Medical expert of the article
New publications
Preparations
Levox
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Levoksa is an antibacterial drug from the category of quinolones.
Indications of the levox
It is used by adults to eliminate infections in a moderate or mild stage that are caused by the activity of bacteria sensitive to levofloxacin:
- chronic form of bronchitis at the stage of exacerbation, acute stage of sinusitis, pneumonia;
- infections affecting the urinary tract (with complications and without them), for example, pyelonephritis;
- infectious lesions of subcutaneous tissues and skin;
- bacterial form of chronic prostatitis.
[1]
Release form
Release of the drug is carried out in tablets, 5 pieces inside a blister pack. In the box there are 2 such packages.
Pharmacodynamics
Levofloxacin has a large range of antibacterial effects.
The bactericidal effect is developed by suppression of the bacterium belonging to topoisomerases of the second type by levofloxacin. As a result of such a suppression of DNA, the microbe loses its ability to transition from relaxation to a twisted state. This leads to the prevention of the subsequent division of cells of pathogenic microorganisms.
The range of activity of the drug includes gram-negative and-positive microbes, and in addition non-fermenting microorganisms.
Pharmacokinetics
Suction.
After oral administration, levofloxacin is almost completely and rapidly absorbed. Peak plasma values are recorded after a lapse of 1-2 hours from the time of reception. The level of bioavailability is about 99-100%. Equilibrium indicators are observed for 48 hours, if the dosing regimen is as follows - taking 0.5 g LS 1-2 times / day.
Distribution processes.
About 30-40% levkosa is synthesized with a blood plasma protein. The average value of the distribution volume is approximately 100 liters with a single dose and 0.5 g repeated dosages. This allows us to conclude that the drug is widely distributed inside the tissues.
Passage of the active element into liquids with tissues.
Levofloxacin is seen inside the bronchial mucosa, lung tissue, bronchial secretion, alveolar macrophages, skin (bubble fluid), urine, and prostate tissue. In this case, the substance does not penetrate the liquor well.
Exchange processes.
Only a very small part of levofloxacin undergoes metabolic processes. Its decay products are the elements of dysmethyl-levofloxacin, and in addition levofloxacin N-oxide. These substances account for less than 5% of the total amount of drugs allocated with urine.
Excretion.
After the use of drugs, the substance is excreted from the blood plasma rather slowly (half-life is about 6-8 hours). Excretion is mainly carried out through the kidneys (85% of the intake).
Linearity.
The drug has linear pharmacokinetic parameters in the range of 50-1000 mg portions.
Dosing and administration
Tablets should be eaten once or twice a day. The size of a portion is determined by taking into account the strength of expression and the type of infection. The duration of the course is selected taking into account the course of pathology, but can not be more than 2 weeks.
It is recommended to continue taking the medication at least 48-72 hours after the temperature is stabilized, or microbiological tests confirm the eradication of microbial pathogens.
Tablets should be swallowed without chewing, and at the same time washed down with water. Levox is allowed to be consumed with food or at any other time.
Use of the levox during pregnancy
It is forbidden to prescribe Levoksu during pregnancy or lactation.
Contraindications
The main contraindications:
- the presence of intolerance against levofloxacin or other quinolones;
- epilepsy;
- The presence of side effects in the tendon area as a result of prior use of quinolones.
[6]
Side effects of the levox
The use of medication can cause the emergence of certain side-effects.
Infectious or invasive lesions.
Sometimes mycoses develop (and in addition, there is a proliferation of other resistant bacteria).
Lesions of the subcutaneous layer and skin surface, and also systemic manifestations of hypersensitivity.
Occasionally, redness or itching occurs.
Also, systemic signs of hypersensitivity (anaphylactic, as well as anaphylactoid) are rarely noted - for example, bronchospasm or urticaria. In addition, it is possible to develop severe suffocation, or, extremely rarely, swelling in the mucosa or skin (for example, on the face or pharyngeal mucosa).
Occasionally, the development of intolerance against UV radiation and sunlight was recorded.
Single occurrence of a strong rash on the surface of the skin and mucous membranes (with the formation of blisters), the development of TEN, Stevens-Johnson syndrome and multiform erythema are noted. Before the development of systemic manifestations of hypersensitivity, sometimes there are more mild skin symptoms. Similar signs can develop already after some minutes or hours after reception of 1st portion.
Problems with the function of the gastrointestinal tract, as well as metabolic processes.
Often there is diarrhea or nausea.
Occasionally, vomiting, digestive disorders or abdominal pain may occur, and in addition loss of appetite.
Very rarely there is diarrhea with blood - it can sometimes signal the development of an inflammatory process inside the intestine (for example, the pseudomembranous form of colitis).
The decrease in glucose values inside the blood (development of hypoglycemia) is recorded individually - this can be important for people with diabetes. Among the symptoms of hypoglycemia - increased appetite, sweating, a feeling of nervousness and trembling of the limbs.
For other quinolones, there is evidence that they probably can lead to the development of porphyria attacks in people with this disorder. A similar effect can be observed with levofloxacin.
Violations of the NA function.
Very rarely there are dizziness and headaches, a sensation of numbness or drowsiness, but also a sleep disorder.
Occasionally there are uncomfortable sensations - such as paresthesias in the hands, feelings of anxiety, confusion or fear, tremors and seizures.
