Levaquin Warnings & Precautions

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Levaquin - Warnings & Precautions [Levofloxacin]

Although levofloxacin is more soluble than other quinolones, adequate hydration of patients receiving levofloxacin should be maintained to prevent the formation of a highly concentrated urine. Administer levofloxacin with caution in the presence of renal insufficiency. Careful clinical observation and appropriate laboratory studies should be performed prior to and during therapy since elimination of levofloxacin may be reduced.

In patients with impaired renal function (creatinine clearance <50 mL/ min), adjustment of the dosage regimen is necessary to avoid the accumulation of levofloxacin due to decreased clearance. (See CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION.) Moderate to severe phototoxicity reactions have been observed in patients exposed to direct sunlight while receiving drugs in this class.

Excessive exposure to sunlight should be avoided. However, in clinical trials with levofloxacin, phototoxicity has been observed in less than 0.1% of patients. Therapy should be discontinued if phototoxicity (e. g., a skin eruption) occurs.

As with other quinolones, levofloxacin should be used with caution in any patient with a known or suspected CNS disorder that may predis-pose to seizures or lower the seizure threshold (e. g., severe cerebral arteriosclerosis, epilepsy) or in the presence of other risk factors that may predispose to seizures or lower the seizure threshold (e. g., certain drug therapy, renal dysfunction). (See WARNINGS and Drug Interactions.)

As with other quinolones, disturbances of blood glucose, including symp-tomatic hyper-and hypoglycemia, have been reported, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e. g., glyburide/ glibenclamide) or with insulin. In these patients, careful monitoring of blood glucose is recommended. If a hypoglycemic reaction occurs in a patient being treated with levofloxacin, levofloxacin should be discontinued immediately and appropriate therapy should be initiated immediately. (See Drug Interactions and ADVERSE REACTIONS.)