Levaquin Warnings and Precautions

Before you start treatment with Levaquin, warnings and precautions for the drug should be reviewed with your healthcare provider to help minimize complications. Levaquin may cause tendon rupture, liver damage, nerve problems, and central nervous system problems. Since certain conditions may increase the risk of these problems, be sure to tell your healthcare provider about all existing medical conditions you have before taking Levaquin.

What Should I Tell My Healthcare Provider Before Taking Levaquin?

You should talk with your healthcare provider prior to taking Levaquin® (levofloxacin) if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings for Levaquin

Some warnings and precautions to be aware of with Levaquin include the following:
 
  • Levaquin can cause severe allergic reactions. Seek immediate medical attention if you develop any signs of an allergic reaction, such as a rash or hives, itching, swelling of the lips or throat, wheezing, or difficulty breathing.
     
  • There have been reports of liver damage possibly caused by Levaquin. Let your healthcare provider know if you develop any signs of a liver problem, such as upper right abdominal pain, yellow eyes or skin (jaundice), dark urine, or light-colored stools.
     
  • Levaquin and other similar antibiotics can cause rupture of tendons, including shoulder, hand, or Achilles tendons. This can be disabling and can require surgical repair. Let your healthcare provider know right away if you develop tendon soreness or pain.

Do not exercise until your healthcare provider makes sure you do not have a ruptured tendon. This problem can occur while you are taking the medication or even months later.  

  • People who are over 60 years old, who have had liver, lung, or heart transplants, or who take corticosteroid drugs are at an increased risk for tendon rupture. People with kidney disease, those who exercise vigorously, and people with rheumatoid arthritis (or other tendon disorders) may also be at a higher risk.

 

  • Levaquin can cause central nervous system problems, such as seizures, tremors, restlessness, anxiety, lightheadedness, confusion, hallucinations, paranoia, depression, nightmares, insomnia, and suicidal thoughts or acts. Certain conditions (including epilepsy, cerebral arteriosclerosis, and kidney disease) may increase the risk of these problems.

 

  • Pseudotumor cerebri, a condition involving high pressure inside the cranium, has been reported rarely in people taking this medication. Let your healthcare provider know if you develop signs of this condition, such as:
     
    • Nausea
    • Vomiting
    • Headaches
    • Vision changes. 

 

  • Let your healthcare provider know if you experience bloody or watery diarrhea. While diarrhea is a common side effect of Levaquin, bloody or watery diarrhea may be a sign of a serious reaction to Levaquin that can occur when certain bacteria (Clostridium difficile) overgrow in the colon. This severe reaction can occur long after you stop taking Levaquin and can be life-threatening.
     
  • Levaquin can cause nerve problems. Be sure to tell your healthcare provider if you develop any unusual sensations (such as numbness, burning, or tingling) while taking Levaquin.
     
  • Levaquin can cause a change in the heart rhythm known as QT prolongation. This can be dangerous and may be more common in people with low blood potassium and in those taking certain arrhythmia medications (see Levaquin Interactions).

 

  • Levaquin (as well as all other fluoroquinolone antibiotics) can cause worsening of myasthenia gravis symptoms, such as muscle weakness and breathing problems. This is a serious occurrence, which can be life-threatening. In severe cases, this can result in the need to be put on a ventilator, or even death. Levaquin should be avoided in people with a known history of myasthenia gravis. 

 

  • The medication can cause muscle, joint, or tendon problems in children. Levaquin is not approved to be used in children except to prevent infection after anthrax exposure or to treat or prevent plague.
     
  • Levaquin can cause changes in blood sugar (both high and low) in people with diabetes. If you have diabetes, you may need to monitor your blood sugar more closely while taking this drug.
     
  • People taking this drug may become more sensitive to the sun. Try to avoid excessive sun exposure while taking the medication.
     
  • Levaquin can cause false positives for opiates on some drug tests.
     
  • Overuse of antibiotics (including Levaquin) increases the risk for developing antibiotic-resistant bacteria. Your healthcare provider should prescribe antibiotics only when necessary (and only to treat bacterial infections). Antibiotics are not effective for treating viral infections, such as the common cold or the flu.
     
  • Make sure your healthcare provider knows if you have kidney disease, as you may need a lower Levaquin dosage.
     
  • Sometimes, antibiotics (including Levaquin) can cause yeast infections, since they can get rid of "good" bacteria that help protect against yeast infections. Let your healthcare provider know if you develop a vaginal yeast infection or thrush (a yeast infection of the mouth) while taking Levaquin.
     
  • It is very important to take Levaquin exactly as prescribed. Skipping doses or stopping Levaquin too early (even if you feel better) can lead to bacterial resistance to Levaquin.
     
  • Levaquin can interact with other medications (see Levaquin Interactions).
     
  • This drug is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using Levaquin during pregnancy (see Levaquin and Pregnancy for more information).
     
  • This medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to talk with your healthcare provider about using Levaquin (see Levaquin and Breastfeeding for more information).
     
 
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