacin is a synthetic broad-spectrum antibacterial drug from the group of fluoroquinolones, containing the levorotatory isomer of ofloxacin as an active substance. Levofloxacin blocks DNA gyrase, disrupts supercoiling and cross-linking of DNA breaks, inhibits DNA synthesis, and causes profound morphological changes in the cytoplasm, cell wall and membranes of bacteria. Levofloxacin has a bactericidal effect and is active against a large number of pathogens of bacterial infections both in vitro and in vivo. Aerobic gram-positive microorganisms: Corynebacterium diphtheriae, Enterococcus spp. (including Enterococcus faecalis), Listeria monocytogenes, Staphylococcus spp. (including Staphylococcus coagulase-negative (sensitive to methicillin and moderately sensitive to methicillin), Staphylococcus aureus (sensitive to methicillin), Staphylococcus epidermidis (sensitive to methicillin)), Streptococci groups C and G, Streptococcus agalactiae, Streptococcus pneumoniae (sensitive and resistant to penicillin), Streptococcus pyogenes, Streptococcus viridans (sensitive and resistant to penicillin), Aerobic gram-negative microorganisms: Acinetobacter spp. (including Acinetobacter baumannii, Actinobacillus actinomycetemcomitans), Citrobacter freundii, Eikenella corrodens, Enterobacter spp. (including Enterobacter aerogenes, Enterobacter agglomerans, Enterobacter cloacae), Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae (sensitive and resistant to ampicillin), Haemophilus parainfluenzae, Helicobacter pylori, Klebsiella spp. (including Klebsiella oxytoca, Klebsiella pneumoniae), Moraxella catarrhalis, Morganella morganii, Neisseria gonorrhoeae (penicillinase-producing and non-penicillinase-producing), Neisseria meningitidis, Pasteurella spp. (including Pasteurella canis, Pasteurella dagmatis, Pasteurella multocida), Proteus mirabilis, Proteus vulgaris, Providencia spp. (including Providencia rettgeri, Providencia stuartii), Pseudomonas spp. (including Pseudomonas aeruginosa), Salmonella spp., Serratia spp. (including Serratia marcescens). Anaerobic microorganisms: Bacteroides fragilis, Bifidobacterium spp., Clostridium perfringens, Fusobacterium spp., Peptostreptococcus spp., Propionibacterum spp., Veilonella spp. Other microorganisms: Bartonella spp., Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella spp. (including Legionella pneumophila), Mycobacterium spp. (including Mycobacterium leprae, Micobacterium tuberculosis), Mycoplasma hominis, Mycoplasma pneumoniae, Rickettsia spp., Ureaplasma urealyticum. Pharmacokinetics. After oral administration, levofloxacin is rapidly and almost completely absorbed from the small intestine. Food intake has little effect on the speed and completeness of absorption. The bioavailability of 500 mg levofloxacin after oral administration is almost 100%. After taking a single dose of 500 mg, the maximum concentration of levofloxacin is 5.2-6.9 mcg/ml, the time to reach the maximum concentration is 1.3 hours, the half-life is 6-8 hours. Communication with plasma proteins is 30-40%. Penetrates well into organs and tissues: lungs, bronchial mucosa, genitourinary system organs, bone tissue, cerebrospinal fluid, prostate gland, polymorphonuclear leukocytes and alveolar macrophages. In the liver, a small portion is oxidized and/or deacetylated. It is excreted from the body primarily by the kidneys by glomerular filtration and tubular secretion. After oral administration, approximately 87% of the dose is excreted unchanged by the kidneys within 48 hours, less than 4% is excreted unchanged within 72 hours by the intestines. Indications for use. Infectious and inflammatory diseases caused by microorganisms sensitive to the drug: - lower respiratory tract (exacerbation of chronic bronchitis, community-acquired pneumonia); — ENT organs (including acute sinusitis); - urinary tract and kidneys (including acute pyelonephritis); - skin and soft tissues (abscesses, furunculosis); — chronic bacterial prostatitis; - intra-abdominal infections; — drug-resistant forms of tuberculosis — as part of complex therapy. Contraindications. Hypersensitivity to levofloxacin, other fluoroquinolones or components of the drug, epilepsy, tendon damage during previous treatment with quinolones, pregnancy, lactation, childhood and adolescence (up to 18 years). Lactose intolerance or lactase deficiency, as well as glucose-galactose malabsorption. With caution: elderly people with glucose-6-phosphate dehydrogenase deficiency. Method of administration and dose. Orally, before meals or between meals, without chewing, with a sufficient amount of liquid. Acute sinusitis: 500 mg 1 time per day for 10-14 days; Community-acquired pneumonia: 500 mg 1-2 times a day, 7-14 days; Exacerbation of chronic bronchitis: 250-500 mg 1 time per day for 7-10 days; Uncomplicated urinary tract infections - 250 mg once a day for 3 days; Complicated urinary tract infections (including pyelonephritis): 250 mg 1 time per day (in case of severe disease, the dose should be increased) for 7-10 days; Chronic bacterial prostatitis - 500 mg once a day, course of treatment - 28 days; Infections of the skin and soft tissues: 250-500 mg 1-2 times a day for 7-14 days; Intra-abdominal infection - 500 mg once a day, course of treatment for 7-14 days (in combination with antibacterial drugs acting on anaerobic microflora); Complex therapy of drug-resistant forms of tuberculosis: 500 mg 1-2 times a day, course of treatment - up to 3 months; The duration of treatment depends on the type and severity of the disease. After relief of symptoms of acute inflammation and normalization of temperature, it is recommended to continue therapy with levofloxacin for 48-72 hours. Dosing of the drug in patients with impaired renal function (creatinine clearance less than 50 ml/min)

Creatinine clearance, ml/min	Dosage regimen
Creatinine clearance, ml/min	Initial dose 250 mg/24 h	Initial dose 500 mg/24 h	Initial dose 500 mg/12 h
50-20	Next 125 mg/24 h	Next 250 mg/24 h	Next 250 mg/12 h
19-10	Next 125 mg/48 h	Next 125 mg/24 h	Next 125 mg/12 h
Less than 10 (including with hemodialysis and continuous outpatient peritoneal dialysis)	Next 125 mg/48 h	Next 125 mg/24 h	Next 125 mg/24 h

After hemodialysis or continuous ambulatory peritoneal dialysis, no additional doses are required.
No dose adjustment is required in patients with impaired liver function. Side effect. From the digestive system: nausea, vomiting, diarrhea (including blood), indigestion, loss of appetite, abdominal pain, pseudomembranous colitis; increased activity of “liver” transaminases, hyperbilirubinemia, hepatitis, dysbacteriosis. From the cardiovascular system: decreased blood pressure, vascular collapse, tachycardia, prolongation of the QT interval, atrial fibrillation. From the nervous system: headache, dizziness, weakness, drowsiness, insomnia, tremor, anxiety, paresthesia, fear, hallucinations, confusion, depression, movement disorders, convulsions. From the senses: disturbances of vision, hearing, smell, taste and tactile sensitivity. From the musculoskeletal system: arthralgia, muscle weakness, myalgia, tendon rupture, tendonitis, rhabdomyolysis. From the urinary system: hypercreatininemia, interstitial nephritis, acute renal failure. From the hematopoietic organs: eosinophilia, hemolytic anemia, leukopenia, neutropenia, agranulocytosis, thrombocytopenia, pancytopenia, hemorrhages. Metabolism: hypoglycemia (increased appetite, increased sweating, trembling). Allergic reactions: itching and redness of the skin, swelling of the skin and mucous membranes, urticaria, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), bronchospasm, suffocation, anaphylactic shock, allergic pneumonitis, vasculitis. Other: asthenia, exacerbation of porphyria, photosensitivity, persistent fever, development of superinfection. Overdose. Symptoms of an overdose of levofloxacin appear at the level of the central nervous system (confusion, dizziness, impaired consciousness and convulsions). In addition, gastrointestinal disorders (for example, nausea, vomiting) and erosive lesions of the mucous membranes of the gastrointestinal tract may occur. Studies conducted using ultra-high doses of levofloxacin have shown prolongation of the QT interval. Levofloxacin is not eliminated by hemodialysis or peritoneal dialysis. There is no specific antidote (counteracting substance). Treatment is gastric lavage and symptomatic therapy. Interactions with other drugs. There are reports of a marked decrease in the seizure threshold with the simultaneous use of quinolones and substances that reduce the cerebral seizure threshold. This also applies to the simultaneous use of quinolones and theophylline, as well as non-steroidal anti-inflammatory drugs - propionic acid derivatives. The effect of the drug is weakened when used simultaneously with sucralfate, antacids containing magnesium or aluminum, and iron salts. Levofloxacin should be taken at least 2 hours before these medications. When using vitamin K antagonists simultaneously, monitoring of the blood coagulation system is necessary. The renal clearance of levofloxacin is slightly slowed down by cimetidine and probenecid. Levofloxacin slightly increases the half-life of cyclosporine. Taking glucocorticosteroids increases the risk of tendon rupture. Special instructions. When treating elderly patients, it should be borne in mind that they often suffer from impaired renal function (see section “Dosage and Administration”). Despite the fact that photosensitivity during treatment with levofloxacin is quite rare, patients are not recommended to be exposed to strong solar or artificial ultraviolet irradiation. If pseudomembranous colitis is suspected, levofloxacin should be discontinued immediately and appropriate treatment should be initiated. In such cases, drugs that inhibit intestinal motility should not be used. Patients with glucose-6-phosphate dehydrogenase deficiency (an inherited metabolic disorder) may respond to fluoroquinolones by destroying red blood cells (hemolysis). In this regard, treatment with levofloxacin should be carried out with caution. Side effects of levofloxacin, such as dizziness or drowsiness, as well as visual disturbances (see section “Side effects”), can impair reactivity and make it difficult to drive a car, maintain machines and mechanisms. Release form. Film-coated tablets 250 mg and 500 mg. 5, 7 or 10 tablets in a blister pack made of polyvinyl chloride film and printed varnished aluminum foil. 10 tablets in a plastic bottle with a screw cap or a polymer jar with a screw cap. 1 or 2 blister packs or 1 bottle or 1 jar along with instructions for use are placed in a cardboard pack. Storage conditions: Store in a place protected from moisture and light at a temperature not exceeding 25 °C. Keep out of the reach of children. Shelf life: 2 years. Do not use after expiration date. Conditions for dispensing from pharmacies. On prescription. Owner of the registration certificate. LLC "AVVA RUS" Russia, 121614 Moscow, st. Krylatskie Hills, 30, building 9. Tel.. Manufacturer/organization receiving claims: LLC "AVVA RUS" Russia, 610044 Kirov, st. Luganskaya, 53A. Tel.,. www.avva-rus.ru www.ecoantibiotic.ru Consumer complaints should be directed to the manufacturer. ABVA RUS company cares about the safety of its drugs and the health of consumers. Following the ethical principles and requirements of the legislation of the Russian Federation, ABVA RUS JSC collects and analyzes information about side effects.

