Levofloxacin

Drug

Levofloxacin

Pronounced

"lev-oh-FLOX-uh-sin"

Drug Interactions

See also How to Use section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

A product that may interact with this drug is: strontium.

Levofloxacin is very similar to ofloxacin. Do not use medications containing ofloxacin while using levofloxacin.

This medication may interfere with certain lab tests (such as urine screening for opiates), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

  • Negative Interactions

    9
    • Levofloxacin

      Foods with Caffeine

      Potential Negative Interaction

      Caffeine may have an intensified effect in people taking levofloxacin. Drugs similar to levofloxacin have been shown to cause caffeine to persist longer in the blood. However, the effects of levofloxacin on caffeine blood levels or symptoms of caffeine ingestion have not been studied.

      Foods with Caffeine
      Levofloxacin
      ×
      1. Barnett G, Segura J, de la Torre R, Carbo M. Pharmacokinetic determination of relative potency of quinolone inhibition of caffeine disposition. Eur J Clin Pharmacol 1990;39:63-9.
    • Levofloxacin

      Calcium

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Minerals including calcium, iron, magnesium, and zinc can bind to fluoroquinolones, including ofloxacin, greatly reducing drug absorption. Ofloxacin should be taken four hours before or two hours after consuming antacids (Maalox®, Mylanta®, Tumms®, Rolaids® and others) that may contain these minerals and mineral-containing supplements.

      Calcium
      Levofloxacin
      ×
      1. Lomaestro BM, Bailie GR. Quinolone-cation interactions: a review. DICP 1991;25:1249-58.
      2. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340q-0r.
    • Levofloxacin

      Copper

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Minerals such as aluminum, calcium, copper, iron, magnesium, manganese, and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

      Copper
      Levofloxacin
      ×
      1. Campbell NR, Hasinoff BB. Iron supplements: A common cause of drug interactions. Br J Clin Pharmacol 1991;31:251-5.
      2. Lim D, McKay M. Food-drug interactions. Drug Information Bull 1995;15(2) [review].
      3. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340n-40o.
      4. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 74.
    • Levofloxacin

      Fennel

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Preliminary research in animals has shown that fennel (Foeniculum vulgare) may reduce the absorption of ciprofloxacin. This interaction may be due to the rich mineral content of the herb; it has not yet been reported in humans. People taking ciprofloxacin should avoid supplementing with fennel-containing products until more is known.

      Fennel
      Levofloxacin
      ×
      1. Zhu M, Wong PY, Li RC. Effect of oral administration of fennel (Foeniculum vulgare) on ciprofloxacin absorption and disposition in the rat. J Pharm Pharmacol 1999;51:1391-6.
    • Levofloxacin

      Iron

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Taking iron supplements concomitantly with levofloxacin can reduce the absorption—and thus the effectiveness—of the drug. Therefore, nutritional supplements containing iron, if used, should be taken two hours before or after taking levofloxacin.

      Iron
      Levofloxacin
      ×
      1. Fish DN, Chow AT. The clinical pharmacokinetics of levofloxacin. Clin Pharmacokinet 1997;32:101-19.
    • Levofloxacin

      Khat

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Khat (Catha edulis) is an herb found in East Africa and Yemen that has recently been imported into the United States. Studies have shown that chewing khat significantly reduces the absorption of ampicillin, which might reduce the effectiveness of the antibiotic. Therefore, people taking ampicillin should avoid herbal products that contain khat.

      Khat
      Levofloxacin
      ×
      1. Attel OA, Ali AA, Ali HM. Effect of khat chewing on the bioavailability of ampicillin and amoxicillin. J Antimicrob Chemother 1997;39:523-5.
    • Levofloxacin

      Magnesium

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Taking calcium, iron, magnesium, or zinc at the same time as minocycline can decrease the absorption of both the drug and the mineral. Therefore, calcium, iron, magnesium, or zinc supplements, if used, should be taken an hour before or after the drug.

      Magnesium
      Levofloxacin
      ×
      1. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1535-7.
      2. Brion M, Lambs L, Berthon G. Metal ion-tetracycline interactions in biological fluids. Part 5. Formation of zinc complexes with tetracycline and some of its derivatives and assessment of their biological significance. Agents Actions 1985;17:229-42.
    • Levofloxacin

      Manganese

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Minerals such as aluminum, calcium, copper, iron, magnesium, manganese, and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

      Manganese
      Levofloxacin
      ×
      1. Campbell NR, Hasinoff BB. Iron supplements: A common cause of drug interactions. Br J Clin Pharmacol 1991;31:251-5.
      2. Lim D, McKay M. Food-drug interactions. Drug Information Bull 1995;15(2) [review].
      3. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340n-40o.
      4. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 74.
    • Levofloxacin

      Zinc

      Reduces Effectiveness

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Minerals including calcium, iron, magnesium, and zinc can bind to fluoroquinolones, including ofloxacin, greatly reducing drug absorption. Ofloxacin should be taken four hours before or two hours after consuming antacids (Maalox®, Mylanta®, Tumms®, Rolaids® and others) that may contain these minerals and mineral-containing supplements.

      Zinc
      Levofloxacin
      ×
      1. Lomaestro BM, Bailie GR. Quinolone-cation interactions: a review. DICP 1991;25:1249-58.
      2. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340q-0r.
  • Supportive Interactions

    10
    • Levofloxacin

      Folic Acid

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

      Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin. Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.

