Levofloxacin: Uses, Dosage, Side Effects, Precautions and Price in India

Levofloxacin is a prescription antibiotic used for certain bacterial infections. It can cause serious, sometimes long-lasting side effects, so it should be used only under qualified medical supervision. This article explains what it is used for, how it is taken, its risks, and its approximate cost in India.

Levofloxacin at a Glance

What Is Levofloxacin?

Levofloxacin is a fluoroquinolone antibiotic. It treats infections caused by susceptible bacteria. It is not for the common cold, flu or other viral infections, and you cannot tell from symptoms alone whether an antibiotic is needed. A doctor must make that decision.

How Levofloxacin Works

Levofloxacin inhibits the DNA gyrase enzyme in bacteria, which is crucial for DNA replication and repair. By disrupting bacterial DNA synthesis, it kills the bacteria and helps clear the infection.

When Levofloxacin Is Used

The US label lists these uses, which a doctor may consider when bacteria are susceptible

• Respiratory infections: pneumonia, flare-ups of chronic bronchitis (acute bacterial exacerbation), and acute bacterial sinusitis.
• Urinary tract infections (UTIs): complicated UTIs, kidney infection (acute pyelonephritis) and uncomplicated UTIs.
• Skin and soft tissue infections.
• Chronic bacterial prostatitis.
• Inhalational anthrax (after exposure) and plague.

Important: the US label says levofloxacin should be reserved for uncomplicated UTI, flare-ups of chronic bronchitis and acute bacterial sinusitis only when a patient has no alternative treatment options, because of the risk of serious side effects. This is US labelling. Indian approvals could not be checked.

Levofloxacin Dosage and How to Take It

The dose and duration are set by your doctor. They depend on the type and severity of the infection, kidney function, your age and health, and the approved product information. The US label describes once-every-24-hours regimens of different strengths and lengths (for example, short courses for some urinary infections and longer ones for prostatitis or anthrax), so there is no single dose that suits every infection. A broad range such as “250 to 750 mg” is not a regimen for any individual.

If kidney function is reduced (creatinine clearance below 50 mL/min), the US label says the dosing regimen must be adjusted so the medicine does not build up.

Take this medicine only as advised by your doctor or healthcare professional. Do not start, stop, or change the dose on your own, and do not extend treatment without medical advice.

• Tablets can be taken with or without food. The liquid should be taken 1 hour before or 2 hours after eating.
• Take each dose at around the same time every day.
• Drink plenty of fluids during treatment.
• Take antacids, vitamins or mineral supplements containing aluminium, magnesium, iron or zinc at least 2 hours before or 2 hours after levofloxacin.

Following the prescribed course. Follow the treatment plan your doctor has given you. The exception is a suspected serious reaction (see below). In that case, stop levofloxacin right away and get medical help. Do not restart it on your own. Your doctor will decide how to treat the infection.

Side Effects of Levofloxacin

Common side effects

• Nausea, vomiting, diarrhea
• Stomach pain, constipation, heartburn
• Headache, dizziness
• Vaginal itching or discharge

Levofloxacin Serious Side Effects and Warnings

Levofloxacin carries a boxed warning (the US regulator’s strongest warning) about serious reactions that can be disabling and potentially irreversible: tendon inflammation and rupture, nerve damage (peripheral neuropathy), effects on the brain and nervous system, and worsening of muscle weakness in myasthenia gravis. The US label says to discontinue levofloxacin immediately if any of these reactions occur, and to avoid fluoroquinolones afterwards.

Stop taking levofloxacin and seek urgent medical assessment if you notice:

• Pain, swelling, inflammation or stiffness in a tendon (such as the back of the ankle). Rest the area and do not exercise it.
• Numbness, tingling, pain or weakness in the arms, legs, hands or feet.
• Seizures, tremors, hallucinations, severe headache, dizziness, or mood or behaviour changes, including thoughts of self-harm.
• Worsening muscle weakness or breathing difficulty (especially in people with myasthenia gravis).
• Rash, hives, peeling or blistering skin, or fever.
• Fainting or a fast, pounding or irregular heartbeat.
• Yellow skin or eyes, dark urine, or unusual bruising or bleeding.
• Severe diarrhea, which can start up to 2 months or more after treatment.

