Levofloxacin 5 Mg/Ml Solution For Infusion
Package leaflet: Information for the patient
Levofloxacin 5 mg/ml Solution for infusion
Levofloxacin
-♦-
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
What is in this leaflet
1. What Levofloxacin Solution for infusion is and what it is used for
2. What you need to know before you use Levofloxacin Solution for infusion
3. How to use Levofloxacin Solution for infusion
4. Possible side effects
5. How to store Levofloxacin Solution for infusion
6. Contents of the pack and other information
1. What Levofloxacin Solution for infusion is and what it is used for
The name of your medicine is Levofloxacin solution for infusion. Levofloxacin solution for infusion contains a medicine called levofloxacin. This belongs to a group of medicines called antibiotics. Levofloxacin is a ‘quinolone’ antibiotic. It works by killing the bacteria that cause infections in your body.
Levofloxacin Solution for infusion is used to treat infections of the:
• Lungs, in people with pneumonia
• Urinary tract, including your kidneys or bladder
• Prostate gland, where you have a long lasting infection
• Skin and underneath the skin, including muscles. This is sometimes called “soft tissue”.
In some special situations, Levofloxacin solution for infusion may be used to lessen the chances of getting a pulmonary disease named anthrax or worsening of the disease after you are exposed to the bacteria causing anthrax.
2. What you need to know before you use Levofloxacin Solution for infusion
Do not use this medicine and tell your doctor if you •You are allergic to levofloxacin, any other quinolone antibiotic such as moxifloxacin, ciprofloxacin or ofloxacin or to any of the other ingredients of the medicine (listed in section 6). Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue.
• You have ever had epilepsy.
• You had ever had a problem with tendons such as tendonitis that was related to treatment with a ‘quinolone antibiotics’. A tendon is the cord that joins your muscle to your skeleton.
• You are a child or growing teenager
• You are pregnant, might become pregnant, or think you may be pregnant.
• You are breast-feeding.
Do not have this medicine if any of the above applies to you. If you are not sure, talk to your doctor, nurse or pharmacist before you are given Levofloxacin .
Warnings and precautions
Talk to your doctor, or pharmacist before you using this medicines if
• You are 60 years of age or older.
• You are using corticosteroids, sometimes called steroids (see section “Other medicines and Levofloxacin”).
• You have ever had fits (seizure)
• You have had damage to your brain due to a stroke or severe brain injury).
• You have kidney problems.
• You have something known as ‘glucose - 6 - phosphate dehydrogenase deficiency’. You are more likely to have serious problems with your blood when taking this medicine
• You have ever had mental health problems
• You have ever had heart problems. caution should be taken when using this kind of medicine, if you were born with or have family history of prolonged QT interval (seen on ECG, electrical recording of the heart), have salt imbalance in the blood (especially low level of potassium or magnesium in the blood), have a very slow heart rhythm (called ‘bradycardia’), have a weak heart (heart failure), have a history of heart attack (myocardial infarction), you are female or elderly or you are taking other medicines that result in abnormal ECG changes (see section “Other medicines and Levofloxacin”).
• You are diabetic.
• You have ever had liver problems.
• You have myasthenia gravis.
If you are not sure if any of the above applies to you, talk to your doctor, nurse or pharmacist before being given Levofloxacin
Other medicines and Levofloxacin
Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines. This is because Levofloxacin can affect the way some other medicines work. Also, some medicines can affect the way Levofloxacin can work.
In particular tell your doctor if you are taking any of the following: medicines. This is it can increase the chance of you getting side effects, when taken with Levofloxacin:
• Corticosteroids, sometimes called steroids-used for inflammation and/or rupture of your tendons.
• Warfarin - used to thin the blood. You may be more likely to have a bleed. Your doctor may need to take regular blood tests to check how well your blood can clot.
• Theophylline - used for breathing problems. You are more likely to have a fit (seizure) if taken with Levofloxacin.
• Non-steroidal anti-inflammatory drugs (NSAIDs) - used for pain and inflammation, such as aspirin, ibuprofen, fenbufen, ketoprofen and indomethacin. You are more likely to have a fit (seizure) if taken with Levofloxacin
• Ciclosporin-used after organ transplants. You may also be more likely to get the side effects of ciclosporin.
• Medicines known to affect the way your heart beats. This includes medicines used for abnormal heart rhythm (antiarrhythmics such as quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide and amiodarone), for depression (tricyclic antidepressants such as amitriptyline and imipramine), for psychiatric disorders (antipsychotics), and for bacterial infections (“macrolide” antibiotics such as erythromycin, azithromycine and clarithromycin) and some antipscyhotics.
• Probenecid- used to prevent gout and cimetidine- used to treat ulcers and heartburn. Special care should be taken when taking either of these medicines with Levofloxacin. If you have kidneys problems your doctor may want to give you a lower dose.