REPORT SIDE EFFECTS

Analogs

Levofloxacin can be replaced by other medications based on the same active compound for eye diseases in children. Among them, the drugs L-Optic Rompharm, Oftaquix and Signicef are produced in the form of eye drops

All of them can be used from 1 year of age, but are prescribed to children with caution

Instead of Levofloxacin, the pediatrician or ophthalmologist may also prescribe another antibacterial agent for the child, for example:

. Prescribed from the age of 3, it can also be instilled into the nose or ear.
. Allowed from birth.
Zimar. Prescribed from 1 year.
Oftadek. Can be used at any age.
. Used in children over one year of age.
. Used from birth.

A detailed overview of the drug Levofloxacin can be seen in the following video.

Interaction

The effectiveness of the drug is significantly reduced when combined with Sucralfate, as well as with antacid drugs that contain aluminum, magnesium and iron salts. Thus, there should be an interval of at least two hours between doses of these drugs.

And if simultaneous use with vitamin K antagonists is necessary, the blood coagulation system should be monitored.

Cimetidine and Probenicid slow down the elimination of the active substance Levofloxacin to some extent. So it is advisable to carry out therapy with this combination of drugs with caution.

To a small extent, the drug also increases the half-life of Cyclosporine. And the combination with glucocorticosteroids increases the likelihood of tendon rupture.

When interacting with NSAIDs and Theophylline, convulsive readiness increases.

Levofloxacin for infusion is combined with the following solutions for internal administration:

Ringer's solution with dextrose (concentration 2.5%);
dextrose solution (concentration 2.5%);
saline;
solutions for parenteral nutrition.

Do not mix the medicine with heparin or sodium bicarbonate solution.

Clinically significant drug interactions between eye drops and other drugs are unlikely.

Levofloxacin instructions for use intravenously

Intravenous injections are given for 2-3 days, once a day at a dosage of 500 mg for systemic infections:

lower and upper respiratory tract;
genitourinary organs;
kidney;
skin and soft tissues.

Also included in intravenous use is a solution of Levofloxacin, which is slowly instilled (approximately 50-60 minutes) through an infusion needle, not on an empty stomach. The duration of treatment should not exceed two weeks. Dosages for people with normal kidney function are as follows:

for pneumonia - 500 mg 1-2 times a day;
for prostatitis - 500 mg once a day;
for acute pyelonephritis - 500 mg once a day;
for biliary tract infections - 500 mg once a day.

Indications for use

Detailed instructions for use of Levofloxacin describe diseases for which such a pharmaceutical prescription is appropriate. Medical indications for all forms of release of the specified medication:

tablets: sinusitis, inflammation of the paranasal sinuses, pneumonia, otitis media, bronchitis, urethritis, pyelonephritis, cystitis, uncomplicated bacterial prostatitis, furunculosis, pyoderma, abscess, pneumonitis, urogenital infections in adults, atheroma;
solution for infusion: anthrax, sepsis, chronic bronchitis, tuberculosis, biliary tract infections, impetigo, pyoderma, complicated pneumonia with blood poisoning, complicated prostatitis, panniculitis;
drops: superficial eye infections of bacterial origin.

special instructions

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do not allow drops to enter the anterior chamber of the organ of vision;
before applying the medicine, it is necessary to free the eyes from contact correction devices;
due to instillation of the product, short-term blurred vision is possible, which must be taken into account when operating potentially dangerous mechanisms;
in case of allergic manifestations, it is recommended to stop treatment with the drug and seek medical help;
during the therapy period, it is advisable to refuse to wear a contact device for vision correction;
a long course can provoke fungal eye damage;
during treatment, it is advisable to limit alcohol consumption to prevent the development of systemic side effects;
It is prohibited to administer the medication subconjunctivally.

Reactions to the drug

It is known that Levofloxacin can provoke a hypersensitivity reaction, potentially life-threatening to the patient. If there are hints of such an allergic response, it is necessary to stop treatment and see a doctor as quickly as possible.

From medical practice, there are several cases of bullous reactions, skin necrolysis, and Steven-Johnson syndrome that developed during the use of Levofloxacin. For any skin manifestations of intolerance, sensitivity to the drug, or for disturbing conditions of the mucous membrane, do not use the medication; seek help from a doctor.

In an extremely small percentage of cases, patients experience a photosensitivity reaction when taking Levofloxacin. To minimize the risk of such a phenomenon, during therapy, for two more days after its completion, it is recommended to avoid strong ultraviolet irradiation, that is, not to spend time in sunlight or visit solariums.

The use of the drug is associated with the likelihood of developing superinfection. To a greater extent, this is characteristic of long courses of treatment, when colonies of life forms that are not sensitive to levofloxacin begin to actively multiply in the body. A change in the composition of the human microflora and the appearance of superinfection are possible. During long-term treatment, it is recommended to regularly conduct studies to determine the level of susceptibility to levofloxacin by pathological microorganisms. If a superinfection is identified, the doctor adjusts the therapeutic program taking into account its characteristics.

Interaction with other drugs

It is not recommended to prescribe drugs from the fluoroquinolone group with theophylline and other drugs that increase the risk of developing seizures. This combination can lead to the development of epileptiform seizures.

Simultaneous use with the drug Sucralfate reduces the therapeutic effect of Levofloxacin to a significant extent. A similar effect is observed when consuming iron salts, magnesium- and aluminum-containing antacid drugs. To avoid unwanted consequences, these medications should be taken several hours apart.

When treating with Levofloxacin in parallel with vitamin K antagonists, it is necessary to monitor blood clotting. Prescribing glucocorticosteroid hormones along with an antibiotic can provoke tendon rupture.

The excretion of Levofloxacin through the kidneys may be slowed down when taking Probenecid or Cimetidine simultaneously.

For people with healthy kidneys, the compatibility of these drugs is not clinically significant, but for patients with renal failure, this combination should be used with extreme caution. In turn, Levofloxacin slows down the elimination of Cyclosporine from the blood plasma

It is unacceptable to drink alcohol during treatment with Levofloxacin in any form. The antibiotic enhances the toxic effect of ethyl alcohol on the central and peripheral nervous system, so intoxication can be much more severe and be accompanied by confusion, dizziness, vomiting, and inability to concentrate.

Drug overdose

In case of an overdose of the drug, undesirable reactions from the nervous system are most likely: seizures, dizziness, confusion, etc. In addition, gastrointestinal disorders, prolongation of the QT interval, and erosive lesions of the mucous membranes may occur.

Therapy is symptomatic. Dialysis is not effective, and there is no specific antidote.

An overdose of Levofloxacin in the form of eye drops is unlikely. Possible tissue irritation: burning, swelling, lacrimation, redness, pain in the eyes. If these symptoms appear, the eyes should be rinsed with clean water at room temperature. And if the adverse reactions are severe, you need to consult a specialist.

This situation is possible and is manifested by the following symptoms:

confused consciousness;
dizziness;
loss of consciousness;
convulsions;
nausea;
erosions of mucous membranes;
changes on the cardiogram.

Therapy for this condition must be carried out according to the existing symptoms. They are eliminated by using medications that act in this direction. Any dialysis option to speed up the removal of the drug from the body is ineffective.

Analogs

Antibacterial drugs similar to Levofloxacin can be used in case of intolerance to the drug or its ineffectiveness. Analogues of this medicine can be seen in the table below.

Table No. 1. Analogues of the drug.

Name	Description
"Betaziprol"	Broad-spectrum antibiotic drops containing fluoroquinolone. They affect bacteria at the DNA level. After the course of treatment, the infection is eliminated and its further development in the eye tissues for several months becomes impossible due to the bactericidal effect of the product.
"Vigamox"	A fluoroquinolone-based product that makes it impossible for harmful microorganisms to reproduce, since under the influence of this component the bonds in the DNA and RNA of bacteria are disrupted. The drug has a low risk of developing resistance to it from the main pathogenic bacteria and their strains.
"Vitabakt"	An antimicrobial drug that includes the active antibacterial substance picloxidine. The medicine is active against Klebsiella, staphylococci, streptococci, as well as some types of fungi. It is possible to use drops as a regenerative and prophylactic agent after ophthalmological operations.
"Dancil"	A drug that affects gram-positive and gram-negative microorganisms. It is an effective broad-spectrum remedy and is used as a local remedy in ophthalmology and ENT practice.
"Normax"	A solution containing the antimicrobial substance norfloxacin. This component destroys aerobic, gram-negative and gram-positive bacteria (the drug does not show activity against anaerobic pathogens).
"Okacin"	Another type of drops based on fluoroquinolones. Destroys pathogenic bacteria at the DNA level, preventing their further spread in the eye tissues. The product is one of the lowest toxic and is characterized by a small number of contraindications and side effects.
"Okomistin"	Antiseptic drops that are effective not only against standard types of ophthalmic pathogens, but also against most of their strains. Recommended for use in cases where less powerful antibiotics do not have the desired therapeutic effect.

