Levofloxacin this drug most people are almost commonly used it, it is a class of quinolone drugs, broad-spectrum antibacterial drugs, antibacterial effect, and mainly for gram-positive bacteria and chlamydia and mycoplasma have an antagonistic effect.

Levofloxacin is also known as "Levofloxacin Hydrochloride", the main principle of this drug is to inhibit the activity of bacterial DNA enzymes through various ways, preventing bacterial replication and synthesis, and ultimately killing bacteria. The drug has a high oral absorption rate and is absorbed by all tissues of the body, with a half-life of about 7 hours, and is excreted by the kidneys. It is mainly used in the treatment of respiratory tract infections, urogenital infections, infections of the gastrointestinal tract, bone and joint infections, soft tissue infections and other diseases.

The following side effects can occur with long-term use!

1, gastrointestinal reactions, abdominal pain and discomfort, indigestion, nausea and vomiting, diarrhea and some other lesions, but also lead to ulcers and so on.

2, the appearance of neurological symptoms, there will be dizziness, headache tinnitus, anxiety, drowsiness, insomnia, irritability, mental depression and other symptoms.

3、Allergic people will also have an allergic reaction, there will be erythema, rash and peripheral neurological edema and inflammation.

4, will also lead to liver and kidney function damage, transaminase elevation and hematuria, leukopenia and so on.

5, this drug is prohibited for use under 18 years of age, because the specific side effects are not yet clear, as well as older and liver and kidney insufficiency should be used with caution.

Therefore, you can not take these drugs for a long time, antibiotic drugs are more effective antibacterial effect is strong but the side effects are also very large, so it is still according to the physician's guidance regular use of medication, to avoid blind use of drugs.

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Levofloxacin is one of the quinolone antimicrobial drugs commonly used in clinical practice, and its family members include norfloxacin, ciprofloxacin and moxifloxacin. Because of its broad coverage of the antibacterial spectrum, many people as long as there are symptoms of infection often do not go to the doctor, directly to the pharmacy to buy, resulting in its abuse of the phenomenon is widespread, but also some patients have related side effects, I come to tell you what side effects and precautions may occur:

Let's start with the official(fromState Food and Drug Administration (SFDA)of the website）3 of the data for this class of drugsspecial warning

One,Quinolones can cause serious adverse effects such asTendonitis, tendon ruptureThat is, our heels, shoulders, elbows and other joints, so often people will say, after taking the drug heel pain. There are also peripheral neuropathy and hands and feet caused by nerve damage and pain as well as central nervous system adverse reactions headache and dizziness, etc., appeared how to do, you should immediately stop the drug, and avoid the use of similar drugs that is, the family of salvia can not be in the application of the drug.

II. Myasthenia gravis:This class of drugs willExacerbating myasthenia gravis symptoms in patients with myasthenia gravisTherefore, patients suffering from myasthenia gravis avoid applying this type of medication.

Third, for some diseases such as acute bacterial sinusitis, acute exacerbation of chronic bronchitis, simple lower urinary tract infections, etc. in the absence of other drug treatment before you can choose this type of drug.

Let's take a look at the other major side effects mentioned in the specification:

I. The heart:Patients with tardive dyskinesia or tachycardia should be cautious about whether the drug aggravates their symptoms.

Second, blood sugar abnormalities:It is important to closely monitor changes in blood glucose while taking medication for diabetes. It can go up or down.

III. Gastrointestinal tract:Nausea, vomiting, constipation, diarrhea, etc.

IV. Skin:Rash, itchy rash, hives, etc.

Precautions to be taken while taking the medication:

I. Disablement:Contraindicated for pregnant women, children under 18 years of age. Nursing women are to stop breastfeeding.

Second, the time of taking the medication:It is best to take the medication orally, one hour before or two hours after eating, and drink plenty of water, at least 1,500 ml, during the medication.

Third, sun protection:Avoid direct contact with sunlight or ultraviolet rays after using the medication, you can take sunscreen, sunglasses, etc.

