Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For levofloxacin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to levofloxacin, other fluoroquinolones, or chemically related quinolone derivatives (e.g., nalidixic acid). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in humans. However, this medicine has been shown to cause problems with bone development in young animals. Discuss with your doctor whether or not this medicine should be taken during pregnancy.

Breast-feeding—It is not known whether levofloxacin passes into human breast milk. However, this medicine has been shown to cause bone development problems in young animals. Discuss with your doctor whether to breast-feed during treatment with this medicine.

Children—Caution is recommended in using levofloxacin in children up to 18 years of age because this medicine has been shown to cause bone development problems in young animals. However, your doctor may choose to use this medicine if other medicines cannot be used.

Older adults—There is no specific information comparing use of levofloxacin in the elderly with use in other age groups. However, it has been used in older people and has not been found to cause different side effects or other problems than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking levofloxacin, it is especially important that your health care professional know if you are taking any of the following:

• Antiarrhythmic agents (medicine for abnormal heart rhythm)—Levofloxacin may cause changes in heart rhythm when taken with these drugs

• Antidiabetic agents (medicine for sugar diabetes)—Levofloxacin may change the effects of these drugs, which could cause problems in controlling blood sugar

• Antacids, aluminum-, calcium-, or magnesium-containing or
• Iron supplements or
• Sucralfate (e.g., Carafate) or
• Zinc—Antacids, iron, sucralfate, or zinc may interfere with absorption of levofloxacin into the body

• Inflammation or pain medicine, except narcotics—Possible increased risk of convulsions (seizures)

Other medical problems—The presence of other medical problems may affect the use of levofloxacin. Make sure you tell your doctor if you have any other medical problems, especially:

• Brain or spinal cord disease, including hardening of the arteries in the brain, or epilepsy or other seizures—Levofloxacin may increase the chance of convulsions (seizures) occurring

• Diabetes mellitus (sugar diabetes)—Levofloxacin may cause changes in blood sugar, which could lead to problems in controlling blood sugar

• Kidney disease—Effects may be increased because of slower removal of levofloxacin from the body