There are many analogues of Levofloxacin

In addition to them, there are several more analogues:

"Tobradex";
"Maxitrol";
"Garazon";
"Tsipromed".

"Tsipromed"

"Avelox"

Avelox, which is synthetic in nature, is also often used as a substitute. The active ingredient is moxifloxacin hydrochloride. The mechanism of action is similar to the original: the synthesis of microbial cells is disrupted, which makes their reproduction impossible.

Cases of resistance to the drug are practically not observed. Even when showing resistance to other antibacterial agents, microbes remain sensitive to the effects of moxifloxacin.

Side effects

Undesirable side reactions when taking this drug are quite numerous. They can develop from various organs and systems.

The most commonly reported symptoms are diarrhea, increased liver enzyme activity, and nausea caused by the drug.

In addition, itching, loss of appetite, vomiting, headache, stupor, insomnia, decreased white blood cell count, redness of the skin, digestive problems, abdominal pain, dizziness, drowsiness, increased eosinophils in the blood, and a general feeling of weakness are possible.

In rare cases, anaphylactic reactions, severe bronchospasm, exacerbation of porphyrias, body tremors, hallucinations, excessive agitation, confusion, decreased blood pressure, muscle pain, increased levels of bilirubin and creatinine in the blood, decreased platelet counts in the blood, urticaria, and spotting have been reported with diarrhea, increased anxiety, paresthesia on the hands, depression, convulsions, palpitations, tendinitis, joint pain, a decrease in the number of neutrophils in the blood, increased bleeding.

In extremely rare cases, swelling of the face and throat, blisters on the skin, and shock are likely to occur. Possible disturbances in vision, taste and kidney function, a decrease in the ability to distinguish smells and tactile sensitivity, tendon rupture, a decrease in the number of all blood cells, the formation of persistent infections, a sharp decrease in pressure, as well as the level of glucose and the number of basophils in the blood. In addition, hypersensitivity to the effects of sunlight and ultraviolet radiation, pneumonitis, exudative erythema multiforme, vascular collapse, muscle weakness, hemolytic anemia, fever, vasculitis, Lyell's syndrome, rhabdomyolysis, interstitial nephritis may develop.

In addition to the listed adverse reactions, Levofloxacin, as an antibiotic, can cause dysbacteriosis and also lead to increased proliferation of fungi. Therefore, when using it, it is also advisable to take antifungal medications and agents that contain bacteria to normalize the intestinal microflora.

Levofloxacin eye drops may cause the following unwanted side effects:

formation of mucous strands in the eyes;
burning in the eyes;
conjunctival chemosis;
swelling of the eyelid;
itching in the eye;
redness of the conjunctiva;
erythema on the eyelids;
contact dermatitis;
headache ;
allergies;
decreased visual acuity;
blepharitis;
proliferation of papillae on the conjunctiva;
eye irritation;
photophobia;
rhinitis

Metabolism and Elimination

About 5% of Levofloxacin taken orally is metabolized. Transformation products are excreted by the kidneys. The active component of the drug belongs to stereochemically stable substances; chiral transformations are not characteristic of it.

Elimination of the main dose of the taken composition occurs through the kidneys. The half-life is seven hours, hourly deviations up or down are possible. After taking the medicine orally, 85% of the substance is eliminated in the first two days. Less than 4% of Levofloxacin leaves the body in the intestinal contents within 72 hours of administration. Clearance in general after a single dose of 500 mg is estimated at 175 ml/min with possible upward and downward deviations of 29.2 ml/min.

Experiments have shown that infusion into a vein and oral administration are similar in kinetics, there are no significant differences, which means that these two forms mutually replace each other.

Instructions for use and dosage

Dosages and frequency of instillations per day depend on the severity of the lesion and the patient’s condition. In the first two days, 1-2 drops are usually administered into the conjunctival sac of each eye. Further, the number of instillations is reduced to four times a day, the dosage remains unchanged.

The course of treatment is continued for at least seven days. If recovery does not occur during this time, you should choose another drug.

When administering drops, do not touch the tip of the bottle to your eyes or facial skin to avoid the spread of infection; you should also not share the drops with other patients; they are for individual use only

If another drug is also prescribed for local action at the same time, after using these ophthalmic drops, you should wait at least fifteen minutes before administering the next drug.

Overdose

For those who take Levofloxacin tablets, the instructions for use indicate that the medicine is intended for oral use 1-2 times a day. In this case, the tablets cannot be chewed; they must be washed down with water (about 1 glass).

For people with normal or moderately reduced renal function, the following dosage regimen is recommended:

exacerbation of chronic bronchitis - prescribe 250/500 mg once a day, therapy lasts 7-10 days;
sinusitis - 500 mg is prescribed once a day, therapy lasts 10-14 days;
uncomplicated urinary tract infection - 250 mg is prescribed once a day, therapy lasts 3 days;
community-acquired pneumonia - 500 mg is prescribed to take 1-2 times a day, therapy lasts 1-2 weeks;
complicated urinary tract infection - 250 mg is prescribed once a day, therapy lasts 7-10 days;
prostatitis - prescribed 500 mg once a day, therapy lasts 4 weeks;
infections of the skin and soft tissues - prescribed 250 mg to be taken once a day or 500 mg to be taken 1-2 times a day, therapy in both cases lasts 1-2 weeks;
intra-abdominal infection - 250/500 mg is prescribed once a day, therapy lasts 1-2 weeks (in combination with antibacterial agents that affect the anaerobic flora);
septicemia, bacteremia – 250/500 mg is prescribed once a day, therapy lasts 1-2 weeks.

The instructions for Levofloxacin in the form of a solution for internal administration indicate that the drug should be used 1-2 times a day. The medicine is administered by drip. If necessary, the solution can be replaced with tablets.

The course of application should not exceed 14 days. It is recommended to carry out therapy throughout the illness and for two more days after the temperature becomes normal. The usual dosage indicated by the instructions for Levofloxacin is 500 mg.

acute sinusitis - the medicine is taken once a day for 10-14 days;
pneumonia, sepsis - the medicine is taken 1-2 times a day for 7-14 days;
acute pyelonephritis - the medicine is taken once a day for 3-10 days;
skin infection - the medicine is taken 2 times a day for 7-14 days;
tuberculosis – the medicine is taken 1-2 times a day for 3 months;
exacerbation of chronic bronchitis - the medicine is taken once a day for 7-10 days;
prostatitis – the medicine is taken once a day for 14 days, then you need to switch to using tablets in a dosage of 500 mg according to the same regimen;
biliary tract infection - the medicine is taken once a day;
anthrax - the medicine is taken once a day. After the patient’s condition has stabilized, you need to switch to using the tablet form of the drug according to the same regimen for another 8 weeks;
abdominal infection - the medicine is taken once a day for 7-14 days.

For any disease, after the condition has normalized, you can switch to taking Levofloxacin in tablet form according to the same regimen until the end of the course.

Therapy with this drug should not be stopped in advance, nor should doses be intentionally skipped. If a tablet or infusion is missed, you should immediately take the correct dosage and then continue treatment as usual.

For people with severely impaired renal function with a creatinine clearance of 50 ml/min, their own dosage regimen is required. Depending on creatinine clearance (CC), the treatment regimen may be as follows:

CC 20 ml/min - 50 ml/min - at the beginning of therapy, take 250/500 mg, after which the patient should receive half of the initial dosage, i.e. 125/250 mg every day.
CC 10 ml/min – 19 ml/min – at the beginning of therapy, take 250/500 mg, after which the patient should receive half of the initial dosage, i.e. 125/250 mg every two days.

During therapy with this drug, it is advisable to avoid exposure to sunlight and not go to the solarium.

In rare cases, patients may develop tendinitis. At the slightest suspicion of tendon inflammation, you should stop taking the medication and begin treatment for tendinitis.

In addition, the drug can provoke hemolysis of erythrocytes in case of lack of glucose-6-phosphate dehydrogenase. So this category of patients should be given medicine with caution, monitoring the level of bilirubin and hemoglobin.

The drug has a negative effect on the speed of psychomotor reactions and the ability to concentrate, therefore, when using it, it is advisable to refuse work that requires careful concentration and quick reactions.

Eye drops are instilled into the conjunctival sac in a dosage of 1-2 drops in one or both eyes. This should be done every 2 hours (up to eight times during the day) during the first two days of treatment.

If it is necessary to additionally use other eye medications, a break of 15 minutes should be observed between instillations.

During instillations, you should try to avoid touching the tip of the dropper to the eyelids and tissues near the eyes.

Interaction with other drugs

After instillation, side effects may develop:

chemosis;
swelling of the eyelid;
excessive evaporation of moisture from the surface of the organs of vision;
blepharitis;
photophobia;
proliferation of ocular papillae;
short-term burning sensation in the visual area.

Since the medication penetrates into the blood, systemic side effects may develop:

hyperemia of the epidermis;
confusion;
sensation of scratching the dermis;
convulsive conditions;
insufficient liver function;
anaphylactic reaction;
vaginitis;
attacks of dizziness;
erythema;
increased emotional arousal;
decreased excretory function of the kidneys.