IV. Avoid taking with drugs containing metal ions (drugs containing iron, calcium, aluminum, zinc words), at least 2 hours apart.

In short: levofloxacin tablets before use we must understand his common side effects, and pay attention to the indications for the use of the drug, in accordance with the correct dosage to take, to avoid the emergence of related side effects, at the same time when using the drug and after the use of the drug to pay attention to the monitoring of adverse reactions, can not be taken for a long time, to avoid the emergence of drug resistance.

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There are many types of antibiotics, commonly used with penicillin, cephalosporins, quinolones, carbapenems and so on, and levofloxacin belongs to this quinolone class, this drug is used very widely, a lot of bacteria have a killing effect, commonly used respiratory tract infections, pneumonia, urinary tract infections, skin and soft tissue infections and so on, the effect is not bad. However, the side effects of this drug are still a lot of, now the drug manual are specially labeled out:

In all age groups, fluoroquinolones, including the levofloxacin we're talking about here, can causeTendonitis and tendon rupturethe increased risk of the disease. It can also lead to myasthenia gravis patients having anMyasthenia gravis worsens. That is why levofloxacin should be avoided in patients with myasthenia gravis.

There are many other adverse reactions such as allergic reactions, hepatotoxicity, central nervous system effects (e.g., insomnia, headache, dizziness, etc.), nausea, vomiting, diarrhea, etc., etc., etc. There have been several elderly patients who developed mental abnormalities and talked nonsense after using the drug Levofloxacin, but recovered after stopping the drug. There are also some people who have insomnia, sleeplessness and mental excitement after using it. But in general it is not serious.

Someone asked if pregnant women can use levofloxacin. No. It is contraindicated in pregnant women. Because this drug can cause arthropathy in underage animals inside animal studies, it should still be contraindicated in pregnant women for safety reasons. It is also contraindicated in adolescents under 18 years of age. This is because it may cause arthropathy. So you'll find that in the pneumonia clinic, quinolones are not used in minors under the age of 18, and certainly levofloxacin is not allowed.

However, because these drugs are effective against atypical pathogens, such as Mycoplasma and Chlamydia, and because they are broad-spectrum, they are still commonly used. However, it is important to monitor for adverse effects during administration.

Levofloxacin is a synthetic antimicrobial drug, according to the classification it belongs to the quinolone class of antimicrobial drugs, also known as respiratory quinolones because of its high concentration in the lung tissue, its antimicrobial spectrum is wide, indications are many, the clinical use of high rate, of course, it is also a high incidence of adverse reactions.

Levofloxacin has good antibacterial effect on Gram-positive cocci (staphylococci, streptococci, enterococci, etc.), Gram-negative bacilli (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, etc.), atypical pathogens (Mycoplasma pneumoniae, Chlamydia pneumoniae, etc.), etc. Currently it is used for the treatment of pneumonia, acute bacterial sinusitis, and acute attack of chronic bronchitis, Complex skin and soft tissue infections, complex urinary tract infections, inhalation anthrax, plague, etc.

Levofloxacin is a concentration-dependent antimicrobial drug, once a day can be used, the maximum dose can be used to 0.75g, the domestic general use of 0.6g can be; the domestic specification clearly stipulates that less than 18 years old patients are prohibited levofloxacin, but some of the foreign literature and guidelines for children can be used in the drug, it is personally recommended that levofloxacin not recommended preferred when other drugs can be achieved therapeutic purposes, if the other drugs are not available should be given levofloxacin. Levofloxacin should be given when other drugs are not available, simply put, the pros and cons should be weighed.

With the widespread use of levofloxacin in the clinic, the incidence of adverse reactions has been increasing; common adverse reactions include gastrointestinal (nausea, vomiting, abdominal pain, diarrhea), cutaneous (allergic reactions), neurologic (dizziness, headache, insomnia, etc.), and hepatic (elevated transaminases); rarer adverse reactions include pseudomembranous enterocolitis, myelosuppression, arthralgia, tendonitis, and tendon rupture, muscle weakness, seizures, Stevens-Johnsons syndrome, and interstitial nephritis.

