Levofloxin-Natrapharm Dosage/Direction for Use

Levofloxacin tablets may be given without regard to meals, antacids containing magnesium or aluminum, sucralfate, metal cations such as iron or zinc, and buffered didanosine may interfere with oral absorption of levofloxacin resulting in subtherapeutic systemic concentrations of the quinolone. To minimize the possibility of an interaction, patients should be instructed not to ingest antacids containing magnesium or aluminum, sucralfate, metal cations such as iron or zinc (including multivitamin preparations containing zinc), or buffered didanosine (pediatric oral solution admixed with antacids) concomitantly with or within 2 hours of a levofloxacin oral dose.
Respiratory Tract Infections: Acute Sinusitis: 500 mg once every 24 hours for 10-14 days. Alternatively, a dosage of 750 mg once every 24 hours for 5 days can be used.
Acute Exacerbations of Chronic Bronchitis: 500 mg once every 24 hours for 7 days.
For the treatment of community-acquired pneumonia (CAP), the usual adult dosage of levofloxacin is 500mg once every 24 hours for 7-14 days. Alternatively, a dosage of 750 mg once every 24 hours for 5 days can be used for treatment of CAP caused by S. pneumoniae (penicillin-susceptible strains), Haemophilus influenzae, H. parainfluenzae, Chlamydophila pneumoniae, or Mycoplasma pneumoniae.
When used in empiric regimens for the treatment of CAP or for treatment of CAP caused by Pseudomonas aeruginosa, the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) recommend that levofloxacin be given in a dosage of 750 mg once daily. IDSA and ATS state that CAP should be treated for a minimum of 5 days and patients should be afebrile for 48-72 hours before discontinuing anti-infective therapy.
Nosocomial Pneumonia: 750 mg once every 24 hours for 7-14 days.
Urinary Tract Infections and Prostatitis: 250 mg once every 24 hours for 3 days.
For the treatment of complicated urinary tract infections or acute pyelonephritis, the usual adult dosage of levofloxacin is 250 mg once every 24 hours for 10 days. Alternatively, adults can receive 750 mg once every 24 hours for 5 days for the treatment of complicated urinary tract infections caused by E. coli, K. pneumoniae, or P. mirabilis or for the treatment of acute pyelonephritis caused by E. coli.
Chronic prostatitis: 500 mg once every 24 hours for 28 days.
Anthrax: If oral levofloxacin is used for post exposure prophylaxis following suspected or confirmed exposure to aerosolized anthrax spores (inhalational anthrax), the usual adult dosage is 500 mg once daily and the usual dosage in children 6 months of age or older is 500 mg once daily in those weighing more than 50 kg and 8 mg/kg (not to exceed 250 mg per dose) every 12 hours in those weighing less than 50 kg. This same dosage is recommended if oral levofloxacin is used as an alternative for the treatment of anthrax when a parenteral regimen is not available (e.g., when there are supply or logistic problems because large numbers of individuals require treatment in a mass casualty setting).
Chlamydial Infections: 500 mg once daily for 7 days.
Gonorrhea and Associated Infections: Uncomplicated or Disseminated Gonorrhea, of uncomplicated cervical, urethral, or rectal gonorrhea caused by susceptible Neisseria gonorrhoeae, a single 250 mg dose of oral levofloxacin has been used in adults and adolescents. Epididymitis caused by sexually transmitted enteric bacteria (e.g., Escherichia coli) or when culture or nucleic acid amplification tests are negative for N. gonorrhoeae, a dosage of 500 mg of levofloxacin once daily for 10 days has been recommended by the CDC and others. Levofloxacin should not be used for treatment of epididymitis if N. gonorrhoeae may be involved. Mycobacterial Infections Levofloxacin must be used in conjunction with other antituberculosis agents.
Nongonococcal Urethritis 500 mg once daily for 7 days. Pelvic Inflammatory Disease the drug should be given in a dosage of 500 mg once daily for 14 days with or without oral metronidazole (500 mg twice daily for 14 days). Levofloxacin should only be used for treatment of PID when cephalosporins are not feasible.
Travelers' Diarrhea: 500mg of oral levofloxacin once daily for 1-3 days.
Dosage in Renal and Hepatic Impairment: Dosage of levofloxacin should be modified according to the degree of renal impairment in adults with creatinine clearances less than 50 mL/minute. When used for the treatment of urinary tract infections in adults, levofloxacin dosage does not need to be modified when used for uncomplicated urinary tract infections in those with creatinine clearances of 10-49 mL/minute or complicated urinary tract infections or acute pyelonephritis in those with creatinine clearances of 20 mL/minute or greater.
There are no dosage recommendations for pediatric patients with renal insufficiency. (See Table.)

Click on icon to see table/diagram/image

Additional supplemental doses of levofloxacin are not necessary after dialysis or CAPD procedures. Adjustment of levofloxacin dosage in patients with hepatic insufficiency would not be expected to be necessary because most of the drug is excreted unchanged in urine.