Levofloxacin is an antibacterial agent with properties similar to antibiotics. Synthetic antibiotics have natural analogues; fluoroquinolones were discovered experimentally. Fluoroquinolones include drugs such as Ofloxacin, Ciprofloxacin.

Eye drops with the active ingredient Levofloxacin are used to treat conjunctivitis caused by gram-positive bacteria, E. coli of various genesis (origin). The drug is used for superficial infection of the anterior part of the eye.

The bactericidal drug has good tissue penetration. It does not form compounds with blood elements and within a short time creates a high concentration at the cellular level. The mechanism of action of fluoroquinolone is to block the life of the bacterium, which leads to its death.

The high susceptibility of bacteria to third-generation fluoroquinolones allows the drugs to be used in minimal concentrations, which reduces the risk of side effects and allows them to be prescribed to children over one year of age.

Levofloxacin is prescribed when the action of other antibacterial agents is not effective due to the immunity of microorganisms to penicillins and aminoglycosides.

Reviews about the medication

Most reviews about the use of this drug are positive and due to the fact that the drug has an effective therapeutic effect. Most often, this drug is used in the treatment of diseases such as:

bronchitis;
sinusitis;
sinusitis;
gynecological infections;
prostatitis.

According to reviews, Levofloxacin relieves severe symptoms of diseases in a fairly short time and leads to a rapid recovery.

Among the negative reviews, there are mainly those caused by the onset of adverse reactions in the form of severe weakness, confusion, muscle and joint pain.

Such signs significantly worsen the quality of life of patients. The severity of side effects varies from minor to severe, when a person’s condition requires immediate hospitalization.

However, even in the event of severe side effects, patients noted that infectious diseases were cured. We reviewed reviews of Levofloxacin.

Shelf life and storage

Keeping the drug suitable for treatment requires compliance with the basic rules:

store in a place inaccessible to children;
the optimal temperature range is from 15 to 25 degrees;
after the production date, the drops are suitable for 3 years;
opening the package reduces this period to 4 weeks;
the medication must be stored with the lid tightly closed;
It is prohibited for the bottle of the product to come into contact with mucous membranes and contaminated surfaces, which is necessary to maintain sterility;
it is recommended to reduce the interaction of droplets and oxygen, since the drug loses its effectiveness when exposed to air;
It is prohibited to freeze the medication;
do not expose the packaging to direct sunlight;

Levofloxacin eliminates a wide range of pathological microorganisms. But during therapy, it is necessary to strictly adhere to the dosage and instillation schedule. Maintaining the sterility of the substance in the bottle prevents additional infection of the organs of vision by fungal microflora.

Special cases

If Pseudomonas aeruginosa is detected and the patient’s condition requires urgent hospitalization, Levofloxacin is used as an element of complex therapy.

Strains of microscopic pathological life forms can become resistant to the active component of the drug. Indicators of sustainability vary significantly in different areas, much depends on time. Before you start using it, you should find out how resistant the strains common in the area, region, or country are to the antimicrobial substance

In the absence of a pronounced effect when taking the composition against the background of a serious illness, it is important to make a timely microbiological diagnosis, identify the pathogen, and establish the degree of sensitivity to Levofloxacin.

From accumulated medical statistics it is known that the risk of methicillin-resistant Staphylococcus aureus being resistant to Levofloxacin is especially high. If you suspect infection with this particular microorganism, you should not use Levofloxacin until laboratory tests confirm the effectiveness of the medication in a particular case.

Quinolones in general, Levofloxacin in particular, can provoke a convulsive state in persons with a predisposition to this. The use of the drug requires caution if a person has previously suffered a traumatic brain injury or is forced to undergo therapy with drugs that lower the threshold of the brain’s readiness for convulsions.

Pharmacodynamics and pharmacokinetics

The medicine is an antibiotic. Belongs to the group of fluoroquinolones. The active component of the drug has bactericidal properties. This is due to inhibition of enzymes that are responsible for DNA replication in bacterial cells.

This drug is active against most pathogens of bacterial respiratory infections. Effective in the treatment of infections caused by penicillin-resistant strains of pneumococcus, Enterobacter spp., Escherichia coli, Klebsiella spp., Citobacter spp.

Levofloxacin appears to be effective for sinusitis and tuberculosis.

When taken on an empty stomach, its bioavailability is approximately 100%. If a dosage of 500 mg is taken with food, maximum plasma concentration is achieved an hour later.

The drug is distributed in interstitial fluid and plasma, and also accumulates to a large extent in tissues. Only 5% of the drug is broken down. The kidneys excrete up to 85%. Half-life is 6-7 hours. But the post-antibiotic effect lasts 2-3 times longer.

"Levostar"

For example, Levostar acts in the same way as the described drug: it blocks and suppresses DNA synthesis, causing irreversible morphological changes in pathogenic cells. It is effective against most strains of microorganisms.

Similar analogues include:

"Vitaletsin"
"Ivacin."
"Flexid".
"Floracid", etc.

These drugs successfully affect:

gram-positive enterococci, diphtheria bacillus, several types of staphylococcus, pneumococcus;
gram-negative Enterobacter spp., Escherichia coli, Proteus spp., Klebsiella, Neisseria, Shigella, Salmonella.

They are also active against tuberculosis pathogens and some anaerobic bacteria. Basically, drugs in this group are prescribed for nasal tract infections, bronchitis, pulmonary diseases, pathologies of the genitourinary system, etc.

Reviews about the price of Levofloxacin analogues are mostly positive.

Basic information pharmacological action

Levofloxacin is prescribed to treat infectious diseases and relieve inflammatory processes caused by pathogenic microorganisms.

Classification of fluoroquinolones

The active substance "Levofloxacin" is an antibiotic of the same name, capable of destroying various microorganisms at the cellular level (DNA level). These include:

streptococci;
meningococci;
chlamydia;
staphylococci.

In addition, the medicine is capable of destroying various strains of these microorganisms, which act as provocateurs for the development of ophthalmic pathologies. By disrupting structural connections and annihilating cell membranes, the drug allows for the destruction of pathogenic microflora, which, at the time of exposure to the drug, loses the ability to self-replicate.

The effectiveness of Levofloxacin is immediately visible

Only five percent of the total drug is broken down in the bloodstream. Everything else is eliminated seven hours after instillation into the eye. It is noteworthy that the active components of the substance do not accumulate in the tissues of the eye.

The main thing worth noting is the high effectiveness of the drops with a low number of side effects.

Fluoroquinolones

"Sparfloxacin"

A drug such as Sparfloxacin is a derivative of fluoroquinolones and belongs to the third generation, like Levofloxacin. The drug is slightly toxic and has a depressant effect on pathogens, including Pseudomonas spp. and staphylococci.

Treponema pallidum is resistant to the active substance; as a result, the medication is not used in the treatment of syphilis. The course of treatment can be up to 10 days.

Indications for use and contraindications are generally the same. However, Sparfloxacin is strictly contraindicated in case of heart and kidney failure. The undoubted advantage of this medicine is that pathogenic microorganisms take a long time to acquire resistance to the active components of the medicine.

In addition, there are analogues for eye drops. They are also represented by a wide range of medicines. This is described in the instructions. The price and reviews of Levofloxacin are of interest to many.

How to use

The patient instills Levofloxacin into the conjunctival sac. In the first two days, he drips one or two drops. He should do this every two hours. In subsequent days, you need to take it less often - four times a day. The course of taking the medicine lasts a week. When prescribing any drug together with Levofloxacin, the interval between taking the two drugs is fifteen minutes.

Burial rules

To prevent contamination of the drug, the patient should not allow the tip of the vial to touch any dirty surfaces.

You need to know how to take the medicine so that it gives the desired effect

The safety of using the drug in newborns who have conjunctivitis caused by gonococcus or a corneal defect (ulcerative type) has not been studied. Elderly people do not need to change the dosage and frequency of taking drops.

Levofloxacin tablets

Instructions explaining how to use the drug must be included by the manufacturer in the packaging of the medication. It is wise to familiarize yourself with it in advance in order to avoid a negative response from the body due to incorrect intake.

It is equally important to follow the recommendations of the doctor who prescribed the medication.

"Levofloxacin" was named after the main component that has a therapeutic effect - levofloxacin. The substance is contained inside a capsule, the coating of which is a thin film. The amount of the active component in one tablet must be indicated both on the outside of the package and in the instructions for Levofloxacin: 250 or 500 mg. In addition to this compound, the following were used in the manufacture of capsules:

polysorbate;
carmellose;
hypromellose;
cellulose;
calcium stearate;
talc;
titanium dioxide;
dyes.

The instructions for Levofloxacin contain a description of the tablets. All copies in the package must be identical, round, convex on both sides. If you cut them crosswise, you can see two layers: inside the tablet consists of a white (sometimes light yellowish) substance, on the outside there is a colored shell. The shade depends on the manufacturer. Pinkish and yellowish capsules are currently available on the market. In the instructions for Levofloxacin, the manufacturer indicates what shade the specimens should be.

Analogue drugs

Floracid

Medicines similar in effect to Levofloxacin are:

Oftadek;
Betaciprol;
Ciloxane;
Vigamox;
Moxifur;
Normax;
Vitabact;
Okomistin.

Only a doctor can select a similar drug, taking into account the individual characteristics of the patient and the level of progression of the disease.

Levofloxacin analog drugs, produced under a different name (generics): Oftavix, Signicef, L-Optic Rompharm, Levofloxacin-Solopharm.