For the adverse reactions of levofloxacin, most of them can be tolerated and can return to normal after stopping the drug, but for some serious ones such as tendon rupture, tardive dyskinesia, phototoxicity, aggravation of myasthenia gravis, irreversible peripheral neuropathy, and affecting the glycemic control of diabetic patients, etc., great attention should be paid, and for this reason, the use of levofloxacin should be strictly controlled, and in 2016 the FDA issued a safety notice not recommending that The drug is used for the treatment of simple urinary tract infections, acute exacerbation of chronic bronchitis, acute bacterial rhinitis, unless such drugs are given when the patient has no other therapeutic options; for certain serious bacterial infections, including anthrax, bubonic plague, and bacterial pneumonia, because the benefits outweigh the risks, and such cases can be used in patients.

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Levofloxacin belongs to the fluoroquinolone class of drugs antimicrobials, also called respiratory quinolones, due to the fact that levofloxacin is more effective against bacterial infections of the respiratory system.

Its mechanism of action is mainly to inhibit the topoisomerase enzyme required for bacterial DNA replication and transcription, thus killing the bacteria. Clinically, it is mainly used for respiratory infections caused by sensitive bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Mycoplasma pneumoniae, Chlamydia, etc., for example, community-acquired pneumonia, hospital-acquired pneumonia, chronic bronchitis, skin and soft-tissue infections, and urinary tract infections.

The main adverse effects of levofloxacin are listed below:

1. Animal experiments show that Levofloxacin has damage to cartilage, so generally Levofloxacin can not be used for minors, it is recommended for people over 18 years old;

2. It may cause tendonitis and tendon rupture. The most common is Achilles tendon rupture, which requires attention if there is heel pain and discomfort during the use of levofloxacin, especially in patients who have been using the drug for a longer period of time.

3. Some people develop photosensitivity reactions after using levofloxacin, so try to avoid light and stay away from the sun for a few days after the levofloxacin infusion.

4. Some patients develop central toxicity after using levofloxacin. For example, symptoms such as tremor, dizziness, insomnia, etc. If these symptoms occur, it is recommended to stop the drug.

5. Long-term use may lead to gastrointestinal symptoms, especially diarrhea caused by flora disorders, so antibacterial drugs use time, when to use should follow the doctor's instructions, do not use their own discretion.

6. Levofloxacin may cause peripheral neuropathy, such as burning and tingling sensations in the skin, which should be stopped immediately.

7. The use of quinolones has been reported to be associated with possible dysglycemia, manifested as an increase or decrease in blood glucose, especially in patients with diabetes mellitus, and the use of levofloxacin should be noted.

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First of all, levofloxacin is a very commonly used clinical antibiotics, it belongs to the quinolone class of a drug, is one of the broad-spectrum antimicrobial agents, and antibacterial effect is very strong, this drug in addition to Pseudomonas aeruginosa weakened, for other bacteria have a strong antimicrobial effect, but also for the Legionella bacteria, Mycobacterium tuberculosis, Chlamydia trachomatis has a good effect, this drug in addition to intravenous infusion in addition to the oral absorption of the drug, the effect is also very good. The drug is absorbed orally in addition to the intravenous infusion, and the effect is also very good, and it is mainly eliminated from the urine in its original form.

What does Levofloxacin do as answered by Dr. Ma below?

1、Urinary system infection

This is one of the most commonly used medications for the treatment of urinary tract infections, bacterial prostatitis, Neisseria gonorrhoeae urethritis or cervicitis (including those caused by enzyme-producing strains), pyelonephritis, and other conditions.

2. Respiratory tract infections

呼吸道感染主要是由于敏感革兰阴性杆菌所致的疾病，还有就是胃肠道感染，对于志贺菌感染、沙门菌感染、产肠毒素大肠杆菌感染、亲水气单胞菌感染、副溶血弧菌感染等所致的疾病的治疗效果很好，还可用于治疗伤寒等疾病。

3. Systemic infections such as bone and joint infections, skin and soft tissue infections and sepsis.

What are the side effects of Levofloxacin answered by Dr. Ma below?