      Folic Acid
      Levofloxacin
      ×
      1. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.
      2. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.
      3. Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608-9.
      4. Dragan L, Eng AM, Lam S, Persson T. Tetracycline and niacinamide: treatment alternatives in ocular cicatricial pemphigoid. Cutis 1999;63:181-3.
      5. Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670-4.
      6. Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427-9.
      7. Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid; further support for its efficacy. Clin Exp Dermatol 1998;23:254-7.
      8. Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9.
      9. Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998-1000.
      10. Shah SA, Ormerod AD. Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide. Clin Exp Dermatol 2000;25:204-5.
      11. Zemtsov A, Neldner KH. Successful treatment of dermatitis herpetiformis with tetracycline and nicotinamide in a patient unable to tolerate dapsone. J Am Acad Dermatol 1993;28:505-6.
    • Levofloxacin

      Potassium

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

      Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin. Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.

      Potassium
      Levofloxacin
      ×
      1. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.
      2. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.
      3. Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608-9.
      4. Dragan L, Eng AM, Lam S, Persson T. Tetracycline and niacinamide: treatment alternatives in ocular cicatricial pemphigoid. Cutis 1999;63:181-3.
      5. Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670-4.
      6. Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427-9.
      7. Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid; further support for its efficacy. Clin Exp Dermatol 1998;23:254-7.
      8. Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9.
      9. Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998-1000.
      10. Shah SA, Ormerod AD. Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide. Clin Exp Dermatol 2000;25:204-5.
      11. Zemtsov A, Neldner KH. Successful treatment of dermatitis herpetiformis with tetracycline and nicotinamide in a patient unable to tolerate dapsone. J Am Acad Dermatol 1993;28:505-6.
    • Levofloxacin

      Vitamin B12

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K. Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

      Vitamin B12
      Levofloxacin
      ×
      1. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].
      2. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.
    • Levofloxacin

      Vitamin B2

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Tetracycline can interfere with the activity of folic acid, potassium, and vitamin B2, vitamin B6, vitamin B12, vitamin C, and vitamin K. This is generally not a problem when taking tetracycline for two weeks or less. People taking tetracycline for longer than two weeks should ask their doctor about vitamin and mineral supplementation. Taking 500 mg vitamin C simultaneously with tetracycline was shown to increase blood levels of tetracycline in one study. The importance of this interaction is unknown.

      Vitamin B2
      Levofloxacin
      ×
      1. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 256-8.
      2. Freinberg N, Lite T. Adjunctive ascorbic acid administration in antibiotic therapy. J Dent Res 1957;36:260-2.
    • Levofloxacin

      Vitamin K

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Several cases of excessive bleeding have been reported in people who take antibiotics. This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal. Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.

      Vitamin K
      Levofloxacin
      ×
      1. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.
      2. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.
      3. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.
      4. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.
      5. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.
    • Levofloxacin

      Bromelain

      Support Medicine

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      When taken with amoxicillin, bromelain was shown to increase absorption of amoxicillin in humans. When 80 mg of bromelain was taken together with amoxicillin and tetracycline, blood levels of both drugs increased, though how bromelain acts on drug metabolism remains unknown. An older report found bromelain also increased the actions of other antibiotics, including penicillin, chloramphenicol, and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to these antibiotics did so after adding bromelain taken four times per day.

      Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

      Bromelain
      Levofloxacin
      ×
      1. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exp Clin Res 1978;4:39-44.
      2. Luerti M, Vignali M. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drugs Exp Clin Res 1978;4:45-8.
      3. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143-60.
    • Levofloxacin

      Probiotics

      Support Medicine

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection. Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.
      Probiotics
      Levofloxacin
      ×
      1. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.
    • Levofloxacin

      Brewer’s Yeast

      Reduce Side Effects

      A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.

      The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii or Saccharomyces cerevisiae (baker’s or brewer’s yeast)—helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection. Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

      Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.

      Brewer’s Yeast
      Levofloxacin
      ×
      1. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].
      2. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.
      3. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.
    • Levofloxacin

      Probiotics

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.

      The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii or Saccharomyces cerevisiae (baker’s or brewer’s yeast)—helps prevent recurrence of this infection.

      Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.

      Probiotics
      Levofloxacin
      ×
      1. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].
      2. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.
    • Levofloxacin

      Vitamin C

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Tooth discoloration is a side effect of minocycline observed primarily in young children, but it may occur in adults as well. Vitamin C supplementation may prevent staining in adults taking minocycline.

      Vitamin C
      Levofloxacin
      ×
      1. Cheek CC, Heymann HO. Dental and oral discolorations associated with minocycline and other tetracycline analogs. J Esthet Dent 1999;11:43-8.
  • Explanation Required

    2
    • Levofloxacin

      Barberry

      Needs Explanation

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Berberine is a chemical extracted from goldenseal (Hydrastis canadensis),barberry (Berberis vulgaris), and Oregon grape (Berberis aquifolium), which has antibacterial activity. However, one double-blind study found that 100 mg berberine given with tetracycline (a drug closely related to doxycycline) reduced the efficacy of tetracycline in people with cholera. In that trial, berberine may have decreased tetracycline absorption. Another double-blind trial found that berberine neither improved nor interfered with tetracycline effectiveness in cholera patients. Therefore, it remains unclear whether a significant interaction between berberine-containing herbs and doxycycline and related drugs exists.

      Barberry
      Levofloxacin
      ×
      1. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. Br Med J 1985;291:1601-5.
      2. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 1987;155:979-84.
    • Levofloxacin

      Vitamin K

      Needs Explanation

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      Several cases of excessive bleeding have been reported in people who take antibiotics. This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal. Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.

      Vitamin K
      Levofloxacin
      ×
      1. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.
      2. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.
      3. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.
      4. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.
      5. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.

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Medication information
Pill & refill reminders
Medication journal & mood log

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