Levofloxacin

General Toxicity Notes
Most agents in this group are malabsorbed in the presence of compounds that contain metals such as magnesium, calcium, aluminum, and iron. Poorly absorbed with antacids, sucralfate, and phosphate binders.
Excreted Unchanged %
67-87
Half-Life (Normalesrd) Hours
4-8/76
Plasma Protein Binding %
24-38
Volume Of Distribution L/Kg
1.1-1.5
Dose For Normal Renal Function
250-750 mg q24h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
250-750 mg q24-48h (500-750 mg initial dose) [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
250-500 mg q48h (500 mg initial dose) [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: 500 mg q48h, [A]
References
Bellmann R, Egger P, Gritsch W, Bellmann-Weiler R, Joannidis M, Dunzendorfer S, et al. Elimination of levofloxacin in critically ill patients with renal failure: influence of continuous veno-venous hemofiltration. Int J Clin Pharmacol Ther. 2002; 40: 142-9. [PMID: 11996208] / Choi G, Gomersall CD, Lipman J, Wong A, Joynt GM, Leung P, et al. The effect of adsorption, filter material and point of dilution on antibiotic elimination by haemofiltration an in vitro study of levofloxacin. Int J Antimicrob Agents. 2004; 24: 468-72. [PMID: 15519479] / Davis R, Bryson HM. Levofloxacin. A review of its antibacterial activity, pharmacokinetics and therapeutic efficacy. Drugs. 1994; 47: 677-700. [PMID: 7516863] / Fillastre JP, Leroy A, Moulin B, Dhib M, Borsa-Lebas F, Humbert G. Pharmaco-kinetics of quinolones in renal insufficiency. J Antimicrob Chemother. 1990; 26 Suppl B: 51-60. [PMID: 2124213] / Gisclon LG, Curtin CR, Chien SC, et al. The pharmacokinetics of levofloxacin in subjects with renal impairment, and in subjects receiving hemodialysis or continuous ambulatory peritoneal dialysis [Abstract]. Abstr Intersci Conf Antimicrob Agents Chemother. 1996; 36: abstr A013. / Goodwin SD, Gallis HA, Chow AT, Wong FA, Flor SC, Bartlett JA. Pharmacokinetics and safety of levofloxacin in patients with human immunodeficiency virus infection. Antimicrob Agents Chemother. 1994; 38: 799-804. [PMID: 8031049] / Guenter SG, Iven H, Boos C, Bruch HP, Muhl E. Pharmacokinetics of levofloxacin during continuous venovenous hemodiafiltration and continuous venovenous hemofiltration in critically ill patients. Pharmacotherapy. 2002; 22: 175-83. [PMID: 11837556] / Hansen E, Bucher M, Jakob W, Lemberger P, Kees F. Pharmacokinetics of levofloxacin during continuous veno-venous hemofiltration. Intensive Care Med. 2001; 27: 371-5. [PMID: 11396281] / Malone RS, Fish DN, Abraham E, Teitelbaum I. Pharmacokinetics of levofloxacin and ciprofloxacin during continuous renal replacement therapy in critically ill patients. Antimicrob Agents Chemother. 2001; 45: 2949-54. [PMID: 11557500] / Saito A, Oguchi K, Harada Y, et al. Pharmacokinetics of levofloxacin in patients with impaired renal function. Chemotherapy. 1992; 40(Suppl 3): 188-95. [PMID unavailable]