Levofloxacin Side Effects Could Lead To Tendon Rupture

If you’re taking Levofloxacin, it’s important to know its potential side effects and how to reduce their discomfort.

Levofloxacin (also called Leflox or Levox) is an antibiotic prescribed to treat bacterial infections. 

It can be prescribed to treat conditions such as UTIs, prostatitis, chest infections, STIs, pneumonia, tuberculosis, and others.

In this article, we’ll discuss the side effects of Levofloxacin, how long they last, and how to reduce adverse reactions from this antibiotic. 

Potential side effects of Levofloxacin 

Levofloxacin and other fluoroquinolone antibiotics have been associated with severe side effects and warnings. 

1) Digestive discomfort

The most commonly reported side effects of Levofloxacin are gastrointestinal symptoms such as nausea, vomiting, dyspepsia, diarrhea, constipation, and abdominal pain. 

2) Malaise

One adverse effect of Levofloxacin is general symptoms of malaise, including headache, dizziness, restlessness, lightheadedness, or disorientation.

3) Tendinitis and other musculoskeletal effects

The most concerning adverse reaction is tendinitis and even rupture of tendons, especially the Achilles tendon. 

If you have myasthenia gravis, fluoroquinolones can worsen your muscle weakness as they have neuromuscular blocking activity. 

Other side effects of fluoroquinolones include nerve damage to peripheral nerves, which can cause numbness, tingling, or a prickling sensation similar to “pins and needles” in the arms and legs. 

Other musculoskeletal effects include muscle weakness, pain, joint pain, swelling, or arthropathy.

4) Central nervous system effects

Taking Leflox can also affect your central nervous system and cause increased intracranial pressure (ICP) and seizures, psychiatric disturbances such as toxic psychosis, suicidality, depression, and worsening of myasthenia gravis. 

5) Side effects on the immune system

Another potential side effect of Levox is hypersensitivity reactions and immune responses, including painful skin rashes, anaphylaxis, jaundice (yellowing of the skin or eyes), and serum sickness.

6) Side effects on the cardiac system

Cardiac system effects include aortic dissection, aortic aneurysm, and vasculitis. Heart rhythm problems like irregular heartbeat, prolonged QT interval, and torsades de pointes can also occur. 

7) Other side effects on the body

There is also a risk of severe hypoglycemia or low blood sugar, disorders of the blood, including blood dyscrasias and myelosuppression, kidney injury from renal system involvement, including crystals in the urine and nephrotoxicity, bacterial superinfection, Clostridium difficile-associated diarrhea, liver problems secondary to hepatotoxicity, sensitivity to sunlight, and uveitis.

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Are there any long-term side effects of Levofloxacin?

While severe reactions are rare, Levofloxacin may cause potentially permanent side effects affecting tendons, muscles, joints, and the nervous system. For instance, damage to the tendons, particularly the Achilles tendon.

Other long-term side effects can include:

  • Depression
  • Fatigue
  • Memory impairment
  • Sleep disorders
  • Impaired sensation
  • Arthralgia
  • Pain in extremities
  • Gait disturbance.

Patients should be informed of this severe side effect and notify their healthcare provider immediately if they develop tendinitis or tendon rupture symptoms.  

Do Levofloxacin’s adverse reactions go away?

Some side effects of Levofloxacin may occur that usually do not need medical attention. Discontinuing levofloxacin can resolve mild side effects such as nausea, vomiting, and diarrhea. 

Also, some side effects may disappear during treatment as your body adjusts to the medication, and the drug’s mild side effects should disappear after treatment. 

Levofloxacin stays in your system for 30-40 hours after your last dose, so after this point your side effects should start to go away.

Note that levofloxacin may also have serious long-term side effects.

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How Levofloxacin impacts elderly patients 

Due to the side effects of Levofloxacin in the elderly, it is contraindicated for people over 60 unless there are no other treatment options. 

1) Tendon disorders

Older adults are at an increased risk for developing severe tendon disorders, including tendon rupture, when being treated with fluoroquinolones like levofloxacin. 

This risk is even higher in older patients who are taking corticosteroids. 

Therefore, using a fluoroquinolone like Levofloxacin along with a corticosteroid should be avoided in these cases. 

2) Kidney problems

Additionally, older adults often have reduced kidney function. Since Levofloxacin is mainly removed from the body through the kidneys, it’s crucial to be extremely careful when considering this medication for elderly individuals. 

Furthermore, older patients, those with kidney issues, organ transplant recipients, and those taking corticosteroids are more susceptible to tendon damage. 

3) Heart problems

Certain medications that affect the QT interval can cause heart problems in older adults. 

Thus, it’s essential to be cautious when using levofloxacin in older people who are taking specific antiarrhythmic drugs or have risk factors for a particular type of irregular heart rhythm.

4) Hepatotoxicity

The side effects of Levofloxacin in the elderly can also lead to hepatotoxicity in older adults. 

This can cause symptoms such as: 

  • Fever
  • Fatigue
  • Very dark urine
  • Stool changes
  • Loss of appetite
  • Nausea or vomiting
  • Jaundice
  • Yellowing of the skin and eyes

Patients should stop taking Levofloxacin immediately if these signs of hepatitis develop. 

How to reverse the side effects of Levofloxacin

Below are some solutions to common side effects of Levofloxacin:

Side effectSolution
Nausea or vomitingStick to simple, non-spicy foods and take the tablets after eating. Taking levofloxacin tablets with food may help prevent nausea or vomiting.
DiarrheaDrinking plenty of water when experiencing diarrhea is essential. If symptoms persist or become severe, seek advice from a pharmacist or doctor.
Problems sleepingIt is vital to maintain good sleep hygiene and develop healthy sleep habits. If you are experiencing difficulty sleeping, you should speak with your doctor for further guidance and support.
HeadacheIt’s essential to drink plenty of water and consult your pharmacist for appropriate pain relief. If your headaches persist, inform your doctor.
Feeling dizzyOnly operate a vehicle or machinery once fully recovered.

Side effects of stopping Levofloxacin

There are little to no side effects of stopping the Levofloxacin. However, it’s crucial to follow your doctor’s advice, as discontinuation may impact the effectiveness against targeted bacteria.

Therefore, it is only recommended to stop taking Levofloxacin if you are advised to do so by your doctor.

Is Levofloxacin a high-risk medication?

It’s important to note that while Levofloxacin carries some risks, when used as directed, it is not categorized as a high-risk medication. 

High-risk medications are typically drugs that have an elevated risk of causing substantial patient harm when misused. The FDA and EMA have regulated levofloxacin to prevent misuse.


Levofloxacin is an antibiotic commonly prescribed to treat various bacterial infections. While it effectively treats bacterial diseases, being aware of potential side effects is vital. 

Some common side effects of levofloxacin include nausea, diarrhea, and dizziness. Elderly patients may be more susceptible to these side effects. 

Most side effects are temporary and go away once the medication is discontinued. However, following the prescribed dosage and consulting with a healthcare professional if any concerns arise is crucial.

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  1. Stewart, M. (2023, May 18). Levofloxacin tablets for infection (Evoxil). 
  2. Drugwatch. (2023, September 5). Cipro, Levaquin & Avelox Side Effects | Fluoroquinolone Risks. Drugwatch.com. 
  3. Ema. (2018, November 16). Disabling and potentially permanent side effects lead to suspension or restrictions of quinolone fluoroquinolone antibiotics – European Medicines Agency. European Medicines Agency. 

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