Levofloxacin Hemihydrate

Introduction

. Levofloxacin Hemihydrate is an antibiotic belonging to the fluoroquinolone family of drugs. Levofloxacin, a fluorinated fluoroquinolone structurally related to ciprofloxacin, is the l-isomer of the racemic mixture ofloxacin, and possesses enhanced potency and greater lipophilicity than its parent compound.

Uses

Levofloxacin Hemihydrate is used to treat certain bacterial infections, including urinary tract infections, respiratory infections, sinus infections, skin and soft tissue infections, and others. It is also used in the treatment of some sexually-transmitted diseases (STDs).

Mechanism of action

Levofloxacin Hemihydrate works by inhibiting bacterial DNA gyrase, an enzyme responsible for the replication, transcription, and repair of bacterial DNA. This inhibition causes the cells to stop multiplying and leads to cell death.

How long does it take to work

The antibiotic effects of Levofloxacin Hemihydrate can usually be felt within a few hours, and the full effect can be seen within two to three days. However, it is important to take the medication for the entire course of treatment in order to fully clear the infection.

Absorption

Levofloxacin Hemihydrate is rapidly and well absorbed from the gastrointestinal tract. The peak plasma concentration occurs about 1-2 hours after oral dosing.

Route of elimination

Levofloxacin Hemihydrate is mainly eliminated by the kidneys. About 65% is excreted unchanged by the kidneys, 15% as metabolites, and the remainder via the biliary system.

Dosage

The usual dose of Levofloxacin Tablets is 250 mg or 500 mg or 750 mg administered orally every 24 hours. Levofloxacin tablets can be administered without regard to food. Levofloxacin oral solution should be taken 1 hour before, or  2 hours after eating.

Levofloxacin injection should only be administered by intravenous infusion. It is not for intramuscular, intrathecal, intraperitoneal, or subcutaneous administration. The usual dose of Levofloxacin injection is 250 mg or 500 mg administered by slow infusion over 60 minutes every 24 hours or 750 mg administered by slow infusion over 90 minutes every 24 hours. Since the Levofloxacin injections are for single-use only, any unused portion should be discarded. Additives or other medications should not be added to Levofloxacin Injection or infused simultaneously through the same intravenous line.

Adults:

• Acute sinusitis: 500 mg once daily for 10-14 days, or 750 mg once daily for 5 days
• Exacerbation of chronic bronchitis: 500 mg once daily for 7 days, or 750 mg once daily for 3 days (Uncomplicated), 750 mg once daily for 5 days (Complicated)
• Community-acquired pneumonia: 500 mg once daily for 7-14 days, or 750 mg once daily for 5 days
• Uncomplicated urinary-tract infections: 250 mg once daily for 3 days
• Complicated urinary-tract infections and acute pyelonephritis: 250 mg once daily for 7-10 days
• Uncomplicated skin and soft-tissue infections: 500 mg once daily for 7-10 days.
• Complicated skin and soft-tissue infections: 750 mg once daily for 7-14 days.
• Enteric fever: 500 mg once daily for 7-14 days.
• Diarrhea, cholera, shigellosis & enteritis: Mild to moderate case: 500 mg (single dose). Moderate to sever case: 500 mg once daily for 3 days

Children:

• Children 6 months to <5 years: 10 mg/kg every 12 hours.
• Children >5 years: 10 mg/kg every 24 hours

In each case, sequential therapy (intravenous to oral) may be instituted at the discretion of the physician. Levofloxacin Hemihydrate tablets should be taken with a full glass of water. The recommended adult dosage is usually 250mg-750mg by mouth every 24 hours, depending on the severity of the infection and the type of bacteria causing it. The maximum recommended dose is 750mg daily.

Administration

Levofloxacin Hemihydrate tablets can be taken with or without food. It is important to drink plenty of fluids while taking this medication.

Side Effects

The most common side effects of Levofloxacin Hemihydrate include nausea, diarrhea, headache, dizziness, insomnia, abnormal heart rhythms, rash, and itching. It may also cause liver damage, which can be severe.

Toxicity

Levofloxacin Hemihydrate is generally well tolerated, but acute overdosage can cause toxic reactions. Symptoms of an overdose may include abdominal pain, nausea, vomiting, confusion, and drowsiness.

Precautions

Patients should be monitored for signs and symptoms of liver damage, such as nausea, vomiting, jaundice, fatigue, dark urine, or light-colored stools. Patients with kidney impairment may need to adjust their dose of Levofloxacin Hemihydrate .