Fluoroquinolone eye drops:

Ofloxacin (1st generation);
A good modern remedy for treating eyes in the shortest possible time
Phloxal (II generation);
Ciprofloxacin (II generation);
Tsipromed (II generation);
Vigamox (IV generation);
Drops for rapid action against bacteria
Moxifur (IV generation) / But in which case Nevanak eye drops are used, you can see here.
Okatsin (IV generation)

Eye medications containing antibiotics:

Tobradex;
Drops based on antibacterial action
Maxitrol;
Vitabact;
Decamethoxin.

When using Erythromycin ointment, follow the instructions! This also applies to other medicines.

The price of analogues depends on the country of origin and the antibacterial substance used.

On average, the price of analogues is about 400 rubles. The exception is eye ointments, the cost of which is less than 200 rubles.

Terms of sale and storage

The drug is available with a doctor's prescription. The shelf life of tablets and solution for infusion is 3 years from the date of issue. The date of manufacture and maximum storage time are usually indicated by the manufacturer on the medication packaging. It is strictly forbidden to use the drug after its expiration date has expired.

The medicine should be stored in a dry place protected from sunlight. The optimal storage temperature should not be higher than +25 degrees

It is very important that the drug is stored out of the reach of children. An open bottle of eye drops can be stored for no more than 30 days.

Regimen and dosage regimen

Levofloxacin is used externally, intravenously, orally. Therefore, each form of medication has its own characteristics of administration: different dosages, course duration, use for various diseases.

Pills

Levofloxacin is taken 1-2 times a day, depending on the severity of the disease.
The drug is taken orally 1-2 times a day, depending on the severity of the infection, the patient’s condition, and the nature of the disease.

Reception regimen:

Exacerbations of chronic bronchitis: once a day for 7-10 days, one pill (250 or 500 mg);
Sinusitis: one pill (500 mg) once a day for 10-14 days;
Infections of soft tissues and skin (abscesses, boils, pyoderma, etc.): one pill (500 mg) twice a day for 7-14 days;
Pneumonia: twice a day, one pill (500 mg) for 1-2 weeks;
Complicated urinary tract infections (urethritis, pyelonephritis, cystitis): one pill (500 mg) twice a day for three days;
Intra-abdominal infection: one pill (500 mg) once a day for 10-14 days;
Uncomplicated urinary tract infections: 7-10 days, one pill (250 mg);
Sepsis: one pill (500 mg) twice a day for 10-14 days;
Prostatitis: one pill (500 mg) once a day for a month.

Levofloxacin tablets are taken between meals with plenty of clean water.

Solution for infusion

The antibiotic Levofloxacin in ampoules is intended for administration into the patient’s vein. In this case, the duration of the medication should not exceed 60 minutes (the solution is administered slowly), and the number of procedures performed is 1-2 times a day.

Reception regimen:

Acute sinusitis – one bottle once a day for 10-14 days;
Prostatitis – one bottle once a day for two weeks;
Pneumonia - 1-2 times a day, one bottle for 1-2 weeks;
Biliary tract infections – one bottle once a day;
Sepsis – one bottle 1-2 times a day for 1-2 weeks;
Skin infections - twice a day, one bottle of solution for 1-2 weeks;
Acute pyelonephritis – one bottle once a day for 3-10 days;
Abdominal infection – one bottle once a day for 7-14 days;
Anthrax – one bottle of solution once a day until the patient’s condition stabilizes, after which a transfer to Levofloxacin tablets is carried out;
Exacerbation of chronic bronchitis - one bottle (500 mg) once a day for 7-10 days;
Tuberculosis - for three months, administer one bottle 1-2 times a day.

The duration of use of the solution in ampoules should not exceed 14 days. But Levofloxacin is used not only during the active period of the disease, but also for an additional 1-2 days after the condition has normalized.

For any of the listed diseases, after stabilizing the patient’s condition, you can switch to oral medication.

Eye drops

Levofloxacin drops are an effective remedy for the treatment of inflammatory eye diseases
. Levofloxacin eye drops are used to treat inflammatory processes of the outer membranes of the eyes. There is a general scheme for using drops for various ophthalmological diseases:

For the first two days, drip 1-2 drops every two hours (no more than 8 times a day in total).
On the third day, drops are given in the same dosage, but 4 times a day. The same scheme is maintained on the fourth and fifth days of treatment.

Therapy usually lasts for five days, but if necessary, the duration of the course can be increased.

Composition and release form

Levofloxacin is available in 3 dosage forms - tablets 250 and 500 mg, infusion solution 0.5%, drops 0.5% (for use in ophthalmology). Round yellow pills have a biconvex shape and a longitudinal notch. The tablets are packaged in cardboard packages of 5 or 10 pieces, and instructions for use are included. Transparent eye drops are poured into dropper bottles of 5 or 10 ml. The green-yellow infusion solution is available in 100 ml bottles. Features of the chemical composition:

Release form of the medicine	Active components	Excipients	Shell composition
tablets, 1 pc.	levofloxacin hemihydrate (250 or 500 mg)	hypromellose, calcium stearate, primellose, microcrystalline cellulose, polysorbate 80	titanium dioxide, yellow iron oxide dye, talc, hypromellose, macrogol 4000
drops, 1 ml	levofloxacin hemihydrate (5 mg)	benzalkonium chloride, sodium chloride, hydrochloric acid solution 1 M, disodium edetate dihydrate, water for injection	—
solution for infusion, 1 ml	levofloxacin hemihydrate (5 mg)	sodium chloride, water for injections	—

Use during pregnancy and breastfeeding

Use during pregnancy is possible only if the expected effect of therapy outweighs the potential risk to the fetus (adequate, strictly controlled studies of the safety of use in pregnant women have not been conducted).

Levofloxacin had no teratogenic effect in rats when administered orally at a dose of 810 mg/kg/day (9.4 times the MRDC in terms of body surface area) or intravenously administered at a dose of 160 mg/kg/day (1. 9 times higher than the MRFC in terms of body surface area). Oral administration to pregnant rats at a dose of 810 mg/kg/day led to an increase in the frequency of intrauterine death and a decrease in fetal body weight. In experiments on rabbits, no teratogenic effects were detected when administered orally at a dose of 50 mg/kg/day (1.1 times the MRDC, based on body surface area) or intravenously at a dose of 25 mg/kg/day, which corresponds to 0.5 MRCH in terms of body surface area.

Category of action on the fetus according to the FDA -

Levofloxacin has not been detected in breast milk, but data from studies with ofloxacin suggest that levofloxacin may pass into the breast milk of nursing women and cause serious adverse reactions in breast-fed infants. Breastfeeding women should stop either breastfeeding or taking levofloxacin (given the importance of the drug to the mother).

Reviews from doctors

Doctors of various specialties are satisfied with the clinical effects of the use of Levofloxacin in their practice. Urologists report good results with the use of this drug.

In the autumn-winter period, the number of patients suffering from cystitis increases, especially among females. I have been using the antibiotic Levofloxacin to treat this (and not only) disease for a long time. For a good result, a dose of 250 mg for 5 days is usually sufficient. After this period of time, in the vast majority of cases, clinical symptoms completely disappear, and patients feel much better.
Abramov S.A., general practitioner

The hospital where I work has Levofloxacin available. The drug is used in the treatment of pathologies of the urinary organs, in the presence of sensitivity of the pathogen to the drug. If this is confirmed, then the product shows high results within a minimum amount of time. An important fact is that this drug is affordable and well tolerated by patients.
Pashkov S.V., urologist

Characteristics of Ceftriaxone

This pharmaceutical product belongs to the category of cephalosporins. Its active ingredient is ceftriaxone. The medication is produced in powder format for the preparation of infusion and injection solutions.

The pharmaceutical product is prescribed to patients for the following problems:

pulmonary abscess, bronchitis, pneumonia and other bacterial pathologies of the respiratory system;
meningoencephalitis, meningitis;
cystitis, pyelonephritis and other infectious lesions of the urinary system;
pyoderma, furunculosis and other dermatological infections;
postpartum complications;
purulent form of otitis, sinusitis and other infectious pathologies of the ENT organs;
gonorrhea;
inflammation of the prostate gland;
infectious complications arising after surgical interventions and severe wounds.

The antibiotic drug is prohibited for use in the 1st trimester of pregnancy. During the rest of the period, its use is possible, but only by agreement and under the careful supervision of the attending physician.

Taking the antibiotic is prohibited in children whose weight is less than 4500 g. Contraindications also include individual intolerance to substances contained in the drug, severe kidney and liver diseases.

Ceftriaxone is prescribed to patients for the following problems: pulmonary abscess, bronchitis, pneumonia and other bacterial pathologies of the respiratory system.

Contraindications

Levofloxacin is a fairly strong antibiotic that has a number of contraindications and side effects. Restrictions on appointment are:

children under 18 years of age;
severe disorders of the renal system;
allergic reactions, intolerance to fluoroquinolones or other quinolones;
epileptic seizures;
inflammatory processes in the tendons.

The medicine is not used during pregnancy: penetrating the placenta, it has a depressing effect on the development of the fetus. During the lactation stage, it is not advisable to use an antibiotic, however, if it is necessary to take it, it is recommended to stop breastfeeding.

The antibiotic is not able to affect the liver, so it can be used by patients with liver pathologies.

Application

Any antibiotics, including Levofloxacin, should be used on the recommendation of a doctor. Before prescribing the drug, the specialist will conduct an examination and establish an accurate diagnosis. Only in this case can the dosage and course of administration be determined.

Method of use

Levofloxacin tablets are best taken between meals, without chewing and with a sufficient amount of water. The solution is administered by intravenous drip infusion. The daily dose can be divided into two times.

