Adverse Effects of Levofloxacin

Gastrointestinal Effects

• Nausea is the most frequently reported adverse effect, occurring in 0.5-1.8% of patients, and is the leading cause of treatment discontinuation (0.6%) 1
• Vomiting and bloating occur in 0.5-1.8% of patients 1

Central Nervous System Effects

• Dizziness, insomnia, tremulousness, and headache occur in approximately 0.5% of patients 1

Dermatologic Reactions

• Rash, pruritus, and photosensitivity occur in 0.2-0.4% of patients 1

Serious but Less Common Adverse Effects

Musculoskeletal Complications

• Tendinitis and tendon rupture are serious complications that led to FDA black box warnings for all fluoroquinolones 2, 3, 4
• Fluoroquinolones exert toxic effects on tendons, cartilage, bone, and muscle 2, 3, 4

Clinical Considerations

• Antacids and medications containing divalent cations must be separated from levofloxacin by at least 2 hours to avoid absorption interference 1

Special Populations

• Avoid in pregnancy due to teratogenic effects 1
• Dosage adjustment required when creatinine clearance <50 mL/minute 1