Interactions

Levofloxacin Hemihydrate may interact with certain medications, including antacids, other antibiotics, antidepressants, seizure medications, and blood thinners. Patients should tell their doctor about all the medications they are taking before starting treatment with Levofloxacin Hemihydrate .

Disease Interactions

Levofloxacin Hemihydrate may not be suitable for some patients with certain medical conditions, such as kidney disease, kidney failure, liver disease, or myasthenia gravis. Patients should discuss their medical conditions with their doctor before taking Levofloxacin Hemihydrate .

Drug Interactions

Levofloxacin Hemihydrate may interact with certain medications, including certain anti-inflammatory drugs (NSAIDs), cimetidine, digoxin, diuretics, tetracycline, and warfarin. Patients should tell their doctor about all the medications they are taking before starting treatment with Levofloxacin Hemihydrate .

Food Interactions

Levofloxacin Hemihydrate should be taken on an empty stomach two hours before or after meals. Patients should avoid taking this medication with dairy products, iron, zinc, or magnesium supplements.

Pregnancy Use

The safety of Levofloxacin Hemihydrate during pregnancy has not been established. Women who are pregnant or planning to become pregnant should talk to their doctor before taking this medication.

Lactation Use

It is not known if Levofloxacin Hemihydrate passes into breast milk. Women who are breastfeeding or planning to breastfeed should talk to their doctor before taking this medication.

Acute Overdose

An acute overdose of Levofloxacin Hemihydrate can be life-threatening. Symptoms of an overdose may include nausea, vomiting, confusion, and drowsiness.

Contraindications

Levofloxacin Hemihydrate is contraindicated in patients with a known hypersensitivity to fluoroquinolones, or in those with known kidney or liver impairment.

Use Directions

Patients should take Levofloxacin Hemihydrate exactly as directed by their doctor. The tablets should be taken with a full glass of water. The capsules should not be opened, crushed or chewed.

Storage Condition

Levofloxacin Hemihydrate should be stored at room temperature, away from heat and moisture. It should be kept out of reach of children.

Volume of Distribution

The volume of distribution of Levofloxacin Hemihydrate is approximately 8-12 L/kg.

Half Life

The half-life of Levofloxacin Hemihydrate is approximately eight hours.

Clearance

The clearance of Levofloxacin Hemihydrate is approximately 10-20ml/min/kg.

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Some Frequently Asked Questions About Levofloxacin Hemihydrate

1. What is levofloxacin hemihydrate?

Levofloxacin hemihydrate is a hydrated crystalline form of levofloxacin, a broad-spectrum fluoroquinolone antibiotic used to treat bacterial infections.

2. How does levofloxacin hemihydrate differ from levofloxacin?

The hemihydrate form includes half a water molecule in its crystal structure, which may affect its stability, solubility, or manufacturing process, but its therapeutic action is identical to levofloxacin.

3. What is levofloxacin hemihydrate used for?

It treats bacterial infections such as:

Pneumonia

Urinary tract infections (UTIs)

Sinusitis

Skin infections

Chronic bronchitis exacerbations

4. How does levofloxacin hemihydrate work?

It inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and killing susceptible bacteria.

5. Is levofloxacin hemihydrate a prescription drug?

Yes, it requires a doctor’s prescription.

6. Who can take levofloxacin hemihydrate?

It’s suitable for adults with bacterial infections but avoided in children, pregnant women, or those with tendon issues unless necessary.

7. How is levofloxacin hemihydrate taken?

It is taken orally as tablets or liquid, or given intravenously, depending on the formulation.

8. What is the typical dosage of levofloxacin hemihydrate?

Dosage depends on the infection:

Pneumonia: 500-750 mg once daily for 7-14 days

UTIs: 250-500 mg once daily for 3-10 days

Adjusted for kidney function

9. How long does levofloxacin hemihydrate take to work?

It begins working within hours, with symptom relief in 1-3 days, but the full course must be completed.

10. Can levofloxacin hemihydrate be taken long-term?

No, it’s used short-term (3-14 days) due to risks like tendon damage or resistance.

11. Does levofloxacin hemihydrate treat viral infections?

No, it only targets bacterial infections, not viruses.

12. What are the common side effects of levofloxacin hemihydrate?

Common side effects include:

Nausea

Diarrhea

Headache

Dizziness

13. Can levofloxacin hemihydrate cause tendon damage?

Yes, it may lead to tendonitis or tendon rupture, particularly in older adults or those on steroids.

14. Does levofloxacin hemihydrate affect mental health?

Rarely, it can cause confusion, anxiety, or hallucinations. Contact a doctor if these occur.

15. Can levofloxacin hemihydrate be taken with food?

Yes, but avoid dairy or calcium-rich products, which reduce absorption.