1. Gastrointestinal discomfort

Long-term application of levofloxacin can irritate the gastrointestinal tract, so symptoms such as food upset, nausea and vomiting, diarrhea and constipation may occur.

2、Allergic reaction

Regardless of any antibiotic for people with special constitution will have an allergic reaction, the usual infusion process of levofloxacin stimulation is relatively strong, will lead to the emergence of the infusion site swelling and pain, pinprick sensation, itchy skin and other sensations.

3. Hepatorenal toxicity

It is a drug three times poison, long-term use of this drug liver and kidney toxic side effects are very big, so antibiotics should be applied in strict accordance with the course of treatment, long-term application of levofloxacin will lead to increased serum aminotransferase, serum total bilirubin elevation, etc., blood urea nitrogen, so not only on the liver and kidney damage, but also tiredness, fever, palpitations, taste abnormalities and other symptoms.

4. Headache and dizziness, sleep disorders

This symptom is mainly due to the fact that long-term application will have a certain hmmm effect on the human nervous system, so these symptoms will appear.

6. Muscle and joint pain

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Levofloxacin is a quinolone antimicrobial drug with a wide range of indications and frequent adverse reactions, coupled with a lag in updating the manual, in July 2017 China's Food and Drug Administration issued a warning on quinolone antimicrobial drugs for systemic use, with revisions to indications, adverse reactions and precautions, which was reported in the news broadcast at the time.

All drugs have adverse reactions, or side effects, and the side effects of a drug are not a determining factor in choosing a drug, and should not be avoided for fear of choking, but we should be alert to these side effects in the process of using the drug, and take the necessary measures to minimize the occurrence of side effects. The common side effects of Levofloxacin are:

1. Allergic reaction

Manifestations include rash, urticaria, itching, fever, dyspnea, angioneurotic edema, and even the possibility of anaphylaxis.

2. Central nervous system effects

Manifestations include dizziness, agitation, depression, insomnia, seizures, and psychosis.

3. Skeletal muscles

Manifestations include myalgia, muscle weakness, myositis, tendon rupture, and worsening of myasthenia gravis.

4. Cardiovascular system

It manifests as a prolonged QT gap on the electrocardiogram and induces a lethal tip-twisting ventricular tachycardia.

5. Peripheral neuropathy

Manifestations include numbness, weakness, burning sensation, and polyneuritis.

6. Phototoxicity

Exposure to sunlight or ultraviolet light after use of the medication may result in a sunburn reaction manifested by erythema, blisters, edema, and a burning sensation.

7. Effect on blood sugar

It can lead to dysglycemia, which occurs most often in diabetics taking oral hypoglycemic drugs or using insulin.

8. Antibiotic diarrhea

Long-term application of quinolone antimicrobials can disrupt the balance of intestinal flora and lead to diarrhea.

9. Blood system

Manifestations include granulocyte deficiency, thrombocytopenia, and anemia.

10. Hepatobiliary system

Manifestations include jaundice, acute hepatitis, and even liver failure.

11. Urinary system

It manifests as crystalluria, tubular urine, and renal insufficiency.

The clinical application of quinolone antibacterial drugs is relatively common, especially levofloxacin, which can be used for respiratory tract infections, urinary tract infections, gastrointestinal tract infections, skin and soft tissue infections, and other major systems, so it is necessary to strictly grasp the indications, some common upper respiratory tract infections, urinary tract infections, etc., you should try to use other antimicrobial drugs to reduce the use of quinolone antibacterial drugs, such as the occurrence of the above adverse reactions to stop the drug immediately to seek medical attention If any of the above adverse reactions occur, stop the drug immediately and seek medical attention, to ensure the safety of medication.

