Levofloxacin
In brief
- Levofloxacin is a prescription-only medicine (POM) in the UK.
- Levofloxacin is used to treat a range of bacterial infections including acute sinusitis, community‑acquired pneumonia, chronic bronchitis exacerbations, complicated urinary tract infections and pyelonephritis, skin and soft tissue infections, prostatitis and complicated intra‑abdominal infections. It is a fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and causing bacterial cell death.
- Usual adult doses vary by indication: commonly 500 mg once daily (OD) for many infections; prostatitis may require 500 mg OD for up to 28 days. Doses and duration depend on the infection, severity and renal function; adjustments are required in renal impairment.
- Forms of administration include oral tablets (250 mg, 500 mg), intravenous infusions (eg 500 mg/100 mL) and ophthalmic 0.5% eye drops.
- Antibacterial activity begins shortly after absorption (Tmax ≈ 1–2 hours); many patients notice symptomatic improvement within 24–48 hours although this varies by infection and severity.
- Elimination half‑life is around 6–8 hours; once‑daily dosing provides approximately 24‑hour antibacterial coverage. Total treatment duration depends on the indication (typically 5–28 days as guided by clinical response).
- Avoid excessive alcohol while taking levofloxacin — alcohol can worsen side effects such as dizziness, drowsiness and impaired coordination; it is not recommended to consume alcohol during treatment.
- The most common side effect is nausea.
- Would you like to try levofloxacin without a prescription?
Basic levofloxacin information
- INN (international nonproprietary name): Levofloxacin
- Brand names available in the United Kingdom: Tavanic; generic levofloxacin
- ATC code: J01MA12
- Forms and dosages: Tablets 250 mg / 500 mg; IV infusion 500 mg/100 mL; Ophthalmic 0.5% eye drops
- OTC / Rx classification: Prescription-only medicine (POM)
Legal status and availability in the UK
Levofloxacin is a prescription-only medicine (POM) in the UK.
Our online pharmacy offers discreet delivery to the United Kingdom in 9–21 days.
Product overview: forms and dosages
| Form | Strength | Route |
|---|---|---|
| Film-coated tablets | 250 mg / 500 mg | Oral |
| IV infusion (ready-to-use) | 500 mg/100 mL | Intravenous |
| Ophthalmic solution | 0.5% | Ophthalmic |
Brand and generic options
In the UK, levofloxacin is available as Tavanic (Sanofi) and as generics from firms such as Teva, Sandoz and Zydus.
Indications and standard adult regimens
Common licensed indications
| Indication | Typical dose | Duration |
|---|---|---|
| Acute sinusitis | 500 mg once daily | 10–14 days |
| Community‑acquired pneumonia | 500 mg once or twice daily | 7–14 days |
| Chronic bronchitis exacerbation | 500 mg once daily | 7 days |
| Complicated urinary tract infection, pyelonephritis | 500 mg once daily | 7–10 days |
| Prostatitis | 500 mg once daily | 28 days |
Typical regimens (practical dosing)
Levofloxacin 500 mg once daily is a common regimen for many infections, while 500 mg twice daily may be used for more severe pneumonia.
Typical durations range from 5 to 14 days depending on infection severity and site, with prostatitis courses extending to around 28 days when indicated.
Dosing must be adjusted for renal impairment and individualised per specialist guidance and local formularies.
Contraindications and high‑risk patients
Absolute contraindications
- Known hypersensitivity to levofloxacin/quinolones — risk of severe allergic reactions if given.
- History of quinolone‑related tendon disorders — prior tendonitis or tendon rupture increases recurrence risk.
- Children and adolescents — routine use is contraindicated due to potential effects on growth cartilage unless specialist‑approved.
Conditions requiring caution
Use caution where QT prolongation, seizure disorders, myasthenia gravis, significant renal impairment, pregnancy or breastfeeding are present.
Prescribers should assess seizure history and cardiac risk before choosing levofloxacin, and pharmacists should flag these risks at dispensing.
Side effects — frequency, seriousness, and patient counselling
Common and mild effects
- Nausea — common; advise taking with food if tolerated to reduce stomach upset.
- Headache — common; usually self‑limiting.
- Diarrhoea — common; advise hydration and seek advice if severe or persistent.
- Insomnia, dizziness, photosensitivity — reported at varying frequency.
Serious adverse events and red flags
Tendonitis and tendon rupture are recognised serious risks, especially in older adults and patients using systemic corticosteroids.
CNS events such as confusion or seizures, cardiac QT prolongation, severe hypersensitivity and persistent peripheral neuropathy are red flags that require urgent review.
