Cravit/Cravit IV Drug Interactions

Levofloxacin has potential to form stable coordination compounds with many metal ions. This in-vitro chelation potential has the following formation with Al⁺³>Cu⁺²>Zn⁺²>Mg⁺²>Ca⁺². Antacids containing alumunium or magnesium and drugs containing iron decrease absorption of CRAVIT. The administration of these drugs is recommended at least 2 hours before or after CRAVIT administration.
The concomitant administration of a non-steroidal anti-inflammatory drug with a quinolone, including CRAVIT, may increase the risk of CNS stimulation and convulsive seizures.
Anti-diabetic agents: Disturbances of blood glucose, including hyperglycaemia and hypoglycaemia. Therefore, careful monitoring of blood glucose is recommended when these agents are co-administered.
Levofloxacin may inhibit the growth of Mycobacterium tuberculosis, and therefore, may give false-negative results in the bacteriological diagnosis of tuberculosis.
Warfarin: No significant effect of levofloxacin on the peak plasma concentration, 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 absorption and disposition was observed. However, there have been reports during the postmarketing experience in patients that levofloxacin enhances the effects of warfarin. Elevations of the prothrombin time in the setting of concurrent warfarin and levofloxacin use have been associated with episodes of bleeding. Prothrombin time, International Normalized Ratio (INR), or the suitable anticoagulation tests should be closely monitored if levofloxacin is administered concomitantly with warfarin. Patient should also be monitored for evidence of bleeding.
Theophylline: No significant effect of levofloxacin on the plasma concentrations, AUC, and other disposition parameters for theophylline was detected in a clinical study involving healthy volunteers. Similarly, no apparent effect of theophylline on levofloxacin absorption and disposition was observed. However, concomitant administration of other fluoroquinolones with theophylline has resulted in prolonged elimination half-life, elevated serum theophylline levels, and a subsequent increase in the risk of theophylline -related adverse reaction in the patient population. Therefore, theophylline levels should be closely monitored and appropriate dosage adjustments made when levofloxacin is coadministered. Adverse reactions, including seizures, may occur with or without an elevation in serum theophylline levels.