Levofloxacin

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

250–500 mg once or twice a day (varies depending on indication)

PHARMACOKINETICS

  • Molecular weight                           :361.4
  • %Protein binding                           :30–40
  • %Excreted unchanged in urine     : >85
  • Volume of distribution (L/kg)       :1.1–1.5
  • half-life – normal/ESRD (hrs)      :6–8/35

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Initial dose 250–500 mg then reduce dose by 50%
  • 10 to 20     : Initial dose 250–500 mg then 125 mg 12–24 hourly
  • <10           : Initial dose 250–500 mg then 125 mg 24–48 hourly

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Not dialysed. Dose as in GFR <10 mL/min
  • HD                     :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Not dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Not dialysed. Loading dose: 500 mg then 250 mg every 24 hours.1

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Analgesics: possibly increased risk of convulsions with NSAIDs
  • Anticoagulants: anticoagulant effect of coumarins and phenindione enhanced
  • Antimalarials: manufacturer advises avoid concomitant use with artemether and lumefantrine
  • Ciclosporin: half-life of ciclosporin increased by 33%; increased risk of nephrotoxicity
  • Tacrolimus: may increase tacrolimus concentrationTheophylline: possibly increased risk of convulsions

    ADMINISTRATION

    Reconstition

    Route

    Oral, IV

    Rate of Administration

    30 minutes per 250 mg

    Comments

    OTHER INFORMATION

    Dose and frequency depend on indication

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