Levofloxacin Interactions: Drugs, Supplements & Medical Conditions

Levofloxacin is an antibiotic commonly used to treat bacterial infections. 

It belongs to a group of drugs called fluoroquinolone antibiotics.

Levofloxacin has the potential for interactions with other medications and may impact certain pre-existing medical conditions

Therefore, certain precautions should be followed when taking Levaquin.

Keep reading to learn about different levofloxacin interactions to be aware of.

Drugs and Medications That Interact with Levofloxacin

Here is a list of medications that may interact with Levofloxacin. These drugs might exacerbate the side effects of Levofloxacin or reduce its effectiveness.

1) NSAIDs (non-steroidal anti-inflammatory drugs)

NSAIDs are painkillers commonly used to relieve pain and inflammation. Some studies suggest that certain painkillers, when used with levofloxacin, may stimulate the nervous system, potentially increasing the risk of seizures.

You must inform your physician if you are using NSAIDs before you start Levaquin treatment.

Your doctor might recommend an alternative antibiotic or advise you to stop using or lower the dose of NSAIDs until the course of levofloxacin is over.

2) Antacids

Antacids are medications that help to lower the secretion of acids in the stomach and provide relief from gastritis or hyperacidity.

Certain antacids may interfere with the absorption of levofloxacin, possibly affecting its effectiveness.

You should especially avoid calcium-containing antacids as calcium tends to bind to levofloxacin and keep it from acting correctly. 

You can take doses of antacids two hours before or after taking levofloxacin in order to maintain its effectiveness. 

It is generally advisable to take a dose of antacids about half an hour before meals and levofloxacin about two hours after the meals to avoid the interactions.

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3) Supplements containing minerals

Supplements containing minerals, such as iron, zinc, aluminum, and magnesium, often interact with levofloxacin. 

These supplements can lower the availability of levofloxacin in the body, thus reducing its effectiveness. 

Taking levofloxacin about two hours before or after using these supplements can help you avoid these interactions.

4) Anti-diabetic drugs

Patients using oral antidiabetic drugs or insulin should be aware that levofloxacin may impact blood glucose levels.

Levofloxacin might give either a lower or higher blood sugar reading than normal.

Inform your doctor if you are using anti-diabetic drugs and monitor your blood sugar levels regularly while using levofloxacin.

Levofloxacin Condition Interactions

Patients suffering from certain medical conditions may develop exacerbations of the symptoms when they start using levofloxacin. This may occur due to the effect of levofloxacin on the affected organs.

Hence, you must inform your physician if you suffer from any medical condition before you start using this drug.

Here are some condition interactions associated with the use of levofloxacin.

1) Tendonitis

Tendonitis occurs due to the inflammation and swelling of the fibrous tissue, which connects the bones and muscles.

Studies show that taking Levofloxacin can increase the risk of developing tendonitis. It may also exacerbate the symptoms of pre-existing tendonitis.

If you have this condition, inform your physician. They might prescribe you an alternative antibiotic for managing your infection.

If you experience the symptoms of tendonitis, such as pain, tenderness, swelling, stiffness, and difficulty in moving a muscle, after you start using levofloxacin, inform your doctor immediately. 

2) Tendon rupture

The rupture of a tendon is a common complication associated with the use of levofloxacin. The rupture may occur in the tendons of the shoulders, hands, or the back of the ankles. 

Studies have found that this side effect can occur during the treatment or even up to several months after you stop using it.

Tendon rupture from Levofloxacin can occur in people of all ages. However, it is particularly common in patients above 60.

If you experience the symptoms of tendon rupture, such as feeling or hearing a pop or snap in a tendon area or inability to move and bear weight on an affected area, stop taking levofloxacin and seek emergency medical treatment.

3) Peripheral neuropathy

In some cases, levofloxacin may lead to nerve damage, causing changes in sensations. The damage may begin to occur soon after you start the treatment with levofloxacin.  

The change in sensations often persists for a long duration and may not go away even after you stop using this drug.

The risk of nerve damage is higher in patients who suffer from peripheral neuropathy, a neurological condition marked by symptoms such as tingling, numbness, and pain in the hands and legs.

Inform your doctor if you suffer from peripheral neuropathy or develop any signs of this condition before you start using levofloxacin.

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4) Epilepsy

Levofloxacin has the potential to impact the brain and nervous system, particularly in individuals with conditions like epilepsy.

The side effects of Levofloxacin may develop after the first dose of this medication.

Hence, make sure you inform your doctor if you have had seizures, epilepsy, or any other neurological condition affecting the brain, such as cerebral arteriosclerosis (narrowing of the blood vessels in the brain) or stroke.

5) Myasthenia gravis

Myasthenia gravis is a disorder affecting the nervous system. It is marked by severe muscle weakness and difficulty breathing.

Studies show that Levofloxacin might worsen muscle weakness in patients with myasthenia gravis. 

Inform your physician if you have myasthenia gravis. Your doctor might tell you not to take levofloxacin and prescribe another antibiotic.

Also, if you experience unusual muscle weakness or difficulty breathing after you start using levofloxacin, stop the treatment and call your doctor immediately for further advice.

Conclusion

Levofloxacin may interact with specific medications, so it’s important to be aware of potential drug interactions.

It may also increase the symptoms of some pre-existing medical conditions, such as tendonitis, tendon rupture, and myasthenia gravis.

It is important to be aware of the drug interactions and condition interactions of this drug.

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Sources

  1. Podder V, Sadiq NM. Levofloxacin. [Updated 2022 Sep 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 
  2. Durey A, Baek YS, Park JS, Lee K, Ryu JS, Lee JS, Cheong MH. Levofloxacin-induced Achilles tendinitis in a young adult in the absence of predisposing conditions. Yonsei Med J. 2010 May;51(3):454-6. doi: 10.3349/ymj.2010.51.3.454. PMID: 20376902; PMCID: PMC2852805.
  3. Stephenson AL, Wu W, Cortes D, Rochon PA. Tendon Injury and Fluoroquinolone Use: A Systematic Review. Drug Saf. 2013 Sep;36(9):709-21. doi: 10.1007/s40264-013-0089-8. PMID: 23888427.
  4. Gunduz A, Turedi S, Kalkan A, Nuhoglu I. Levofloxacin induced myasthenia crisis. Emerg Med J. 2006 Aug;23(8):662. doi: 10.1136/emj.2006.038091. PMID: 16858118; PMCID: PMC2564188. 

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