Urine tests for opiates
Urine tests may show “false-positive” results for strong painkillers called “opiates” in people taking Levofloxacin . If your doctor has prescribed a urine test, tell your doctor you are having Levofloxacin .
Tuberculosis tests
This medicine may cause “false negative” results for some tests used in laboratory to search for the bacteria causing tuberculosis.
Pregnancy and Breast-feeding
Do not have this medicine if
• You are pregnant, might become pregnant or think you might be pregnant.
• You are breast-feeding a baby or planning to breast-feed.
Driving and using machines
You may get side-effects after being given this medicine, including feeling dizzy, sleepy, a spinning feeling (vertigo) or change to your eyesight. Some of these side effects can affect you being able to concentrate and your reaction speed. If this happens, do not drive or carry out any work that requires a high level of attention.
Levofloxacin Solution for infusion contains sodium
This medicine contains 177 mg of sodium per 250mg dose. This should be taken into consideration by patients on a controlled sodium diet.
3. How to use Levofloxacin Solution for infusion
• Levofloxacin Solution for infusion is a medicine for use in hospitals.
• It will be given to you by a doctor or nurse as an injection. The injection will be into one of your veins and be given over a period of time (this is called an intravenous infusion).
• For 250mg Levofloxacin Solution for infusion, the infusion time should be 30 minutes or more.
• For 500 mg Levofloxacin Solution for infusion, the infusion time should be 60 minutes or more.
• Your heart rate and blood pressure should be closely monitored. This is because an unusual fast beating of the heart and a temporary lowering of blood pressure are possible side effects that have been seen during the infusion of a similar antibiotic. If your blood pressure drops noticeably while you are being given the infusion, it will be stopped straight away.
How much Levofloxacin Solution for infusion is given
If you are not sure why you are being given Levofloxacin or have any questions about how much Levofloxacin is being given to you, speak to your doctor, nurse or pharmacist.
• Your doctor will decide on how much Levofloxacin you should have.
• The dose will depend on the type of infection you have and where the infection is in your body.
• The length of your treatment will depend on how serious your infection is. The usual doses are given below.
Adults and the elderly:
• Pneumonia: 500mg once or twice daily.
• Infection of urinary tract, including your kidneys or bladder: 500mg once daily
• Prostate gland: 500mg once daily.
• Infection of skin and underneath the skin, including muscles: 500mg once or twice daily.
Adults and the elderly with kidney problems:
Your doctor may need to give you a lower dose.
Children and Teenagers:
This medicine must not be given to children or teenagers.
Protect your skin from sunlight
Keep out of direct sunlight while having this medicine and for 2 days after you stop having it. This is because your skin will become much more sensitive to the sun and may burn, tingle or severely blister if you do not take the following precautions:
• Make sure you use high factor sun cream
• Always wear a hat and clothes which cover your arms and legs
• Avoid sun beds
If you take more Levofloxacin Solution for infusion than you should
It is unlikely that your doctor or nurse will give you too much medicine. Your doctor and nurse will monitor your progress, and check the medicine you are given. Always ask if you are not sure why you are getting a dose of medicine.
Having too much Levofloxacin may cause the following effects to happen: convulsive fits (seizures) feeling confused, dizzy, less conscious, having tremor and heart problems, leading to uneven heart beats as well as feeling sick (nausea).
The following information is intended for healthcare professionals only:
Levofloxacin 5 mg/ml Solution for infusion
Method of Administration
Levofloxacin Solution for infusion solution is intended exclusively for the slow intravenous infusion once or twice daily.
Duration of Treatment
The infusion time must be at least 30 minutes for 250 mg or 60 minutes for 500 mg Levofloxacin Solution for infusion.
The following dose recommendations can be given for Levofloxacin:
|
Dosage in patients with normal renal function (creatinine clearance > 50 ml/min) Indication |
Daily dose regimen (according to severity) |
Total duration of treatment (according to severity) |
|
Community-acquired pneumonia |
500 mg once or twice daily |
7 - 14 days |
|
Pyelonephritis |
500 ma once daily |
7 - 10 days |
|
Complicated urinary tract infections |
500 mg once daily |
7 - 14 days |
|
Chronic bacterial prostatitis |
500 mg once daily |
28 days |
|
Complicated skin and soft tissue infections |
500 mg once or twice daily |
7 - 14 days |
|
Inhalation anthrax |
500 mg once daily |
8 weeks |
Special populations
|
Impaired renal functon (creatinine clearance <50 ml/min) Dose regimen | |||
|
250 mg/24 h |
500 mg/24 h |
500 mg/12 h | |
|
Creatinine clearance |
first dose: 250 mg |
first dose: 500 mg |
first dose: 500 mg |
|
50 - 20 ml/min |
then: 125 mg/24 h |
then: 250 mg/24 h |
then : 250 mg/12 h |
|
19 - 10 ml/min |
then: 125 mg/48 h |
then: 125 mg/24 h |
then: 125 mg/12 h |
|
< 10 ml/mi (including haemodialysis and CAPD)1 |
then: 125 mg/48 h |
then: 125 mg/24 h |
then: 125 mg/24 h |
1No additional doses are required after haemodialysis or continuous ambulatory peritoneal dialysis (CAPD).