Which regimen to follow during treatment with the drug depends on the nature of the pathology and the properties of the pathogen. The dosage is determined by the doctor individually. For example, for bronchitis or sinusitis, take 1 tablet per day, and pneumonia requires double intensity. In elderly patients, dose adjustment is not required, but in case of impaired renal function it is reduced.

Treatment should continue for at least 3 days after the elimination of fever or until the bacterial agent is eliminated from the body. As a rule, the course of therapy with Levofloxacin ranges from 7 to 14 days. Injection of the antibiotic is practiced for several days, and then switched to tablet forms.

Side effects

During treatment with the drug, adverse reactions from various systems are possible. Their frequency varies, and they do not necessarily appear in a particular patient. Side effects of Levofloxacin mainly occur in patients with individual characteristics of response to the drug. These include the following (table):

We must not forget that Levofloxacin, like antibiotics of other groups, with long-term use can provoke inhibition of natural microflora and the addition of a secondary infection (for example, candidiasis). Fluoroquinolones can also aggravate the manifestations of porphyria in a patient.

Adverse reactions that occur while taking Levofloxacin are quite varied. Their frequency is very variable, and it is unknown which ones will occur in a particular case and whether they will appear at all.

Overdose

Exceeding the therapeutic dose specified in the instructions and recommendations of the doctor leads to a sharp development of adverse events. Among them it is worth noting:

Nausea and vomiting.
Dizziness.
Impaired consciousness.
Tremors and convulsions.

There is no specific antidote for Levofloxacin, so overdose is treated symptomatically: the stomach is washed, sorbents are given and other means. During dialysis, the antibiotic is not removed from the body.

Characteristics of Levofloxacin

This fluoroquinolone antibiotic has bactericidal activity. It is produced in tablet format with a dosage of 500 or 200 mg of the active ingredient.

The drug demonstrates high efficiency in the fight against most anaerobes, aerobes and intracellular pathogens. The instructions for its use indicate the following indications:

community-acquired pneumonia;
bacterial bronchitis;
inflammation of the prostate gland;
infectious lesions of soft tissues and dermis;
pelvic organ infections.

The medicine is not prescribed for hypersensitivity to fluoroquinolones or any elements of its composition. If you have insufficient kidney function or epileptic seizures, do not use the drug. Other contraindications are minor age, lactation and pregnancy.

Levofloxacin is not prescribed for hypersensitivity to fluoroquinolones or any elements of its composition.

Drug interactions

Is Levofloxacin an antibiotic or not? Levofloxacin is a synthetic antibacterial drug representing a large group of fluoroquinols. The main active ingredient of the antibiotic is the left-handed isomer of ofloxacin. The drug exhibits high activity against a variety of bacterial strains, including aerobic gram-positive and gram-negative and some anaerobic microorganisms.

The active substance penetrates deeply through the membrane protection of bacteria, destroys them at the DNA level, and prevents the ability to recover and reproduce. The antibiotic penetrates perfectly into all tissues or systems of the body, and the maximum concentration of the active substance is observed 2 hours after administration. Levofloxacin is not involved, does not affect metabolic processes, and is excreted from the body by the kidneys through formed urine.

• Violation of the functional activity of the digestive tract. The patient experiences heartburn, unpleasant taste, diarrhea, and flatulence. High likelihood of loss of appetite. • Pain syndrome. Localization - area around the navel, lower abdomen. The pain is accompanied by increased spasms (mainly during bowel movements and diarrhea).

• Neurological disorders. Headache, dizziness, apathy, drowsiness, feeling of weakness. The patient notes the presence of paresthesia - an imaginary sensation of goosebumps moving throughout the body. • Skin rashes, itching, irritation. Inflammatory elements take the form of papules, spots, pimples. • Dyspeptic disorders (nausea and vomiting) are caused by increased concentrations of liver enzymes.

• Dysbacteriosis (disturbance of intestinal microflora). • Formation of facial edema, inflammation of the nasal mucosa, abundant nasal secretion. Less commonly, polyps appear in the nasal cavity. • When using a solution in the form of drops, purulent accumulations appear in the inner corners of the eyes (those closer to the bridge of the nose). • Swelling of the eyelids, redness of the conjunctiva, itching of the eyes, a feeling of sand in them, photophobia.

When using the medicine in the form of a solution, there is a high probability of headache and the appearance of erythema on the eyelids (a specific dark spot of large size). When administering Levofloxacin drops, you need to regularly visit an ophthalmologist to check your visual acuity - the drug can reduce it. Especially with prolonged or uncontrolled use. The medicine negatively affects the condition of the conjunctiva if the patient uses drops more often than prescribed by the specialist.

Due to its effect on the DNA of pathogens, the drug deeply morphologically changes the cytoplasm, cell wall and membranes of the pathogen. Levofloxacin is active against corynebacteria, enterococci, listeria, staphylococci, streptococci, cyanobacteria, citrobacteria, Escherichia coli, Klebsiella, Moraxella, Morganella, pseudomonads, salmonella, clostridia, propionobacteria, mycoplasma.

The active component is quickly absorbed into the bloodstream, has almost 100% bioavailability, reaches maximum concentration after 1.5 hours, and has a seven-hour half-life. The active substance combines with plasma proteins by 35%, penetrates organs and tissues, and is metabolized in the liver.

The antimicrobial agent Levofloxacin belongs to the group of fluoroquinolones. This is a synthetic broad-spectrum antibacterial drug. Its active substance, levofloxacin, blocks DNA gyrase and disrupts DNA supercoiling.

The instructions for use talk about drug interactions between the drug and other medications. These are combinations and reactions:

Levofloxacin reduces the seizure threshold while taking quinolones and Theophylline.
The effect of the drug is weakened by sucralfate, magnesium- or aluminum-containing antacids, and iron salts. There should be 2 hours between taking these medications.
The simultaneous use of the drug with vitamin K antagonists is prescribed with caution; the blood coagulation system should be monitored.
Cimetidine and Probenecid slow down the elimination of levofloxacin.
The drug increases the half-life of cyclosporine.

When treated with Levofloxacin, side effects develop. Possible options, according to the instructions, are:

itching, redness of the skin, hypersensitivity, anaphylaxis, urticaria, edema, allergic pneumonitis, vasculitis, photosensitivity, blisters, furunculosis, erythema;
suffocation, narrowing of the bronchi, bronchospasm;
vascular collapse, increased heart rate, tachycardia, tremor;
nausea, abdominal pain, diarrhea, vomiting, loss of appetite, increased activity of liver enzymes;
trembling, nervousness, hypoglycemia, perspiration;
disturbances of tactile sensitivity, ophthalmology, confusion, numbness, sleep disturbances, hallucinations, irritation, drowsiness;
tendon damage, Achilles tendon rupture, rhabdomyolysis (muscle damage);
interstitial nephritis, acute renal failure;
pancytopenia, eosinophilia, hemolytic anemia, neutropenia, agranulocytosis, thrombocytosis;
general weakness, fever;
superinfection (growth of insensitive microflora), dysbacteriosis, reduced immunity.

How to treat tonsillitis using traditional medicine

Traditional medicine offers many ways to treat chronic tonsillitis. Priority directions:

Healthy lifestyle;
Strengthening immunity;
Impact on inflamed areas by rinsing.

A Tibetan recipe helps improve immunity: Take 100 g of immortelle, chamomile, St. John's wort and birch buds, brew them with boiling water (0.5 l) and leave for 3-4 hours in a thermos. Take this medicine in the evening half an hour before meals, adding a little honey.

The following recipe is also effective: 2 tbsp. Mix spoons of beet juice with 0.25 l. kefir, add 1 teaspoon of rosehip syrup and the juice of half a lemon.

It is recommended to drink healing tea daily, consisting of nettle, chamomile, and yarrow. To do this, take 1 tbsp. spoons of herbs and add 2 teaspoons of any tea. Use the decoction as tea leaves and drink, diluting it with boiling water.

Treatment of colds during lactation
Acetylsalicylic acid - instructions for use, features of drug treatment and dosage are described here.
How to quickly restore your voice during a cold //drlor.online/zabolevaniya/gortani-glotki-bronxov/laringit/kak-vosstanovit-golos-pri-prostude-osnovnye-priyomy.html

The following solutions can be used to gargle:

Lemon juice diluted in warm water;
Diluted fresh horseradish juice;
Burdock root decoction;
500 ml. weak solution of potassium permanganate + 7-8 drops of iodine;
Infusion of golden mustache;
An infusion of 3 cloves of garlic and 1 teaspoon of green tea.

Folk remedies for chronic tonsillitis help strengthen a sore throat. If they are used in combination with medications prescribed by a doctor, then you can get rid of this disease forever.

Other information

Some features of the use and effectiveness of the antibiotic Levofloxacin are also taken into account by doctors when prescribing it to a patient. The main points include:

the antibiotic may be ineffective in case of aggravated pneumonia;
ineffectiveness of active substances against hospital infections (for example, Pseudomonas aeruginosa);
the possibility of developing seizures in the presence of any brain diseases;
possibility of photosensitivity (intolerance to light, ultraviolet radiation);
the likelihood of pseudomembranous colitis;
alcoholic drinks during antibiotic therapy are prohibited and even dangerous;
pathologies of tendons and ligaments are possible.

Simultaneous use of antacids with high concentrations of aluminum and magnesium reduces the effectiveness of the antibiotic. The interval between them should be about 3 hours.

Anti-convulsants and Levofloxacin, on the contrary, increase the occurrence of seizures.
Concomitant use of non-steroidal anti-inflammatory drugs stimulates the central nervous system and provokes the development of seizures.
With regular use of Probenecid or Cimetedine, the renal clearance of Levofloxacin is significantly reduced.
A combined course with glucocorticosteroids promotes tendon rupture.
The antibiotic Levofloxacin increases the half-life of the active components of Cyclosporine from the body.

