Safety of Running While Taking Levaquin (Levofloxacin)

Risks of Fluoroquinolones and Physical Activity

Levofloxacin and other fluoroquinolones are associated with a wide array of musculoskeletal complications involving tendon, cartilage, bone, and muscle that are likely underrecognized and underreported 1

Athletes should avoid all use of fluoroquinolone antibiotics unless no alternative is available 2
If a fluoroquinolone must be used, training alterations should begin at the first dose, including reduction in high-intensity activities, reduction in ballistic activities, and decrease in total training volume 2
The American College of Sports Medicine recommends that athletes cease all athletic activity immediately at the onset of any musculoskeletal symptoms while taking fluoroquinolones 2

Athletes taking levofloxacin should avoid running and high-impact activities during the entire treatment course and only return to running if they have no symptoms after completing the antibiotic course 2
Return to activity should be gradual and under direct medical supervision, with close monitoring continuing for at least 1 month after completing the antibiotic 2

Consideration may be given to magnesium supplementation during treatment with levofloxacin, but dosing should be separated from levofloxacin by at least 2 hours to avoid decreased antibiotic efficacy, as recommended by the American College of Sports Medicine 1, 3