This medicinal product is authorised in the Member States of the EEA under the following names:
Belgium
Germany
France
Ireland
Italy:
Luxembourg
Latvia
Netherlands
Portugal
UK
If you forget to take Levofloxacin Solution for infusion
Your doctor or nurse will have instructions on when to give you this medicine. It is unlikely that you will not be given the medicine as it has been prescribed However If you think that you may have missed a dose, tell to your doctor or nurse.
If you stop taking Levofloxacin Solution for infusion
Your doctor or nurse will continue giving you Levofloxacin, even if you feel better. If it is stopped too soon, your condition may get worse or the bacteria may become resistant to the medicine. After a few days treatment with the solution for infusion, your doctor may decide to switch you to the tablet form of this medicine to complete your course of treatment.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all other medicines, this medicine can cause side effects although not everybody gets them.
These effects are normally mild or moderate and often disappear after a short time
Stop having Levofloxacin and tell a doctor or nurse straight away if you notice the following side effect:
Very rare (may affect up to 1 in 10,000 people)
You have an allergic reaction. The signs may include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue.
Stop having Levofloxacin and tell a doctor or nurse straight away if you notice any of the following serious side effects -
you may need urgent medical treatment: Rare (may affect up to 1 in 1,000 people)
Watery diarrhoea which may have blood in it, possibly with stomach cramps and a high temperature. These could be signs of a severe bowel problem
• Pain and inflammation in your tendons or ligaments which could lead to rupture. The Achilles tendon is affected most often
• Fits (convulsions)
Very rare (may affect up to 1 in 10,000 people)
Burning, tingling, pain, or numbness. These may be signs of something called ‘neuropathy’
Other:
• Severe skin rashes which may include blistering or peeling of the skin around your lips, eyes, mouth, nose and genitals
• Loss of appetite, skin and eyes becoming yellow in colour, dark-coloured urine, itching, or tender stomach (abdomen). These may be signs of liver problems which may include a fatal failure of the liver.
If your eyesight becomes impaired or if you have any other eye disturbances whilst taking Levofloxacin, consult an eye specialist immediately.
Tell your doctor if any of the following side effects gets serious or lasts longer than a few days:
Common (may affect up to 1 in 10 people):
• Sleeping problems
• Headache, feeling dizzy
• Feeling sick (nausea, vomiting) and diarrhoea
• Increase in the level of some liver enzymes in your blood
• Reactions at the site of infusion
• Inflammation of a vein.
Uncommon (may affect up to 1 in 1,00 people):
• Changes in the number of other bacteria or fungi, infection by fungi named Candida, which may need to be treated
• Changes in the number of white blood cells shown up in the results of some blood tests (leukopenia, eosinophilia)
• Feeling stressed (anxiety), feeling confused, feeling nervous, feeling sleepy, trembling, a spinning feeling (vertigo)
• Shortness of breath (dyspnoea)
• Changes in the way things taste, loss of appetite, stomach upset or indigestion (dyspepsia), pain in your stomach area, feeling bloated (flatulence) or constipation
Itching and skin rash, severe itching or hives (urticaria), sweating too much (hyperhidrosis)
Joint pain or muscle pain
Blood tests may show unusual results due to (bilirubin increased) or kidney (creatinine increased) problems General weakness
Rare (may affect up to 1 in 10,00 people):
• Bruising and bleeding easily due to a lowering in the number of blood platelets (thrombocytopenia)
• low number of white blood cells (neutropenia)
• Exaggerated immune response (hypersensitivity)
• Lowering of your blood sugar levels (hypoglycaemia). This is important for people that have diabetes.
• Seeing or hearing things that are not there (hallucinations, paranoia), change in your opinion and thoughts (psychotic reactions) with a risk of having suicidal thoughts or actions
• Feeling, depressed, mental problems, feeling restlessness (agitation), abnormal dreams or nightmares
• Tingly feeling in your hands and feet (paraesthesia)
• Problems with your hearing (tinnitus) or eyesight (blurred vision)
• Unusual fast beating of your heart (tachycardia) or low blood pressure (hypotension)
• Muscle weakness. This is important in people with myasthenia gravis (a rare disease of the nervous system).
• Changes in the way your kidney works and occasional kidney failure which may be due to an allergic kidney reaction called interstitial nephritis.