References:

Levofloxacin Tablets Instructions

CFDA official website

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What are the side effects of levofloxacin hydrochloride tablets? Are Levofloxacin Hydrochloride and Levofloxacin's the same?

Let's first look at the difference between levofloxacin hydrochloride and levofloxacin

Levofloxacin and levofloxacin hydrochloride have the same function in clinical application, both of them are antibacterial and have the same antibacterial spectrum. However, levofloxacin is the active ingredient, which is not easy to be preserved, the pharmaceutical process is troublesome, and the price is more expensive. Levoxyl hydrochloride is hydrochloride, relatively stable, long preservation time, relatively simple pharmaceutical process, less cost and cheaper, easier to absorb, less irritation. Levoxyl hydrochloride appeared on the market first, and then appeared more refined levoxyl.

So what are the side effects of levofloxacin hydrochloride tablets?

1. Gastrointestinal reactions: nausea, vomiting, diarrhea, loss of appetite, abdominal pain, bloating, and other symptoms.
2. Abnormalities of hepatic and renal function: e.g., increased blood transaminases, increased serum total bilirubin, and occasional rise in blood urea nitrogen.
   
3. Neurologic symptoms: occasional tremor, numbness, visual abnormalities, insomnia, headache, dizziness, etc.
4. Allergic reaction: swelling, rash, itching and erythema may occur.
5. Diseases of the blood system: sometimes anemia, leukopenia, thrombocytopenia, and so on.

The incidence of the above adverse reactions ranges from 0.1 to 5%, which are generally tolerated and disappear rapidly after the end of the treatment. If any abnormality is detected, it should be observed and, if necessary, the drug should be stopped and appropriate treatment should be carried out.

Summary: Levofloxacin hydrochloride belongs to the quinolone group of drugs, and is contraindicated in people who are allergic to quinolones, pregnant and breastfeeding women, and patients under 18 years of age.

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Levofloxacin belongs to the quinolone class of synthetic antimicrobial drugs.

A broad-spectrum fungicide.

These drugs are well absorbed orally.

Although levofloxacin has a broad antimicrobial spectrum, strong antimicrobial activity, convenient and inexpensive oral medication, it should not be used blindly .

Levofloxacin is used to treat the following conditions.

1, genitourinary tract infections: for simple Neisseria gonorrhea urethritis or cervicitis levofloxacin can be the drug of choice. Ciprofloxacin is preferred for Pseudomonas aeruginosa urethritis.

2. Pneumonia: Levofloxacin and vancomycin are used in combination and preferred for Streptococcus pneumoniae pneumonia, which is highly resistant to penicillin.

3, typhoid or paratyphoid fever: for salmonella caused by levofloxacin or ceftriaxone can be preferred

4, acute and chronic diarrhea or toxic bacillary dysentery: preferred for Shigella caused by

The widespread use of these drugs has been accompanied by a succession of adverse effects, with temafloxacin and gepafloxacin being withdrawn from the market because of severe toxicity.

The side effects are as follows.

1, gastrointestinal reactions: generally not serious, common nausea and vomiting, indigestion, stomach upset

2、Central nervous system toxicity: dizziness, headache and insomnia in mild cases, mental abnormality and cramps in severe cases. Usually occurs in overdose, psychiatric or epileptic patients with theophylline or non-steroidal anti-inflammatory drugs.

3, skin and photosensitive reactions: can appear rash, some patients can appear itchy skin or angioneurotic edema. Phototoxicity is manifested as itchy erythema at the site of light exposure, and skin erosion and peeling can occur in serious patients, which can be restored after stopping the drug.

4, cartilage damage: the cartilage of the weight-bearing joints of young animals can be damaged. Joint pain and joint edema may occur in children.

Because of this.

Contraindicated for children, pregnant and lactating women

It should also not be used in patients with a history of psychosis or epilepsy

Avoid combining with antacid drugs and drugs containing metal ions; if combined, take 2 to 4 hours apart.

Avoid combining with theophylline or NSAIDs.