The antibiotic should be stored in a dark place away from children. Dispensed from pharmacy chains using a prescription form. Cannot be used after the expiration date.

This information about the antibiotic does not constitute real instructions for the use of the antibiotic and is for informational purposes only. Each antibiotic package includes these instructions for use with the necessary dosages and other information. The optimal dosage of the drug is distributed for each kg of the patient’s weight and is prescribed only by a doctor.

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From the instructions for use you can learn about special instructions for the drug. These are the following recommendations:

When treating elderly patients, it is necessary to take into account that they have an increased risk of developing renal dysfunction.
If the patient has a history of brain damage, there is a risk of developing a seizure attack.
During treatment it is not recommended to be exposed to sunlight.
During treatment, tendonitis may develop, which can cause tendon rupture. The risk increases in old age, while taking glucocorticosteroids.
If glucose-6-phosphate dehydrogenase is deficient, hemolysis (destruction of red blood cells) can occur.
During therapy, it is not advisable to drive vehicles or operate machinery.
Dry eyes may occur when using lenses.

Useful video

Dr. Komarovsky talks about what antibiotics should be taken for pneumonia.

Elena Malysheva in the program “Live Healthy!” about pneumonia.

Source www.immed.ru

The antibiotic drugs Levofloxacin and Ceftriaxone have similar principles of action, indications and contraindications. Despite this, they have several differences.

For infectious pneumonia, the doctor may prescribe Ceftriaxone and Levofloxacin for combination use.

Is it possible to take Levofloxacin and Ceftriaxone at the same time?

Depending on the disease and the type of pathogen, the doctor may prescribe antibiotics from different groups. Thus, for pneumonia, the combined use of Ceftriaxone and Levofloxacin is sometimes used. But only a doctor can select a course of treatment after examining the patient and obtaining the results of a bacteriological examination.

For pneumonia, Ceftriaxone is sometimes used in combination with Levofloxacin.

Restrictions

The use of the drug may be limited by certain factors. First of all, we are talking about concomitant conditions and characteristics of the body that the patient may have. Other drugs taken in parallel also play an important role in terms of safety. All this must be taken into account by the doctor prescribing the antibiotic.

Contraindications

In order to avoid undesirable consequences during treatment with Levofloxacin, you must remember its contraindications. As the instructions for use indicate, the drug has the following:

Individual hypersensitivity.
History of tendon damage from fluoroquinolones.
Myasthenia gravis and epilepsy.

The antibiotic is also contraindicated in children under 18 years of age, pregnant and nursing mothers. This is due to the fact that the drug is able to disrupt the development of cartilage at growth points that have not undergone complete ossification. In addition, adequate research has not been conducted on the safety of the drug during pregnancy. It should be remembered that Levofloxacin should be taken with extreme caution by persons with glucose-6-phosphate dehydrogenase deficiency, impaired renal function, a tendency to seizures, diabetes mellitus, or heart failure.

Interaction

The activity of the drug decreases with the simultaneous use of antacids (with magnesium and aluminum), iron supplements and mineral complexes. Therefore, it is recommended to maintain a time interval of at least 2 hours between taking them. Together with non-steroidal anti-inflammatory drugs, the risk of seizures increases. Taking Levofloxacin may increase the side effects of theophylline, and also requires monitoring of blood coagulation and glucose levels when using anticoagulants and hypoglycemic agents. During treatment with glucocorticoids, the likelihood of tendon damage increases dramatically.

When taking any medications together with an antibiotic, you must inform your doctor about this to avoid negative interactions.

Other instructions

Medicines classified as antibacterial drugs should be used after establishing the type of pathogen and its sensitivity to the drug. But Levofloxacin can be prescribed before receiving test results - empirically (after all, the test period is quite long - at least 5 days). But in the future, treatment should be adjusted taking into account microbiological indicators.

Levofloxacin is an antibiotic from the fluoroquinolone group. It has a wide spectrum of action, covering a wide range of pathogens. The main area of application of the drug is infectious and inflammatory pathology of the respiratory tract, but it is also successfully used for other diseases. The effectiveness and safety of antibiotic treatment directly depends on the quality of diagnosis and the patient’s compliance with the prescribed recommendations.

Description

Levofloxacin is prescribed for the treatment of bacterial inflammatory processes in adult patients. These include pneumonia, pyelonephritis, urinary tract pathologies, chronic prostatitis of bacterial origin, and soft tissue infections.

"Lefofloxacin" is a broad-spectrum antibacterial synthetic drug from the fluoroquinolone group, which contains levofloxacin as an active component. It helps block DNA gyrase, inhibits DNA synthesis, disrupts the cross-linking of breaks and DNA supercoiling, and causes strong morphological changes in the cytoplasm, membranes and cell wall.

This drug has several release forms, each of them optimized for the treatment of certain infections.

Tablets 500 and 250 milligrams. Depending on the dosage, they are called “Levofloxacin 250” or “Levofloxacin 500”.
Eye drops at a concentration of 0.5%.
Infusion solution 0.5%.

The drug is administered intravenously, orally and conjunctivally.

Eye drops are used for a small number of inflammatory diseases affecting the visual analyzer, while solution and tablets are used widely for infectious and inflammatory pathologies of various systems and organs. Levofloxacin analogues should be selected by a doctor.

Antibacterial therapy

An agent for suppressing infection in chronic tonsillitis must freely penetrate into the soft tissues and accumulate there in the quantity necessary to destroy microbes, stopping their growth. Today, only antibacterial drugs are capable of this.

Chronic tonsillitis does not require constant use of antibiotics. Moreover, in the absence of exacerbations, the antibacterial agent can even harm the body, as it promotes addiction to the drug.

The issue of using antibiotics should be resolved individually with the attending physician, who will assess the patient’s condition and determine the benefit or harm of the medicine in each specific case.

The infection must be treated at the moment when it has only caused inflammation and the body itself cannot cope with it. This means that antibacterial treatment is advisable to carry out during an exacerbation of chronic tonsillitis. The use of antibiotics during remission is not justified, since the drug will not completely eradicate the infection at the stage of its dormant state.

Which antibiotics for chronic tonsillitis should be chosen and used to treat the disease?

So, it is necessary to treat chronic tonsillitis with antibiotics at the stage of exacerbation of the disease. What drugs are suitable for this?

Treatment of disease with penicillins in adults

These drugs are considered first-line agents in the treatment of tonsillitis. They not only treat exacerbations of the disease, but are used to prevent complications such as rheumatism and glomerulonephritis caused by hemolytic streptococci.

Previously, mainly natural penicillins were used, but they are becoming a thing of the past due to the inconvenient dosing regimen. Today, semi-synthetic tablet drugs are more relevant, such as:

Amoxicillin;
Lemoxin;
Oxacillin;
Ampicillin;
Ticarcillin;
Carbenicillin.

But the recognized leaders today are inhibitor-protected penicillins, resistant to microbial enzymes due to the addition of clavulanic acid:

Flemoclav;
Panclave;
Amoxiclav;
Augmentin;
Ampiksid;
Sultamicillin;
Unazine;
Ampiox.

Macrolides and cephalosporins during exacerbation

Drugs of the macrolide group are classified as second-line. These include:

Clarithromycin;
Josamycin;
Azitral;
Sumamed;
Chemomycin.

This also includes cephalosporins of the second (Cefuroxime), third (Ceftriaxone, Cefoperazone, Ceftibuten, Cefixime, Cefazidime) and fourth (Cefepime) generations.

Macrolides and cephalosporins

Aminoglycosides and Fluoroquinolones

Drugs of these groups are used for tonsillitis, the causative agent of which is Staphylococcus aureus. In this case, third-generation aminoglycoside antibiotics with the least side effects on the kidneys, for example, Amikacin, are prescribed. Fluoroquinolone drugs can also be used, such as:

Ofloxacin (Zanocin, Glaufos, Quiroll);
Norfloxacin (Quinolox, Loxon, Negaflox,);
Lomefloxacin (Xenaquin, Lomacin);
Lefloxacin;
Ciprofloxacin (Ificipro, Quintor);
Moxifloxacin;
Sparfloxacin (Sparflo);
Levofloxacin;
Gatifloxacin.

Aminoglycosides and Fluoroquinolones

What pills can children take?

What antibiotics are most often prescribed to children for tonsillitis? These are mainly drugs from the penicillin, macrolide and cephalosporin series. Let's look at the most popular medications for children:

Oxacillin is a penicillin antibiotic that causes lysis of bacterial cells. The maximum concentration of the drug in the blood is observed 30 minutes after injection. The drug is taken every 4-6 hours in equal doses. Allergic reactions and other side effects are possible: skin itching, anaphylactic shock, nausea, diarrhea, oral candidiasis, yellowing of the sclera and skin, neutropenia. The drug is prescribed at a dose of 0.25 g-0.5 g 1 hour before meals. Newborns – 90-150 mg/day, up to 3 months – 200 mg/day, up to 2 years – 1 g/day, from 2 to 6 years – 2 g/day. The daily dose is divided into 4–6 doses. The duration of treatment with the drug is 7-10 days.
Phenoxymethylpenicillin is an antibacterial drug of the penicillin group. Children over 10 years of age and adults are prescribed a dosage of 3 million units. The dose is divided into 3 times. Children under 10 years of age are prescribed 0.5 - 1.5 million units. in 3 doses.
Erythromycin is an effective macrolide antibiotic directed against staphylococcal and streptococcal tonsillitis. Important: Erythromycin does not act on viruses and fungi, so it is important to clarify the pathogen. The drug is suitable for a child with an allergy to penicillins. A single dose for a child is 0.25 g. Taken 1 hour before meals 4 times a day. For children under 7 years of age, the dose is calculated based on the formula 20 mg/kg. Possible side effects: nausea, diarrhea, jaundice.
Tantum Verde is a non-steroidal anti-inflammatory drug. Has an analgesic effect. Available in the form of tablets, which are dissolved in the oral cavity, one piece three times a day, and a spray, which is injected 4 times (4 presses) every 2 hours.
Benzylpenicillin has a bactericidal effect on microorganisms. The drug is administered intramuscularly or intravenously for upper respiratory tract infections, 4-6 million units. per day for 4 administrations. A reaction in the form of urticaria and rash on the mucous membranes, bronchospasm, arrhythmia, hyperkalemia, vomiting, and convulsions is possible.

