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Levofloxacin QT prolongation

Effect of ciprofloxacin and levofloxacin on the QT

  1. istration of ciprofloxacin and levofloxacin
  2. Levofloxacin is a fluoroquinolone antibiotic that blocks hERG channels. 15, 16 Causing a slight but significant prolongation of the QTc interval, 17-19 it was shown previously that levofloxacin can be used as a positive comparator in thorough-QT (TQT) studies. 17 In this study, we used pharmacokinetic-pharmacodynamic (PK-PD) modeling to.
  3. Greater changes in QT and QTc intervals after treatment with moxifloxacin compared with levofloxacin or ciprofloxacin are consistent with in vitro observations related to the effect of these drugs on rapid potassium (IK(r)) channels. The clinical relevance of these differences is not known
  4. sitivity to drug-induced QTc prolongation varies during the 24-hour period, using levofloxacin as a model compound. Levofloxacin is a fluoroquinolone antibiotic that blocks hERG channels.15,16 Causing a slight but significant prolon-gation of the QTc interval,17-19 it was shown previously tha

Levofloxacin : Proposed — TdP . Lower risk than that of similar agents. Mefloquine Proposed — — QT with halofantrine. Describes whether the FDA-approved product labelling includes mention of QT prolongation, torsades de pointes, or both. 2-65. d A proton (H) at this position is associated with a QTc prolongation of <2 ms for ciprofloxacin, 3 ms for gatifloxacin and 5-6 ms for gemifloxacin, moxifloxacin and levofloxacin. 8 It should, however, be noted that only a few of the studies demonstrating these QT prolongations were comparative and performed under the same conditions The results of the current study showed the relative risk for QTc prolongation with levofloxacin was more than ciprofloxacin by about 4 and 1.5 times in diabetic and non-diabetic patients, respectively Ciprofloxacin and levofloxacin, two of the more commonly used fluoroquinolones, are considered less likely than other fluoroquinolones to prolong the QT interval. The authors set out to evaluate.. Antimicrobial Agents: Fluoroquinolones, macrolides, and antifungal agents have been associated with prolonged QT interval and TdP. 3 Quinolones are widely used antibiotics frequently prescribed for the treatment of respiratory and urinary tract infections

Electrocardiographic studies of moxifloxacin in 1500 patients at baseline and 2 h post-dose on days 3-5 of therapy have indicated a mean prolongation of QTc of 6 ms (± 26 ms) in 9.5% of moxifloxacin-treated patients compared with 9.2% of comparators. 3 However, 6.5% of patients had QTc prolongation at baseline and no arrhythmias or other cardiac events were observed The QT dispersion (QT d) is a non-invasive means of identifying those patients at an increased risk of developing sudden cardiac death (SCD).Although levofloxacin has a minimal effect on the QT c interval, isolated reports of QT prolongation, polymorphic ventricular tachycardia with a normal QT interval and TdP have been reported. The purpose of this study was to examine the effect of. The prolonged QT interval is both widely seen and associated with the potentially deadly rhythm, Torsades de Pointes (TdP). While it can occur spontaneously in the congenital form, there is a wide array of drugs that have been implicated in the prolongation of the QT interval. Levofloxacin, moxifloxacin, grepafloxacin*) Macrolide. The use of levofloxacin alone, or more often in concomitant therapy with other medications that are known to prolong the QT interval, may cause QT interval prolongation; however, additional studies/case reports are needed to validate this conclusion. Keywords levofloxacin, QT prolongation, torsade de pointe Moxifloxacin, levofloxacin, ciprofloxacin and ofloxacin all have hydrogen atoms at position 5, which means they have a lower risk of prolonging the QT interval and lead to Torsades de Pointes 4

Levofloxacin‐Induced QTc Prolongation Depends on the Time

  1. 1. Am J Med. 1999 Nov;107(5):528-9. QTC interval prolongation and polymorphic ventricular tachycardia in association with levofloxacin. Samaha FF
  2. Therefore, precaution should be taken when using Levofloxacin with concomitant drugs that can result in prolongation of the QT interval (e.g., Class IA or Class III antiarrhythmics) or in patients with risk factors for torsade de pointes (e.g., known QT prolongation, uncorrected hypokalemia) [see Warnings and Precautions (5.11)]
  3. Steps for Management of Drug -Induced QTc Prolongation Define QTc Prolongation and TdP Identify risk factors associated with QTc Prolongation and TdP Assess risk for QTc Prolongation and TdP Reduce risk of QTc prolongation and TdP Monitor and Re-evaluate Risk Assessment Circ Cardiovasc Qual Outcomes. 2013;6:479-487. . Risk Factor Points Age ≥.
  4. Therefore, precaution should be taken when using levofloxacin with concomitant drugs that can result in prolongation of the QT interval (e.g., Class IA or Class III antiarrhythmics) or in patients with risk factors for torsade de pointes (e.g., known QT prolongation, uncorrected hypokalemia) [see Warnings and Precautions (5.11)]
  5. Prolongation of the QT interval and isolated cases of torsade de pointes have been reported. Avoid use in patients with known prolongation, those with hypokalemia, and with other drugs that prolong the QT interval (5.11, 8.5
  6. 16.1 LEVAQUIN ® Tablets 5.7 Peripheral Neuropathy . 16.2 LEVAQUIN ® Oral Solution 5.8 Prolongation of the QT Interval . 16.3 LEVAQUIN ® Injection, Single-Use Vials 5.9 Musculoskeletal Disorders in Pediatric . 16.4 LEVAQUIN ® Injection Pre-Mixed Solution, Patients and Arthropathic Effects in Animals . Single-Use in Flexible Containe