Get emergency medical care immediately for:

• A snap or pop in a tendon, bruising, or being unable to bear weight
• Swelling of the face, lips or throat, or trouble breathing or swallowing
• A seizure
• Sudden chest, stomach or back pain (levofloxacin carries a warning about aortic aneurysm and dissection)
• Trouble breathing from muscle weakness

Do not try to manage these reactions at home or wait to see whether they settle.

Levofloxacin Precautions

Contraindication: known hypersensitivity (allergy) to levofloxacin or other quinolone antibiotics.

Levofloxacin Precautions

• Myasthenia gravis: levofloxacin can worsen muscle weakness. The 2018 US boxed warning advised avoiding it in people with a known history of myasthenia gravis.
• Kidney impairment: the dose needs adjustment (see Dosage).
• Tendon injury: higher risk in people over 60 and in those taking corticosteroids.
• Heart rhythm (QT prolongation): tell your doctor about any heart rhythm problem or low potassium. Older patients may be more susceptible.
• Blood sugar: levofloxacin can disturb blood sugar. Tell your doctor if you have diabetes.
• Liver: tell your doctor about any liver disease. The US label reports that most fatal liver reactions involved patients aged 65 and older.
• Sun sensitivity: avoid unnecessary sun exposure and tanning beds, and use sunscreen and protective clothing.
• Driving: do not drive or operate machinery until you know how it affects you.

Levofloxacin Drug Interactions

• Antacids (magnesium or aluminium), sucralfate, iron, zinc multivitamins and didanosine: take levofloxacin at least 2 hours before or 2 hours after them.
• Warfarin: the label advises monitoring PT/INR and watching for bleeding.
• Diabetes medicines: monitoring of blood sugar is advised, as both low and high levels have been reported.
• NSAIDs (such as ibuprofen and naproxen): may increase the risk of CNS stimulation and seizures.
• Other medicines that prolong the QT interval: levofloxacin should be used with caution or avoided depending on your heart condition.

These interactions differ in importance. Tell your doctor or pharmacist about all prescription medicines, OTC medicines, supplements and herbal products you use.

Levofloxacin in Children, Pregnancy and Breastfeeding

The following describes the US label. Indian approvals could not be checked.

• Children: the US label approves levofloxacin in children only for inhalational anthrax (after exposure) and plague, from age 6 months. Tablets are not for children under 30 kg because of the available strength, and a higher rate of muscle and joint problems has been seen in children. A doctor must decide on any use in a child.
• Pregnancy: tell your doctor if you are pregnant or planning a pregnancy. The current US label states that published data have not identified a drug-associated risk of major birth defects or miscarriage. Whether to use it is a decision for your doctor.
• Breastfeeding: the current US label says breastfeeding is not recommended during treatment and for 2 days after the last dose (or milk may be pumped and discarded). For post-exposure anthrax, it may be acceptable after a risk-benefit assessment by the doctor.
• Older adults: see Precautions (tendons, liver, heart rhythm).

Levofloxacin Price in India

Brands with Indian pharmacy listings (500 mg tablets):

Listing manufacturers: Levoday, Zydus Healthcare Ltd (Truemeds); Loxof, Ranbaxy Laboratories (Sun Pharma) (PharmEasy).

Approximate MRP ranges (listed MRP with a ±₹5 buffer, not selling prices):

• Levoday 500 mg, 10 tablets: about ₹91 to ₹108
• Loxof 500 mg, 5 tablets: about ₹96 to ₹106 (currently shown out of stock)

Prices checked on 12 October 2026. Prices and availability vary by pharmacy, location, date and discounts. This article is not a recommendation to buy or use the medicine without a prescription.

How HealthPil Can Help

Medicines should be started, adjusted, or stopped only under the guidance of a qualified healthcare professional. If you have questions about this medicine, its side effects, or your treatment plan, you can consult a doctor through HealthPil.