Levoflox Adverse Reactions

Levofloxacin is generally well tolerated. The range of adverse effects associated with levofloxacin and the other fluoroquinolones have, like nalidixic acid. They most often involve the gastrointestinal tract, CNS or skin.
Gastrointestinal disturbances include nausea, vomiting diarrhea, abdominal pain, dyspepsia and are most frequent adverse effects.
Pseudomembranous colitis has been reported rarely.
Headache, dizziness and restlessness are among the commonest effects on the CNS. Others include tremor, drowsiness, insomnia, nightmares and visual and other sensory disturbances and more rarely hallucinations, psychotic reactions, depression and convulsions.
Paraesthesia and peripheral neuropathy have occurred occasionally.
In addition to rash and pruritis, hypersensitivity-type reactions affecting the skin have included, rarely, vasculitis, erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Photosensitivity has occurred although it may be more frequent with some newer fluoroquinolones such as Lomefloxacin and sparfloxacin. Anaphylaxis has been associated with levofloxacin and some other quinolone antibacterials. As with other quinolone antibacterial, reversible arthralgia has sometimes occurred and joint erosions have been documented in immature animals. Tendon damage has been reported.
Other adverse effects reported with ciprofloxacin include transient increases in serum creatinine or blood urea nitrogen and, occasionally, acute renal failure secondary to interstitial nephritis, crystalluria; elevated liver enzyme values, jaundice and hepatitis; haematological disturbances including eosinophilia, leucopenia, thrombocytopenia and, very rarely, hemolytic anemia or agranulocytosis; myalgia; gynecomastia and cardiovascular effects including tachycardia. As with other antibacterial, superinfection with organisms not very susceptible to levofloxacin is possible. Such organisms include Candida, Clostridium difficile and Streptococcus pneumoniae. There is some evidence that levofloxacin use may associated with an increased risk of colonization by methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci.
Pain and irritation may occur at the site of injection accompanied rarely by phlebitis or thrombophlebitis.