change in QTc interval (QTc prolongation) Effect of ciprofloxacin versus levofloxacin on fasting blood glucose [ Time Frame: before starting antibiotic, after 24 hours, 72 hours from the first dose and after 72 hours from antibiotic cessation Drugs known to prolong QT interval. Levofloxacin, like other fluoroquinolones, should be used with caution in patients receiving drugs known to prolong the QT interval (e.g Class IA and III antiarrhythmics, tricyclic antidepressants, macrolides and, antipsychotics) (see section 4.4. QT interval prolongation) Other relevant informatio QT prolongation is a measure of delayed ventricular repolarisation, which means the heart muscle takes longer than normal to recharge between beats. It is an electrical disturbance which can be seen on an electrocardiogram (ECG). Excessive QT prolongation can trigger tachycardias such as torsades de pointes (TdP). QT prolongation is an established side effect of anti-arrhythmic medicines, but.

Effects of three fluoroquinolones on QT interval in

Cardiotoxicity of fluoroquinolones Journal of

Levofloxacin is well-known to cause pseudomembranous colitis, hepatotoxicity, and QT prolongation; therefore, patients should receive education to discontinue treatment when the clinical features develop. If diarrhea develops, it is essential to manage fluid and electrolyte replacement in this patient population adequately Bibliography Viskin S: Long QT and TdP. Lancet 1999;354:1625-33 Yap YG, Camm AJ: Drug induced QT prolongation and TdP. Heart 2003;89:1363-72 Al-Khatib SM et al: What clinicians should know about QT interval. JAMA 2003;289:2120-17. Roden DM: Drug induced prolongation of the QT interval. NEJM 2004;350:1013-22. White CM, Coleman CI: Drug- Induced Cardia PALTOO, B., et al. : Levofloxacin Induced Polymorphic Ventricular Tachycardia with Normal QT Interval. Polymorphic ventricular tachycardia (PVT) is a form of ventricular tachycardia characterized by QRS complexes that seem to change direction during the tachycardia. If associated with a prolonged QT interval, it is called torsades de pointes

What do I need to know about fluoroquinolones for childrenQuinolone Antibacterial Agents | Basicmedical Key

the potential risk of QT prolongation with azithromycin should be placed in appropriate drugs azithromycin, amoxicillin, ciprofloxacin (Cipro), and levofloxacin (Levaquin), or n Women are associated with longer electrocardiographic QT intervals and increased proarrhythmic risks of QT-prolonging drugs. The purpose of this study was to characterize the differences in cardiac electrophysiology between moxifloxacin and levofloxacin in men and women and to assess the balance of inward and outward currents through the analysis of QT subintervals Therefore, precaution should be taken when using levofloxacin with concomitant drugs that can result in prolongation of the QT interval (e.g., Class IA or Class III antiarrhythmics) or in patients with risk factors for torsade de pointes (e.g., known QT prolongation, uncorrected hypokalemia) [see Warnings and Precautions (5.9)] What are the Nursing Considerations of Levofloxacin (Levaquin) Nursing Pharmacology Considerations? contraindicated in allergies. may cause QT prolongation, avoid use with other drugs that can cause QT prolongation. can cause seizures, arrythmias, pseudomembranous colitis, anaphylaxis, Stevens Johnson. syndrome

Effect of ciprofloxacin vs levofloxacin on QTc‐interval

Levofloxacin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away Levofloxacin tablets may cause a rare heart problem known as prolongation of the QT interval. This condition can cause an abnormal heartbeat and can be very dangerous. The chances of this happening are higher in people: o who are elderly o with a family history of prolonged QT interval o with low blood potassium (hypokalemia) o who take certain. Derivatives: Levofloxacin is a quinolone/fluoroquinolone antibiotic related to ciprofloxacin, enoxacin, fleroxacin, gatifloxacin, gemifloxacin, grepafloxacin, effects were considered to be related to histamine release. 11 Some quinolones including LEV have been associated with prolongation of the QT interval and some cases of arrhythmias. Drugs known to prolong QT interval. Levofloxacin, like other fluoroquinolones, should be used with caution in patients receiving drugs known to prolong the QT interval (e.g. Class IA and III antiarrhythmics, tricyclic antidepressants, macrolides, antipsychotics). (See section 4.4 QT interval prolongation). Other relevant informatio Torsade de Pointes is a life-threatening arrhythmia associated with prolongation of the QT corrected (QTc) interval. A QTc interval over 500 milliseconds (ms) is predictive of increased risk for Torsade de Pointes. Levofloxacin 186 6.0±5.6 Gemifloxacin 788 2.56±24.

