LEVOFLOXACIN-D5W (levofloxacin/dextrose 5 % in water)

There are 8 contraindications. Absolute contraindication.

Contraindication List
Aortic aneurysm
Congenital long QT syndrome
Dissection of aorta
Ehlers-danlos syndrome
Loeys-dietz syndrome
Marfan syndrome
Myasthenia gravis
Torsades de pointes

There are 15 severe contraindications. Adequate patient monitoring is recommended for safer drug use.

Severe List
Cardiac transplantation
Chronic kidney disease stage 3A (moderate) GFR 45-59 ml/min
Chronic kidney disease stage 3B (moderate) GFR 30-44 ml/min
Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
Chronic kidney disease stage 5 (failure) GFr<15 ml/min
Clostridioides difficile infection
Glucose-6-phosphate dehydrogenase (g6Pd) deficiency
Hypokalemia
Idiopathic intracranial hypertension
Lung transplantation
Peripheral neuropathy
Prolonged QT interval
Renal transplant
Tendon rupture
Tendonitis

There are 12 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Bradycardia
Diabetes mellitus
Disease of liver
Hallucinations
Hypoglycemic disorder
Kidney disease with likely reduction in glomerular filtration rate (GFr)
Lower seizure threshold
Myocardial ischemia
Rhabdomyolysis
Seizure disorder
Severe cerebral arteriosclerosis
Tremor

There are 57 severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare

Abnormal hepatic function tests Acute generalized exanthematous pustulosis Acute hepatic failure Acute renal failure Anaphylaxis Angioedema Aortic aneurysm Aplastic anemia Arterial dissection Cardiac arrhythmia Cholestatic hepatitis Clostridioides difficile infection Dissection of aorta Drug-induced psychosis Encephalopathy Erythema multiforme Hallucinations Hearing loss Hemolytic anemia Hepatitis Hyperkalemia Hypersensitivity drug reaction Hypersensitivity pneumonitis Hypertonia Hypoglycemic disorder Idiopathic intracranial hypertension Interstitial nephritis Intracranial hypertension Jaundice Leukopenia Multiple organ failure Neuromuscular blockade Non-traumatic rupture of achilles tendon Pancreatitis Pancytopenia Peripheral neuropathy Phlebitis after infusion Phototoxicity Prolonged QT interval Rhabdomyolysis Rotator cuff tendon rupture Seizure disorder Serum sickness Severe diarrhea Skin rash Stevens-johnson syndrome Suicidal ideation Tendon rupture Tendon rupture extensor of hand and wrist Tendon rupture flexor of hand and wrist Tendonitis Thrombotic thrombocytopenic purpura Torsades de pointes Toxic epidermal necrolysis Uveitis Valvular regurgitation Vasculitis

There are 66 less severe adverse reactions.

More Frequent	Less Frequent
Constipation Diarrhea Dizziness Headache disorder Insomnia	Abdominal pain with cramps Candidiasis Drowsy Dysgeusia Dyspepsia Dyspnea Edema Esophagitis Nausea Nervousness Vomiting

Rare/Very Rare

Acute cognitive impairment Agitation Agranulocytosis Anemia Anorexia Arthralgia Arthritis Chest pain Crystalluria Delirium Depression Diplopia Disturbance of attention Dysesthesia Epistaxis Erythema Fever Flatulence Gait abnormality Gastritis Gastroenteritis General weakness Glossitis Hyperglycemia Hyperkinesis Hypoesthesia Loss of sense of smell Memory impairment Muscle weakness Myalgia Nightmares Palpitations Paranoid disorder Paresthesia Parosmia Pruritus of skin Scotomata Stomatitis Symptoms of anxiety Syncope Tachycardia Thrombocytopenic disorder Tinnitus Toxic psychosis Tremor Urticaria Vaginitis Vasodilation of blood vessels Vertigo Visual changes

There are no adequate and well-controlled studies of levofloxacin in pregnant women, and the drug should be used during pregnancy only if potential benefits justify potential risks to the fetus. Reproduction studies in rats or rabbits have not revealed evidence of teratogenicity at oral doses 9.4 or 1.1

times the maximum recommended human dose, respectively, or IV doses 1.9 or 0.5 times the maximum human dose, respectively, based on relative body surface area.

Levofloxacin is distributed into milk following oral or IV administration. Because of the potential for serious adverse reactions in the infant, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman.

No overall differences in safety and efficacy were observed between geriatric patients and younger adults in clinical trials, but increased sensitivity in some older individuals cannot be ruled out. The risk of fluoroquinolone-associated tendon disorders, including tendon rupture, is increased in older adults (usually those older than 60 years of age). This risk is further increased in those receiving concomitant corticosteroids.

(See Tendinitis and Tendon Rupture under Warnings/Precautions: Warnings, in Cautions.) Caution is advised if levofloxacin is used in geriatric adults, especially those receiving concomitant corticosteroids. Severe and sometimes fatal hepatotoxicity has been reported in patients receiving levofloxacin, and the majority of fatalities have occurred in geriatric patients 65 years of age or older. (See Hepatotoxicity under Warnings/Precautions: Other Warnings/Precautions, in Cautions.) The risk of prolonged QT interval leading to ventricular arrhythmias may be increased in geriatric patients, especially those receiving concurrent therapy with other drugs that can prolong QT interval (e.g., class IA or III antiarrhythmic agents) or with risk factors for torsades de pointes (e.g., known QT prolongation, uncorrected hypokalemia).

(See Prolongation of QT Interval under Warnings/Precautions: Other Warnings/Precautions, in Cautions.) The risk of fluoroquinolone-associated aortic aneurysm and dissection may be increased in geriatric patients. (See Risk of Aortic Aneurysm and Dissection under Warnings/Precautions: Other Warnings/Precautions, in Cautions.) Because levofloxacin is substantially eliminated by the kidneys, age-related decreases in renal function should be considered when selecting dosage for geriatric patients and it may be useful to monitor renal function. (See Geriatric Patients under Dosage and Administration: Special Populations.)