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Product Name
:
MINI-TAVOX
Chemical Name
:
Levofloxacin
Therapeutic Category
:
Ophthalmic drugs
Pharmacologic Category
:
Antibiotic, Ophthalmic - Antibiotic, Quinolone
Pharmaceutical Form
:
S.D.Eye Drops
Composition
:
Levofloxacin 0.5 ml
Monitoring Parameters
Dosing
 
Dosing: Adult
Conjunctivitis (0.5% ophthalmic solution): Ophthalmic:
Treatment day 1 and day 2: Instill 1-2 drops into affected eye(s) every 2 hours while awake, up to 8 times/day
Treatment day 3 through day 7: Instill 1-2 drops into affected eye(s) every 4 hours while awake, up to 4 times/day
Corneal ulceration (1.5% ophthalmic solution): Ophthalmic:
Treatment day 1 through day 3: Instill 1-2 drops into affected eye(s) every 30 minutes to 2 hours while awake and 4-6 hours after retiring.
Treatment day 4 through completion: Instill 1-2 drops into affected eye(s) every 1-4 hours while awake.

Dosing: Pediatric

Conjunctivitis (bacterial): Ophthalmic: Children ≥1 year: Refer to adult dosing.
Corneal ulceration: Ophthalmic: Children ≥6 years: Refer to adult dosing.

Dosing: Geriatric

Refer to adult dosing.
Use
 
Treatment of bacterial conjunctivitis caused by susceptible organisms (Quixin® 0.5% ophthalmic solution); treatment of corneal ulcer caused by susceptible organisms (Iquix® 1.5% ophthalmic solution)
Medication Safety Issues
Sound-alike/look-alike issues:
Levofloxacin may be confused with levETIRAcetam, levodopa, levothyroxine
Adverse Reactions
 
1% to 10%:
Gastrointestinal: Taste disturbance (8% to 10%)
Ocular: Decreased vision (transient), foreign body sensation, transient ocular burning, ocular pain or discomfort, photophobia
<1% (Limited to important or life-threatening): Allergic reaction, lid edema, ocular dryness, ocular itching
Contraindications
 
Hypersensitivity to levofloxacin, any component of the formulation, or other quinolones
Warnings / Precautions Drug
 
Concerns related to adverse effects:
• Hypersensitivity: Serious hypersensitivity reactions have been reported with systemic use of fluoroquinolones.
• Superinfection: Prolonged use may lead to overgrowth of nonsusceptible organisms, including fungi. Discontinue use and institute appropriate alternative therapy if superinfection is suspected.

Special populations:

• Pediatrics: Safety and efficacy have not been established in children <1 year of age for Quixin® and in children <6 years of age for Iquix®.

Dosage form specific issues:

• Ophthalmic solution: For topical use only. Do not inject subconjunctivally or introduce into anterior chamber of the eye. Contact lenses should not be worn during treatment for bacterial conjunctivitis. Indications for ophthalmic solutions are product concentration-specific and should not be used interchangeably.
Interactions
 
There are no known significant interactions.
Pregnancy
 
C
Pregnancy Implications
Adverse events have been observed in some animal studies; therefore, the manufacturer classifies levofloxacin ophthalmic as pregnancy category C. When administered orally or I.V., levofloxacin crosses the placenta. Refer to the Levofloxacin (Systemic) monograph for details. The amount of levofloxacin available systemically following topical application of the ophthalmic drops is significantly less in comparison to oral or I.V. doses.
Lactation
 
Use caution
Breast-Feeding Considerations
When administered orally or I.V., levofloxacin enters breast milk. Refer to the Levofloxacin (Systemic) monograph for details. The amount of levofloxacin available systemically following topical application of the ophthalmic drops is significantly less in comparison to oral or I.V. doses. The manufacturer recommends that caution be exercised when administering levofloxacin eye drops to nursing women.
Mechanism of Action
 
As the S(-) enantiomer of the fluoroquinolone, ofloxacin, levofloxacin, inhibits DNA-gyrase in susceptible organisms thereby inhibits relaxation of supercoiled DNA and promotes breakage of DNA strands. DNA gyrase (topoisomerase II), is an essential bacterial enzyme that maintains the superhelical structure of DNA and is required for DNA replication and transcription, DNA repair, recombination, and transposition.
Pharmacodynamics / Kinetics
 
Absorption: Only small amounts are absorbed systemically after ophthalmic instillation
 
   
 
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