Acute tonsillitis must be treated correctly. If a doctor has prescribed an antibiotic that is considered particularly harmful, then it is necessary.

Vitamins and hardening play an important role in the prevention of acute and chronic tonsillitis.

Characteristics of Ceftriaxone

Ceftriaxone is an antibacterial drug belonging to the cephalosporin group. The active ingredient is ceftriaxone, which has a bactericidal effect. The drug is available in powder form, from which solutions for injections and infusions are prepared.

Ceftriaxone is prescribed for pathologies caused by microorganisms sensitive to the active substance:

pneumonia, bronchitis, lung abscess, pleurisy and other respiratory diseases of bacterial origin;
meningitis, meningoencephalitis;
pyelonephritis, cystitis and other infections of the urinary system;
boils, carbuncles, pyoderma and other infections of the skin and subcutaneous tissues;
diverticulitis, retroperitoneal abscess and other infections of the gastrointestinal tract;
complications developing after childbirth, including after cesarean section;
arthritis, osteomyelitis and other infections of the musculoskeletal system;
sinusitis, purulent otitis and other infections of the ENT organs;
gonorrhea, including complicated;
bacterial prostatitis;
peritonitis, inflammation of wound surfaces and other postoperative complications.

Antibiotics are not prescribed in the 1st trimester of pregnancy. At later stages, treatment is possible, but only as prescribed by a doctor.

The medicine is not prescribed to children if their body weight is less than 4.5 kg.

Contraindications include liver and kidney pathologies, allergies to antibiotics and intolerance to the components that make up Levofloxacin.

Indications and pharmacological action

The described drug belongs to synthetic antibacterial drugs. The active substance is called levofloxacin. The drug is active against the vast majority of pathogens that cause inflammation in various organs. As a result, the cause of inflammation is eliminated and a cure occurs.

Levofloxacin acts on any organ that develops inflammation caused by antibiotic-sensitive bacteria. That is, the drug will be equally effective against cystitis and bronchitis if the pathological conditions are caused by bacteria on which the medicine has a detrimental effect. This indicates instructions for use for Levofloxacin.

Reviews abound.

Gram-positive bacteria are sensitive to the drug: staphylococci, enterococci, streptococci, Enterococcus spp., Corynebacteriumdiphteriae, Viridansstreptococci, Listeria monocitogenes and some others. Among the gram-negative ones, the following can be distinguished: Acinetobacter spp., Gardnerellavaginalis, Citrobacterfreundi, Escherichiacoli, Enterobacter spp., Haemophilusinfluencae, Klebsiellaoxytoca, Proteusmirabilis, Proteusvulgaris, Helicobacterpylori, Moraxellacatarrhalis, Providenciarettgeri, Pseudomonasaeruginosa, Salmonella spp., and others . Anaerobic bacteria are Bifidobacterium spp., Propionobacterium spp., Veilonella spp., Bacteroidesfragilis, Clostridium perfringens, Peptostreptococcus and others.

Levofloxacin eye drops are prescribed for superficial bacterial infections that are caused by microorganisms susceptible to the active substance of the drug. For prevention, the drug is prescribed for eye surgery to patients whose age exceeds one year. Tablets and solution are prescribed in cases of sinusitis, bronchitis, pneumonia, urinary tract infections, and various types of sepsis.

The price and reviews of Levofloxacin are of interest to many. Let's look at them below.

Basic selection of drugs

Below, a list of first-choice drugs for the treatment of pneumonia will be published, depending on the physiological condition of the patient.

For patients with no chronic diseases and mild/moderate pneumonia.

The optimal combination of antibiotics is Avelox and Doxycycline.

Avelox . A drug belonging to the fourth generation of quinolones. The drug has extensive systemic action, directly affects DNA hydrases and destroys pathogenic agents. The toxic effect on the body is minimal. Effective against most aerobic and anaerobic bacteria, chlamydia, mycoplasma, atypical forms of Legonella and Cahiella, pneumococci, staphylococci. The bioavailability of Avelox is more than 90 percent. The course of treatment is ten days, the daily dose is about 400 mg (single dose). Contraindications – liver failure, age under 18 years, colitis, pregnancy, lactation, intolerance to moxifloxacin or its derivatives. Side effects: allergic manifestations, temporary decreased vision, impaired coordination, lability, hypotension, bronchospasm, increased liver enzymes, decreased glucose, sudden changes in blood element concentration levels.
Doxycycline . A drug belonging to the tetracycline group of antibiotics on a semi-synthetic basis. Effective against aerobic cocci and spore-forming bacteria, mycoplasma and chlamydia. Bioavailability is up to 95 percent with a elimination period of up to 24 hours. The course period is about two weeks. On the first day, 200 mg of the drug is taken, on subsequent days - 150 mg daily, once. Contraindications: pregnancy, lactation, children under nine years of age, porphyria, leukopenia, liver failure. Side effects - anemia, dysbacteriosis, discoloration of tooth enamel (long-term use), Quincke's edema, sweating, allergic rashes, diarrhea, vomiting with nausea.

Patients with moderate or severe chronic diseases

In this case, the optimal choice would be inpatient treatment. The antibiotics commonly used are Levofloxacin along with Ceftriaxone.

Levofloxacin . A fluoroquinolone drug with a broad spectrum of action. Blocks DNA gyrase in microbial cells. Effective against a wide range of gram-positive and gram-negative pathogens, including those resistant to penicillins. Bioavailability - 99 percent, elimination period from the body - about eight hours. The therapeutic course lasts 14 days. The daily dose is 500 mg twice a day, administered by intravenous drip. Contraindications: pregnancy, lactation, age under eighteen years, epilepsy, renal failure, glucose-phosphate dehydrogenase deficiency, tendon pathologies after a history. Side effects - digestive disorders, slow metabolism, immune allergic reactions, disruption of the normal functioning of the PNS, tendon damage, hypotension, and rarely - vascular collapse.
Ceftriaxone . A beta-lactam drug belonging to the third generation cephalosporin antibiotics. It has a powerful antimicrobial effect on a number of gram-positive and gram-negative bacteria, mycoplasma, anaerobes, aerobes, streptococci, etc. Bioavailability is 100 percent, half-life is about 9 hours. The course period is 10 days. Dose of the drug: 50 mg per kilogram of body weight, administration using the intravenous infusion method (2 g of the drug is dissolved in 40 ml of one percent sodium chloride). Contraindications: renal and liver failure, pregnancy, sensitivity to cephalosporins and penicillins, lactation period. Side effects: candidiasis, diarrhea, vomiting, nephritis, phlebitis, jaundice, Quincke's edema, nausea and colitis.

"Levofloxacin": analogues

The drug "Levofloxacin" has several effective and proven analogues.

"Tavanik" is an effective remedy that is prescribed for numerous pathologies. It is characterized by a high level of medicinal activity and influence on groups of pathogenic microorganisms; thanks to its use, it is possible to obtain good treatment results in the shortest possible time. The price of the Russian analogue of Levofloxacin is determined by the form of its release. The injection solution costs about 1,600 rubles, tablets can be purchased from 600 rubles.

Is it possible to find analogues of Levofloxacin eye drops?

Ciprofloxacin is one of the active antibiotics with broad effects. Used to treat infectious pathologies of internal tissues and organs, including the genitourinary system. The drug is available in various forms, including suspension, eye drops and injection solutions, capsules and tablets. The cost of this medicine is affordable - from 18 rubles, it can be purchased at any pharmacy.

In addition to the Russian-made drugs listed above, there are also foreign analogues of Levofloxacin for the active substance, which successfully cope with many infectious diseases:

"Glevo" is a drug that is produced in India and has a wide range of effects, perfect for the treatment of all types of prostatitis.
"Eleflox" - an analogue of "Levofloxacin", also produced by an Indian pharmaceutical company, is actively used to treat various types of prostatitis, suppresses the functioning of harmful microorganisms. Used in systemic therapy, which provides rapid relief from the disease.

A specialist will help you choose a particular drug. In some cases, cheaper products produce the necessary therapeutic effect, but before using them you should definitely consult a doctor. There are a large number of reviews about Levofloxacin and analogues.

Diagnoses and Levofloxacin

While taking the drug, there is a risk of prolonged loose stool containing blood. This may indicate colitis caused by one of the forms of clostridia. If such a complication of the patient's condition is suspected, the patient is transferred to treatment with antibiotics:

metronidazole;
teicoplanin;
vancomycin.

Do not use agents that can slow down gastrointestinal motility.

Tendonitis is possible with the use of Levofloxacin. This is rare, but can cause tendon rupture. As a rule, if a side effect develops, it occurs in the first two days from the moment you start taking it. Bilateral tendinitis is possible. To a greater extent, the risk of this condition is inherent in elderly patients, as well as those taking glucocorticosteroids.

If the symptoms suggest tendinitis, antibiotic therapy is stopped and a course of restoring the integrity of the tendon is begun, immobilizing the damaged area.