Levaquin Warnings & Precautions

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Levaquin - Warnings & Precautions [Levofloxacin]

Some quinolones, including levofloxacin, have been associated with prolongation of the QT interval on the electrocardiogram and infrequent cases of arrhythmia. During post-marketing surveillance, rare cases of torsades de pointes have been reported in patients taking levofloxacin. These reports generally involved patients with concurrent medical con-ditions or concomitant medications that may have been contributory.

The risk of arrhythmias may be reduced by avoiding concurrent use with other drugs that prolong the QT interval including class Ia or class III antiarrhythmic agents; in addition, use of levofloxacin in the presence of risk factors for torsades de pointes such as hypokalemia, significant bradycardia, and cardiomyopathy should be avoided. As with any potent antimicrobial drug, periodic assessment of organ system functions, including renal, hepatic, and hematopoietic, is advis-able during therapy. (See WARNINGS and ADVERSE REACTIONS.)

Information for Patients

Patients should be advised:

° to drink fluids liberally;

° that antacids containing magnesium, or aluminum, as well as sucral-fate, metal cations such as iron, and multivitamin preparations with zinc or Videx Ž (didanosine), chewable/ buffered tablets or the pediatric powder for oral solution should be taken at least two hours before or two hours after oral levofloxacin administration. (See Drug Interactions);

° that oral levofloxacin can be taken without regard to meals;

° that levofloxacin may cause neurologic adverse effects (e. g., dizziness, lightheadedness) and that patients should know how they react to levofloxacin before they operate an automobile or machinery or engage in other activities requiring mental alertness and coordination.
(See WARNINGS and ADVERSE REACTIONS);

° to discontinue treatment and inform their physician if they experience pain, inflammation, or rupture of a tendon, and to rest and refrain from exercise until the diagnosis of tendinitis or tendon rupture has been confidently excluded;