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Levofloxacin is a broad-spectrum fluoroquinolone antimicrobial agent available in injectable, oral, and eye drop dosage forms, which can be administered by the appropriate route as needed for the treatment of bronchitis, pneumonia, sinusitis, prostatitis, urinary tract infections, conjunctivitis, skin infections, anthrax, tuberculosis, and other diseases caused by sensitive bacterial infections.

Because levofloxacin does not have as serious allergic reactions as penicillins and is relatively safe in comparison, it is widely used in the treatment of infectious diseases. With the long-term popularization of its use and the detection of clinical adverse reactions, the following 8 adverse reactions have been known:

1. Tendinopathy and tendon rupture:Various quinolones, including levofloxacin, have been shown to cause tendonitis and tendon rupture in all people, with this adverse reaction occurring most often in the Achilles tendon, but also in the shoulder, hand, biceps, thumb and other tendons. Elderly people who have been taking glucocorticoids for a long time or who suffer from kidney or heart disease and after lung transplants are especially prone to this adverse reaction. Also people with kidney failure and those who do strenuous physical labor are prone to this adverse reaction.

2. Exacerbation of myasthenia gravis:These drugs have neuromuscular blocking activity and sometimes exacerbate the symptoms of muscle weakness in patients with myasthenia gravis.3. Effects on heart rhythm:Prolonged application of levofloxacin is associated with prolonged QT interval arrhythmias, which are especially likely to be induced in people already suffering from arrhythmias (prolonged QT interval), hypokalemia, and the use of antiarrhythmic drugs (procainamide, amiodarone, sotalol, etc.).

4. Hypersensitivity reactions:Patients treated with any of the fluoroquinolone antimicrobials, including levofloxacin, occasionally experience severe, even fatal, hypersensitivity and or anaphylactic reactions, which most often, but infrequently, occur after the first dose. Some reactions are accompanied by cardiovascular collapse, hypotension/shock, seizures, loss of consciousness, tingling sensation, angioneurotic edema (including edema/swelling of the tongue, larynx, pharynx, or face), airway obstruction (including bronchospasm, shortness of breath, and acute respiratory distress), dyspnea, urticaria, pruritus, and other severe skin reactions. Adverse reactions of photosensitized skin damage also occur during levofloxacin application.

5. Other serious adverse reactions:This type of adverse reaction usually occurs after high doses of the drug. One or more of the following symptoms often occur: fever, rash, severe skin reactions, vasculitis, arthralgia, muscle pain, hypersensitivity pneumonitis, interstitial pneumonitis, acute renal insufficiency or renal failure, hepatitis, jaundice, acute hepatic necrosis or hepatic failure, anemia, thrombocytopenia, granulocyte deficiency, and pancytopenia.

6. Effects on the central nervous system:Levofloxacin can cause convulsions, increased intracranial pressure, and poisoning-induced psychosis. Adverse reactions such as restlessness, agitation, insomnia, anxiety, dreaminess, paranoia, dizziness, tremor, hallucinations, depression, and other abnormalities of mental status often occur with first use.

7. Peripheral neuropathy:Levofloxacin affects nerve conduction and causes adverse reactions such as abnormal skin sensation, dullness of sensation (pain, burning sensation, tingling sensation, numbness, and weakness in the extremities) and other peripheral nerve injuries, which often occur at the time of the first application.

8. Effect on blood sugar:Levofloxacin can cause a symptomatic hyperglycemic or hypoglycemic reaction, which occurs most often with concomitant glucose-lowering medications.

Overall, levofloxacin is a relatively safe and broad-spectrum anti-microbial drug, which can be applied to the treatment of a variety of infectious diseases, and the efficacy of the treatment is also certain, but you should be fully aware of the possible adverse reactions and contraindications before application, to avoid the occurrence of adverse reactions, and pay attention to the observation during the process of use, if there is an adverse reaction, you should stop taking the drug immediately, and if the situation is serious, go to the hospital as soon as possible for the If the situation is serious, go to the hospital as soon as possible for necessary treatment.

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