Fluoning (Levofloxacin)

Active Ingredient: Levofloxacin
Dosage: 500 mg
Route of Administration: Oral
Dosage Form: Tablets
Quantity per package: 7 tablets per pack

Fluoning (levofloxacin) is an antibacterial agent. It is used to treat pyelonephritis and complicated infections of the urinary tract, chronic bacterial prostatitis, uncomplicated cystitis, anthrax, acute bacterial sinusitis, acute exacerbation of chronic bronchitis, community-acquired pneumonia, complicated infection of skin and soft tissues. This antibacterial agent is currently out of stock. It is available Levaquin (Generic Fluoning) for purchase with the same active ingredients, therapeutic effect, and indications.

Indications

Infectious and inflammatory diseases caused by susceptible microorganisms:

• acute sinusitis;
• exacerbation of chronic bronchitis;
• community-acquired pneumonia;
• complicated urinary tract infections (including pyelonephritis);
• uncomplicated urinary tract infections;
• prostatitis;
• infections of the skin and soft tissues;
• septicemia/bacteremia associated with the above indications;
• intraabdominal infection.

Dosage and administration

Fluoning is taken orally 1 or 2 times a day. Do not chew the tablets and wash down with plenty of water. The drug is taken before meals or between meals. Doses are determined by the nature and severity of the infection, as well as the sensitivity of the putative pathogen.

For patients with normal or moderately reduced renal function (creatinine clearance> 50 ml/min.), the following dosage regimen is recommended:

• sinusitis: 500 mg once a day – 10-14 days;
• exacerbation of chronic bronchitis: 250 mg or 500 mg 1 time per day – 7-10 days;
• community-acquired pneumonia: 500 mg 1-2 times a day – 7-14 days
• uncomplicated urinary tract infections: 250 mg once a day – 3 days;
• prostatitis: 500 mg – 1 time per day – 28 days;
• complicated urinary tract infections, including pyelonephritis: 250 mg 1 time per day – 7-10 days;
• infections of the skin and soft tissues: 250 mg once a day or 500 mg 1-2 times a day – 7-14 days;
• septicemia/bacteremia: 250 mg or 500 mg 1-2 times a day for 10-14 days;
• intra-abdominal infection: 250 mg or 500 mg once a day – 7-14 days (in combination with antibacterial drugs acting on the anaerobic flora).

Patients after hemodialysis or continuous ambulatory peritoneal dialysis do not require the additional doses.

Patients with impaired liver function do not require special dose selection since levofloxacin is metabolized in the liver only to a very small extent.

As with other antibiotics, treatment with Fluoning is recommended to continue for at least 48-78 hours after normalization of body temperature or after laboratory-confirmed recovery.

Contraindications

• Hypersensitivity to levofloxacin or to other quinolones;
• Renal failure (with creatinine clearance less than 20 ml/min);
• Epilepsy;
• Tendon lesions with previous treatment with quinolones;
• Children and adolescents (up to 18 years);
• Pregnancy and lactation.

Side effects

Allergic reactions:

• sometimes – itching and skin redness;
• rarely, general hypersensitivity reactions (anaphylactoid reactions) with symptoms such as urticaria, narrowing of the bronchi and severe suffocation;
• very rarely – swelling of the skin and mucous membranes, a sudden drop in blood pressure and shock, increased sensitivity to solar and ultraviolet radiation, allergic pneumonitis, vasculitis;
• in some cases, severe rashes on the skin with the formation of blisters, for example, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell’s syndrome) and exudative erythema multiforme.
• General hypersensitivity reactions can sometimes be preceded by milder skin reactions.

The above reactions may develop after the first dose several minutes or hours after administration of the drug.

Digestive system:

• often – nausea, diarrhea, increased activity of liver enzymes (for example, alanine aminotransferase and aspartate aminotransferase);
• sometimes – loss of appetite, vomiting, abdominal pain, digestive disorders;
• rarely – diarrhea with an admixture of blood, that in very rare cases, can be a sign of intestinal inflammation and even pseudomembranous colitis.

Metabolism system:

very rarely – a decrease in the glucose concentration in the blood, which is of particular importance for patients suffering from diabetes mellitus (increased appetite, nervousness, perspiration, trembling).

Nervous system:

• sometimes – headache, dizziness and/or numbness, drowsiness, sleep disturbances;
• rarely – anxiety, paresthesia in the hands, trembling, psychotic reactions such as hallucinations and depressions, excited state, convulsions, and confusion;
• very rarely – impaired vision and hearing, impaired taste sensitivity and smell, decreased tactile sensitivity.

Cardiovascular system:

• rarely – increased heart rate, lowering blood pressure;
• very rarely – vascular (shock-like) collapse;
• in some cases, lengthening of the Q-T interval.

Musculoskeletal system:

• rarely – tendon lesions (including tendonitis), joint and muscle pain;
• very rarely – tendon rupture (for example, Achilles tendon). This side effect can be observed within 48 hours after the start of treatment and can be bilateral in nature, muscle weakness, which is of particular importance for patients with the bulbar syndrome;
• in some cases, muscle damage (rhabdomyolysis).

Urinary system:

• rarely – increased levels of bilirubin and creatinine in blood serum;
• very rarely – impaired renal function up to acute renal failure, interstitial nephritis.

Hemopoietic organs:

• sometimes – an increase in the number of eosinophils, a decrease in the number of leukocytes;
• rarely – neutropenia, thrombocytopenia, which may be accompanied by increased bleeding;
• very rarely – agranulocytosis and the development of severe infections (persistent or recurrent fever, worsening of well-being);
• in some cases, hemolytic anemia; pancytopenia.

Other:

• sometimes – general weakness;
• very rarely – fever.

Overdose

Symptoms of an overdose are manifested at the central nervous system level (confusion, dizziness, impaired consciousness and bouts of seizures, such as epileptic seizures). In addition, gastrointestinal upsets (e.g. nausea) and erosive lesions of the mucous membranes, lengthening of the Q-T interval can be found.

Treatment should be symptomatic. Fluoning is not excreted by dialysis (hemodialysis, peritoneal dialysis, and permanent peritoneal dialysis). There is no specific antidote.

Interaction

There are reports of an expressed decrease in the cerebral seizure threshold with the simultaneous use of quinolones and substances that, in turn, can reduce the cerebral seizure threshold. This applies equally to the simultaneous use of quinolones and theophylline.

The effect of this drug is significantly weakened with simultaneous use with sucralfate. The same thing happens with the simultaneous use of magnesium – or aluminum-containing antacids, as well as iron salts. Fluoning should be taken at least 2 hours before or 2 hours after taking these substances. No interaction with calcium carbonate was reported.

With the simultaneous use of vitamin K antagonists, control of the blood coagulation system is recommended.

The renal clearance of levofloxacin slightly slows down under the action of cimetidine and probenecid. This interaction has practically no clinical significance. However, with the simultaneous use of drugs such as probenecid and cimetidine, which block a specific excretion route (tubular secretion), treatment with levofloxacin should be carried out with caution. This applies primarily to patients with limited renal function.

Fluoning slightly increases the half-life of cyclosporine.

Taking glucocorticosteroids increases the risk of tendon rupture.