Drug-Drug Interactions Associated with Levofloxacin
Andrew T. Chow, PhD, Shu-Chean Chien, MSc
Clinical Drug Metabolism Department, The R.W. Johnson Pharmaceutical Research Institute, Raritan, New Jersey, USA
Levofloxacin is soluble in many polar and non-polar solvents over a wide range of pH. The drug is rapidly and almost completely absorbed when given orally. Levofloxacin is only moderately bound to plasma proteins, negligibly metabolized and excreted primarily into the urine by passive glomerular filtration and active tubular secretion through the cationic and anionic channels. These favorable pharmacokinetic characteristics of levofloxacin contribute to its low potential for pharmacokinetic interaction with drugs which are known to have clinically significant interactions with other fluoroquinolones. Levofloxacin, however, is prone to complex formation with many metal cations. To avoid significant reduction in absorption, it is important not to administer levofloxacin concurrently with preparations such as aluminum- and magnesium-containing antacids, mineral containing multivitamin preparations, and other drug preparations containing divalent and trivalent cations.