Hearing, olfactory, visual and taste disorders were noted. In addition, tactile sensitivity decreased and psychotic manifestations developed (depressive mood and hallucinations). There are violations of motor processes (sometimes when walking), psychotic symptoms with self-destructive behavior (this includes thoughts and actions of suicidal nature), and also polyneuropathy of sensory or sensorimotor type.
Vascular disorders and disorders affecting the work of the heart.
Occasionally, tachycardia appears or the blood pressure drops.
The collapse is similar to the shock state, the blood pressure drops sharply and the QT-interval is prolonged.
Lesions affecting the connective tissue, as well as the structure of the musculature and bones.
Occasionally, lesions affecting tendons (for example, inflammatory processes) are noted, as well as pain sensations in the muscles or joints.
Very rarely there is a rupture of the tendon (for example, Achilles). This side symptom can develop during the first 48 hours from the start of therapy and affect the achilles on both legs. There may be weakness in the muscles, which is extremely important for people with a serious stage of myasthenia gravis.
Muscular lesions are recorded single-handedly (such as rhabdomyolysis).
Disorders in the system of urination and kidneys, as well as hepatobiliary disorders.
Often there is an increase in the values of liver enzymes (such as ALT or AST).
Occasionally, the values of bilirubin with creatinine in the blood serum increase.
Hepatic disturbances develop (for example, inflammation), and in addition deterioration of renal activity, up to insufficiency of the kidneys in acute form - for example, due to the development of allergies (tubulointerstitial nephritis).
Lesions affecting the lymph and hematopoietic system.
Sometimes the number of certain blood cells (the development of eosinophilia) or the number of leukocytes (the development of leukopenia) may increase.
Occasionally, there is a decrease in the number of certain leukocytes (development of neutropenia) or the number of platelets (development of thrombocytopenia), which may increase the tendency to bleeding or hemorrhage.
Very rarely there is a significant decrease in the number of certain leukocytes (development of agranulocytosis), which can lead to severe clinical symptoms (pharyngitis, a prolonged or recurrent form of fever, and in addition a feeling of malaise).
The decrease in the number of erythrocytes due to their destruction (the development of the hemolytic form of anemia) was recorded individually, and in addition the decrease in the number of all types of blood cells (development of pancytopenia).
Other negative signs.
Occasionally there is a feeling of general weakness (development of asthenia).
Very rarely develops fever, as well as allergy symptoms in the lungs (pneumonitis of allergic origin) or small blood vessels (development of vasculitis). The use of any antibacterial medicines can cause disorders associated with their impact on a healthy human microflora. Because of this, an infection of a secondary nature may occur, at which auxiliary therapy is required.
Other negative manifestations associated with the use of fluoroquinolone:
- extrapyramidal disorders and other problems with motor coordination;
- vasculitis of the hypersensitive type;
- in people suffering from porphyria, there are seizures of this disease.
[7],
Overdose
When the drug is poisoned by the drug, the function of the central nervous system is affected (among the symptoms - dizziness, sensation of confusion, and in addition, seizures and a disorder of consciousness) and there are manifestations on the part of the digestive organs (erosion in the mucous and nausea). Data from clinical trials showed that overdose may prolong the QT interval.
When intoxication, you need to closely monitor the patient's condition and monitor the ECG readings. Symptomatic measures are also carried out. In acute poisoning, gastric lavage is performed. To protect the gastric mucosa, use antacids. Procedures for hemodialysis, including peritoneal dialysis or HAD, do not promote levofloxacin excretion. The medication does not have an antidote.
Interactions with other drugs
Adsorption of the drug is significantly reduced when combined with aluminum and magnesium-containing antacids, and in addition to drugs containing iron salts. It is required to withstand a minimum of 2-hour interval between applications of LAN data.
The bioavailability of the drug is significantly reduced when combined with sucralfate. Because of this, you must observe a minimum 2-hour interval between the administration of these drugs.
Although the drug tests did not reveal the interaction between Levoksa and theophylline, a significant reduction in the convulsive threshold may occur with the combination of quinolones with NSAIDs, theophylline and other agents that lower the border of the convulsive threshold.
The rates of levofloxacin in combination with fenbufen are increased by approximately 13%.
Cimetidine with probenecid has a statistically significant effect on the process of excretion of levofloxacin. The level of renal clearance of the drug is reduced by 34% (with probenecid) and by 24% (with cimetidine). This allows both drugs to block the excretion of the Levoksa tubules.
The half-life of cyclosporine is increased by 33% in the case of application with levofloxacin.
Combination with vitamin K antagonists (eg, warfarin) increases the coagulation assays (IF / INR) or leads to an increase in the severity of bleeding. In this regard, people taking antagonists of the vitamin K group, along with Levoksa, should monitor coagulation values.
It is forbidden to apply the drug in combination with alcoholic beverages.
Storage conditions
Levoksa should be kept in a dark place, closed from penetration of moisture. The temperature level is not more than 25 ° C.
[17]
Shelf life
Levoksa can be used for 3 years since the release of the drug.
[18]
Application for children
Contraindicated use of medication in adolescents and children.
Analogues
Analogues of the drug are Levot, Flaprox and Rotomox with Ciprofloxacin, and in addition, Ciprolet and Ofloxacin with Ciprofloxacin-Solopharm.
[19]
Attention!
To simplify the perception of information, this instruction for use of the drug "Levox" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.