Advise immediate drug cessation and clinical review for acute tendon pain, sensory changes or new severe neurological symptoms, and report serious suspected adverse reactions through national reporting mechanisms.
Drug interactions and clinical monitoring
Key interacting medicines
| Interacting agent | Practical advice |
|---|---|
| Antacids, iron preparations, sucralfate | Space oral doses by 2–4 hours to avoid reduced absorption. |
| QT‑prolonging drugs (some macrolides, certain antipsychotics) | Assess ECG risk and avoid combinations where possible; monitor closely. |
| Systemic corticosteroids | Increased risk of tendon injury; warn patients and consider alternatives where feasible. |
Monitoring and lab checks
Baseline renal function should be checked to allow appropriate dosing adjustments and reduce toxicity risk.
Consider ECG if there is known QT risk or when combining with other QT‑prolonging agents.
Patients should be advised to space antacids and iron from levofloxacin doses.
Renal dosing, elderly and special populations
Renal impairment adjustments
For creatinine clearance 20–49 mL/min use 500 mg once daily followed by 250 mg once daily thereafter where appropriate.
For creatinine clearance less than 20 mL/min use 500 mg once daily followed by 250 mg every 48 hours thereafter where appropriate.
Calculating creatinine clearance before prescribing helps ensure correct renal dosing and safer therapy.
Elderly, pregnancy, and children
No routine age‑based dose change is required, but renal function should guide dosing in older adults who commonly have reduced clearance.
Levofloxacin is generally avoided in pregnancy and breastfeeding unless the benefits clearly outweigh the risks.
Routine use in children is not recommended and should only occur under specialist supervision for severe cases.
Prescribing and regulatory status in the UK
Levofloxacin is a prescription-only medicine (POM) in the UK and is a systemic fluoroquinolone.
NHS antimicrobial stewardship programmes and local formularies inform prescriber choice and influence supply and use patterns.
Storage
Storage conditions and shelf life
Tablets should be stored at 15–30°C and kept away from moisture and direct light to preserve potency.
IV preparations must be stored according to the local product leaflet; some ready‑to‑use vials or infusions may require refrigeration during transport and storage.
Comparison with other fluoroquinolones and antibiotics
Clinical differentiators
| Drug | Strengths | Key risks |
|---|---|---|
| Levofloxacin | Good respiratory and atypical coverage; useful for prostatitis and some complicated UTIs | Tendon risk, QT prolongation, CNS effects |
| Ciprofloxacin | Stronger Gram‑negative activity | Similar class risks; less cover for atypicals |
| Moxifloxacin | Better anaerobic and respiratory coverage in some cases | Higher QT risk; differing renal dosing considerations |
Choosing levofloxacin
Levofloxacin may be chosen when atypical coverage or excellent tissue penetration is needed; alternatives are used for MRSA, paediatric cases and where QT or tendon risks are unacceptable.
Reporting side effects
Serious suspected adverse drug reactions, such as tendon or CNS events, can be reported through the MHRA Yellow Card scheme. Regulator safety alerts should be acted on promptly.
Counselling points and FAQs
Counselling points
- Explain the dosing schedule and advise how to take the medicine safely.
- Tell patients to space antacids and iron by 2–4 hours and to stay hydrated.
- Warn about tendon pain, photosensitivity and CNS effects and advise immediate stopping and review for red‑flag symptoms.
- Advise patients to avoid driving if feeling dizzy or disorientated.
FAQs
Can I take levofloxacin with an antacid?
Do not take antacids or iron close to levofloxacin; space doses by 2–4 hours.
What if I miss a dose?
Take the missed dose as soon as you remember unless it is near the next dose, in which case skip the missed dose—do not double up.
How long until I feel better?
Patients often notice symptom improvement within 48–72 hours for respiratory or urinary infections, but complete the prescribed course unless advised otherwise by a clinician.
Delivery across the United Kingdom
| City | Region | Delivery Time |
|---|---|---|
| London | Greater London | 9–21 days |
| Birmingham | West Midlands | 9–21 days |
| Manchester | Greater Manchester | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Leeds | West Yorkshire | 9–21 days |
| Liverpool | Merseyside | 9–21 days |
| Bristol | South West England | 9–21 days |
| Sheffield | South Yorkshire | 9–21 days |
| Edinburgh | Scotland | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
| Newcastle | North East England | 9–21 days |
| Nottingham | Nottinghamshire | 9–21 days |
| Southampton | South East England | 9–21 days |
| Leicester | Leicestershire | 9–21 days |