16. What happens if I miss a dose of levofloxacin hemihydrate?

Take it as soon as possible unless it’s near the next dose; then skip it. Don’t double up.

17. Can I overdose on levofloxacin hemihydrate?

Yes, overdose may cause seizures or heart issues. Seek emergency help if suspected.

18. Is levofloxacin hemihydrate safe during pregnancy?

No, it’s Category C and not recommended due to potential fetal risks.

19. Can breastfeeding mothers take levofloxacin hemihydrate?

It’s not advised, as it may pass into breast milk and harm the baby.

20. Does levofloxacin hemihydrate interact with other medications?

Yes, it interacts with:

Antacids (reduce absorption)

NSAIDs (increase seizure risk)

Warfarin (increases bleeding risk)

21. Can I drink alcohol while taking levofloxacin hemihydrate?

Avoid alcohol, as it may worsen side effects like dizziness or nausea.

22. Is levofloxacin hemihydrate safe for kidney disease?

Yes, with dose adjustments based on kidney function to avoid toxicity.

23. Can levofloxacin hemihydrate be used in liver disease?

It’s usually safe in mild liver disease but used cautiously in severe cases.

24. How should levofloxacin hemihydrate be stored?

Store at room temperature, away from moisture and heat. The hemihydrate form is sensitive to humidity.

25. Does levofloxacin hemihydrate expire?

Yes, check the expiration date; expired drug may lose potency.

26. Can levofloxacin hemihydrate cause photosensitivity?

Yes, it increases sunburn risk. Use sunscreen and avoid prolonged sun exposure.

27. Is levofloxacin hemihydrate the same as ciprofloxacin?

No, both are fluoroquinolones, but levofloxacin hemihydrate has a broader spectrum and different dosing.

28. Can levofloxacin hemihydrate treat MRSA?

It’s not typically effective against MRSA unless susceptibility is confirmed.

29. Does levofloxacin hemihydrate cause yeast infections?

Yes, it can disrupt gut flora, leading to yeast infections like thrush.

30. Can levofloxacin hemihydrate cause heart problems?

Rarely, it may prolong the QT interval, risking irregular heartbeats.

31. Is levofloxacin hemihydrate gluten-free?

Most formulations are gluten-free, but confirm with the manufacturer.

32. Can levofloxacin hemihydrate tablets be crushed?

Generally, no, unless specified by your doctor, as it may alter absorption.

33. What if I’m allergic to levofloxacin hemihydrate?

Allergic reactions (rash, swelling) are rare but serious. Stop use and seek help.

34. Can levofloxacin hemihydrate cause drowsiness?

It may cause dizziness or fatigue; avoid driving until you know its effects.

35. Does levofloxacin hemihydrate affect blood sugar?

Rarely, it may alter blood sugar levels, especially in diabetics.

36. Can levofloxacin hemihydrate treat ear infections?

It’s not a first-line choice for ear infections unless bacteria are susceptible.

37. Is levofloxacin hemihydrate safe for elderly patients?

Yes, but they’re at higher risk for tendon or kidney issues.

38. Can levofloxacin hemihydrate cause weight gain?

No, weight gain is not a reported side effect.

39. Does levofloxacin hemihydrate need refrigeration?

No, store at room temperature. Liquid forms may vary—check the label.

40. Can levofloxacin hemihydrate treat strep throat?

It’s not preferred; penicillin or amoxicillin is typically used instead.

41. What’s the difference between levofloxacin hemihydrate and amoxicillin?

Levofloxacin hemihydrate is a broader-spectrum fluoroquinolone, while amoxicillin is a narrower-spectrum penicillin.

42. Can levofloxacin hemihydrate cause joint pain?

Yes, it may cause joint pain or swelling due to tendon effects.

43. Is levofloxacin hemihydrate available as a generic?

Yes, it’s available as a generic, often labeled simply as levofloxacin.

44. Can levofloxacin hemihydrate be taken at night?

Yes, take it consistently at the same time daily.

45. Does levofloxacin hemihydrate affect the liver?

Rarely, it may elevate liver enzymes. Report jaundice to your doctor.

46. Can levofloxacin hemihydrate be used for tooth infections?

It’s not a first choice but may be used for resistant bacteria.

47. What should I do if I experience tendon pain?

Stop the drug and contact your doctor immediately.

48. Can levofloxacin hemihydrate cause diarrhea?

Yes, it’s common and may rarely lead to C. difficile infection.

49. Does levofloxacin hemihydrate interact with caffeine?

No major interaction, but caffeine may worsen side effects like jitteriness.