• Fever
Other side effects include:
• Lowering in red blood cells (anemia): this can make the skin pale or yellow due to damage of the red blood cells; lowering in the number of all types of blood cells (pancytopenia)
• Fever, sore throat and a general feeling of being unwell that does not go away. This may be due to a lowering in the number of white blood cells (agranulocytosis).
• Loss of circulation (anaphylactic like shock)
• Increase of your blood sugar levels (hyperglycaemia) or lowering of your blood sugar levels leading to coma (hypoglycaemic coma). This is important for people that have diabetes.
• Changes in the way things smell, loss of smell or taste (parosmia, anosmia, ageusia)
• Problems moving and walking (dyskinesia, extrapyramidal disorders)
• Temporary loss of consciousness or posture (syncope)
• Temporary loss of vision
• Impairment or loss of hearing
• Abnormal fast heart rhythm, life-threatening irregular heart rhythm including cardiac arrest,alteration of the heart rhythm (called ‘prolongation of QT interval’, seen on ECG, electrical activity of the heart)
• Difficulty breathing or wheezing (bronchospasm)
• Allergic lung reactions
• Pancreatitis
• Inflammation of the liver (hepatitis)
• Increased sensitivity of your skin to sun and ultraviolet light (photosensitivity)
• Inflammation of the vessels that carry blood around your body due to an allergic reaction (vasculitis)
• Inflammation of the tissue inside the mouth (stomatitis)
• Muscle rupture and muscle destruction (rhabdomyolysis)
• Joint redness and swelling (arthritis)
• Pain, including pain in the back, chest and extremities
• Attacks of porphyria in people who already have porphyria (a very rare metabolic disease)
• Persistent headache with or without blurred vision (benign intracranial hypertension)
If you get any side effects, talk to your doctor, nurse or pharmacist. This includes any possible side effects not listed in this leaflet.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report any side effects directly (see details below). By reporting side effects you can help provide more information on the safety of this medicine.
United Kingdom
Yellow Card Scheme
Website: www.mhra.gov.uk/yellowcard
Ireland
HPRA Pharmacovigilance Earlsfort Terrace IRL - Dublin 2
Tel: +353 1 6764971, Fax: +353 1 6762517 Website:www.hpra.ie, e-mail:medsafety@hpra.ie
5. How to store Levofloxacin Solution for infusion
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date shown on the labelling as “EXP”. The expiry date refers to the last day of that month.
Do not freeze.
Keep bottle/bag in the outer carton/over wrap pouch in order to protect from light and remove only immediately prior to use. No protection from light is required during infusion.
Once the infusion has been opened (rubber stopper perforated) the solution should be used immediately (within 3 hours) in order to prevent any bacterial contamination.
Only clear solutions practically free from particles should be used. Do not use if container is damaged.
Discard any unused solution.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment
6. Contents of the pack and other information
What Levofloxacin Solution for infusion contains
The active ingredient is levofloxacin (as levofloxacin hemihydrate).
Each ml of solution for infusion contains 5 mg of levofloxacin.
Each 100 ml of solution for infusion contains 500 mg of levofloxacin.
The other ingredients are sodium chloride, sodium hydroxide (for pH adjustment), hydrochloric acid (for pH adjustment) and water for injections
What Levofloxacin Solution for infusion looks like and the contents of the pack:
Levofloxacin 5 mg/ml Solution for infusion is a clear, yellow to greenish-yellow solution. The solution is available in a 100 ml glass bottle closed with a rubber stopper and flip off seal and in 100 ml Non PVC bag.
The 100 ml bottles are available in packs of 1,5 and 10.
The 100 ml bags are available in packs of 1,5 and 10.
Not all pack sizes may be marketed.
Marketing Authorization Holder
Claris Lifesciences (UK) Limited Crewe Hall, Crewe, Cheshire, CW1 6UL United Kingdom
Manufacturer
Peckforton Pharmaceuticals Limited Crewe Hall, Crewe, Cheshire, CW1 6UL United Kingdom
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This leaflet was last revised in 02/2015
Mixture with other solutions for infusion
Levofloxacin Solution for infusion is compatible with the following solutions for infusion:
0.9 % sodium chloride solution USP
5 % dextrose injection USP
2.5 % dextrose in Ringer solution
Combination solutions for parenteral nutrition (amino acids, carbohydrates, electrolytes).
Incompatibilities
Levofloxacin Solution for infusion should not be mixed with heparin or alkaline solutions (e.g. sodium hydrogen carbonate).
Special precautions for the disposal and other handling
From a microbiological point of view, the solution for infusion should be used immediately. If not used immediately, in-use storage times and conditions are the responsibility of the user (refer to section 5 “How to store Levofloxacin Solution for infusion”).
As for all medicines, any unused medicinal product should be disposed of accordingly and in compliance with local environmental regulations.
Information about the storage
See section 5 "How to store Levofloxacin Solution for Infusion".