Dosage of Levofloxacin 0.5.% Ohara in details
Dosage in Adult Patients with Normal Renal Function
The usual dose of Levofloxacin 0.5.% Ohara Tablets, USP is 250 mg, 500 mg, or 750 mg administered orally every 24 hours, as indicated by infection and described in Table 1.
These recommendations apply to patients with creatinine clearance ≥ 50 mL/min. For patients with creatinine clearance <50 mL/min, adjustments to the dosing regimen are required.
Dosage in Pediatric Patients
The dosage in pediatric patients ≥ 6 months of age is described below in Table 2.
Dosage Adjustment in Adults with Renal Impairment
Administer Levofloxacin 0.5.% Ohara Tablets, USP with caution in the presence of renal insufficiency. Careful clinical observation and appropriate laboratory studies should be performed prior to and during therapy since elimination of Levofloxacin 0.5.% Ohara may be reduced.
No adjustment is necessary for patients with a creatinine clearance ≥ 50 mL/min.
In patients with impaired renal function (creatinine clearance <50 mL/min), adjustment of the dosage regimen is necessary to avoid the accumulation of Levofloxacin 0.5.% Ohara due to decreased clearance.
Table 3 shows how to adjust dose based on creatinine clearance.
Drug Interaction With Chelation Agents: Antacids, Sucralfate, Metal Cations, Multivitamins
Levofloxacin 0.5.% Ohara Tablets
Levofloxacin 0.5.% Ohara Tablets, USP should be administered at least two hours before or two hours after antacids containing magnesium, aluminum, as well as sucralfate, metal cations such as iron, and multivitamin preparations with zinc or didanosine chewable/buffered tablets or the pediatric powder for oral solution.
Food and Levofloxacin 0.5.% Ohara Tablets, USP
Levofloxacin 0.5.% Ohara Tablets, USP can be administered without regard to food.
Hydration for Patients Receiving Levofloxacin 0.5.% Ohara Tablets, USP
Adequate hydration of patients receiving oral Levofloxacin 0.5.% Ohara Tablets, USP should be maintained to prevent the formation of highly concentrated urine. Crystalluria and cylindruria have been reported with quinolones.
What other drugs will affect Levofloxacin 0.5.% Ohara?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Levofloxacin 0.5.% Ohara, especially:
a diuretic or "water pill";
heart rhythm medication--amiodarone, disopyramide, dofetilide, dronedarone, procainamide, quinidine, sotalol, and others;
medicine to treat depression or mental illness--amitriptylline, clomipramine, desipramine, iloperidone, imipramine, nortriptyline, and others; or
NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
This list is not complete. Other drugs may interact with Levofloxacin 0.5.% Ohara, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Levofloxacin 0.5.% Ohara interactions
There are no data concerning an interaction of quinolones IV with oral antacids, sucralfate, multivitamins, didanosine or metal cations. However, no quinolone should be co-administered with any solution containing multivalent cations eg, magnesium, through the same IV line.
Theophylline: No significant effect of Levofloxacin 0.5.% Ohara on the plasma concentrations, AUC and other disposition parameters for theophylline was detected in a clinical study involving 14 healthy volunteers. Similarly, no apparent effect of theophylline on Levofloxacin 0.5.% Ohara absorption and disposition was observed. However, concomitant administration of other quinolones with theophylline has resulted in prolonged elimination half-life, elevated serum theophylline levels and a subsequent increase in the risk of theophylline-related adverse reactions in the patient population. Therefore, theophylline levels should be closely monitored and appropriate dosage adjustments made when Levofloxacin 0.5.% Ohara is co-administered. Adverse reactions, including seizures, may occur with or without an elevation in serum theophylline levels.
Warfarin: No significant effect of Levofloxacin 0.5.% Ohara on the Cmax, AUC and other disposition parameters for R- and S-warfarin was detected in a clinical study involving healthy volunteers. Similarly, no apparent effect of warfarin on Levofloxacin 0.5.% Ohara absorption and disposition was observed. There have been reports during the postmarketing experience in patients that Levofloxacin 0.5.% Ohara enhances the effects of warfarin. Elevations of the prothrombin time in the setting of concurrent warfarin and Levofloxacin 0.5.% Ohara use have been associated with episodes of bleeding. Prothrombin time, INR or other suitable anticoagulation tests should be closely monitored if Levofloxacin 0.5.% Ohara is administered concomitantly with warfarin. Patients should also be monitored for evidence of bleeding.
Cyclosporine: No significant effect of Levofloxacin 0.5.% Ohara on the Cmax, AUC and other disposition parameters for cyclosporine was detected in a clinical study involving healthy volunteers. However, elevated serum levels of cyclosporine have been reported in the patient population when co-administered with some other quinolones. Levofloxacin 0.5.% Ohara Cmax and ke were slightly lower while Tmax and t½ were slightly longer in the presence of cyclosporine than those observed in other studies without concomitant medication. The differences, however, are not considered to be clinically significant. Therefore, no dosage adjustment is required for Levofloxacin 0.5.% Ohara or cyclosporine when administered concomitantly.
Digoxin: No significant effect of Levofloxacin 0.5.% Ohara on the Cmax, AUC and other disposition parameters for digoxin was detected in a clinical study involving healthy volunteers. Levofloxacin 0.5.% Ohara absorption and disposition kinetics were similar in the presence or absence of digoxin. Therefore, no dosage adjustment for Levofloxacin 0.5.% Ohara or digoxin is required when administered concomitantly.
Probenecid and Cimetidine: No significant effect of probenecid or cimetidine on the rate and extent of Levofloxacin 0.5.% Ohara absorption were observed in a clinical study involving healthy volunteers. The AUC and t1/2 of Levofloxacin 0.5.% Ohara were 27-38% and 30% higher, respectively, while CL/F and CLR were 21-35% lower during concomitant treatment with probenecid or cimetidine compared to Levofloxacin 0.5.% Ohara alone. Although these differences were statistically significant, the changes were not high enough to warrant dosage adjustment for Levofloxacin 0.5.% Ohara when probenecid or cimetidine is co-administered.
Nonsteroidal Anti-Inflammatory Drugs: The concomitant administration of a nonsteroidal anti-inflammatory drug with a quinolone, including Levofloxacin 0.5.% Ohara, may increase the risk of CNS stimulation and convulsive seizures.
Antidiabetic Agents: Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. Therefore, careful monitoring of blood glucose is recommended when these agents are co-administered.
- PubMed Health. "Levofloxacin (Into the eye): This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhealth... (accessed September 18, 2017).
- FDA/SPL Indexing Data. "RIX4E89Y14: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/DataStan... (accessed September 18, 2017).
ReviewsThe results of a survey conducted on ndrugs.com for Levofloxacin 0.5.% Ohara are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Levofloxacin 0.5.% Ohara. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.
Information checked by Dr. Sachin Kumar, MD Pharmacology