Parenteral Manual

Levofloxacin

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
LEVAQUIN
Classification: 
Quinolone Antibiotic
Original Date: 
December 2009
Revised Date: 
November 2021
Indications: 
  • Broad spectrum antibiotic indicated for treatment of infections due to susceptible organisms when oral route is not feasible.
Reconstitution and Stability: 
  • Available in bags of 5 mg/mL solution premixed in D5W
  • Bags stable in fridge or at room temperature
  • Keep infusion bags in overwrap until ready to use -protect from light
  • Solution is clear and yellow to greenish yellow -does not adversely affect product
  • Syringes or part bags stable 24 hrs refrigerated
Compatibility: 

-Solutions Compatible:  NS, D5W, D5W-NS, D5W-ringer's lactate

-Additive/Above Cassette Compatible:  should not be admixed with other drugs or infused simultaneously through the same tubing with other drugs.  Flush tubing before and after administration of other drugs

-Incompatible:  Sodium bicarbonate, mannitol, multivalent cations ( ie. Zinc, Magnesium, Calcium)

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion YES
Usual dilution:  5 mg/mL
Infusion time:  for doses  500 mg and less  -over 60 minutes
                        for doses greater than 500 mg  -over 90 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:

  • 6 months - 5 years:  10 mg/kg/dose Q12H
  • Greater than 5 years:  10 mg/kg/dose Q24H.  Maximum dose 750 mg

Adult:

  • 250 -750 mg IV Q24H depending on indication

Dosing in Renal Impairment in Adults:

  •  adjust dose according to the type of infection
    CrCl (mL/min):  20-49      dose 250 mg Q24H - 750 mg Q48H
                               <20              250 mg - 500 mg Q48H
Potential hazards of parenteral administration: 
  • Hypotension with rapid or bolus injection, QT prolongation and arrythmias
  • Central nervous system:   dizziness, fever, headache, insomnia
  • Dermatologic:  photosensitivity , pruritus, urticaria, rash
  • Gastrointestinal:  nausea, vomiting, diarrhea, constipation
  • Neuromuscular & skeletal:  tremor, arthralgia,  tendonitis
  • Endocrine:  hypoglycemia, hyperglycemia
  • Injection site reactions:  pain, inflammation
  • Hypersensitivity reactions and anaphylaxis;  discontinue therapy if rash or any symptoms develop
Notes: 
  • Limited information regarding use in pediatric patients
  • Patient should be well hydrated to prevent crystalluria
  • Use with caution in patients predisposed to seizures

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