The QTc interval was determined at baseline and after 72 hours of levofloxacin administration. Changes in the QTc interval before and after the levofloxacin prescription were determined. Results: The mean age of recruited patients was 63.26 ± 14.56 years. More than 80% of patients who received levofloxacin experienced QTc prolongation Levofloxacin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away. The risk of QT prolongation may be increased if you have certain medical. Pharmacodynamics. Levofloxacin is bactericidal and exerts its antimicrobial effects via inhibition of bacterial DNA replication. 9 It has a relatively long duration of action in comparison with other antibiotics that allows for once or twice daily dosing. Levofloxacin is associated with QTc-interval prolongation and should be used with caution in patients with other risk factors for. QT interval prolongation; Levofloxacin should be cautiously used along with drugs causing QT prolongation. Special population Pregnancy. Animal studies have shown damage to the weight bearing joints in the foetus. So, levofloxacin should be avoided in pregnancy. Breast-feeding. Levofloxacin is secreted during lactation and hence it should be.

Drug-Induced QT Prolongatio

Clinical trials have been conducted to investigate the effect of the fluoroquinolones gemifloxacin, levofloxacin, ofloxacin, ciprofloxacin and moxifloxacin on QT interval prolongation .[51-55] Available evidence suggests that, of the most widely used fluoroquinolones, moxifloxacin has the greatest potential to cause QT interval prolongation. The potential risk of QT prolongation should be placed in appropriate context when choosing an antibacterial drug: Alternative drugs in the macrolide or fluoroquinolone drug classes also have the. Mizolastine has a weak potential to cause QT interval prolongation in some people and this may be additive to the effects of levofloxacin. Nonsteroidal anti-inflammatory drugs (NSAIDs) — possible increased risk of seizures when quinolones are given with NSAIDs. Avoid concurrent use in people with epilepsy or people predisposed to seizures, or.

Quinolone-induced QT interval prolongation: a not-so

  1. The Levofloxacin and Amiodarone interaction - The decision against the use of Levofloxacin is because of its potential for major interaction with Amiodarone. Patient's QTc from the most recent reading is 507. Concurrent use of these two agents is known to cause ventricular arrhythmia by prolonging QT interval
  2. QTc prolongation was defined as >450 ms in males and >470 ms in females, based on the European Society of Cardiology (ESC) guidelines. However, a QTc interval of ≥500 ms or an increase of ≥60 ms from baseline were considered to be clinically relevant 33. Twelve-lead ECGs were recorded with the Mortara® ELI-350 ECG device (Milwaukee, WI, USA)
  3. Levofloxacin is a third generation fluoroquinolone that is widely used in the treatment of mild-to-moderate respiratory and urinary tract infections due to sensitive organisms. Levofloxacin has been linked to rare instances of clinically apparent hepatic injury marked by a short latency period and a hepatocellular pattern of enzyme elevations, similar to what has been described with ciprofloxacin
  4. QT Prolongation Some quinolones, including levofloxacin, have been associated with prolongation of the QT interval on the electrocardiogram and infrequent cases of arrhythmia. During post-marketing surveillance, very rare cases of torsades de pointes have been reported in patients taking levofloxacin
  5. Levofloxacin is used to treat a variety of bacterial infections.This medication belongs to a class of drugs known as quinolone antibiotics.It works by stopping the growth of bacteria.This.

The Effects of Intravenous Levofloxacin on the QT Interval

T2 - Fatal Forty DDI: Methadone, amitriptyline, levofloxacin, CYP2D6, QT-prolongation. AU - Hoelzer, Bryan C. AU - Nicholson, Wayne T. PY - 2015/9/15. Y1 - 2015/9/15. N2 - This case discusses pharmacokinetic and pharmacodynamic drugs interactions between methadone, amitriptyline, and moxafloxacin leading to QT prolongation Therefore, precaution should be taken when using Levofloxacin with concomitant drugs that can result in prolongation of the QT interval (e.g., Class IA or Class III antiarrhythmics) or in patients with risk factors for torsade de pointes (e.g., known QT prolongation, uncorrected hypokalemia) Levofloxacin has been associated with a risk of QT prolongation; although extremely rare, torsade de pointes has been reported during postmarketing surveillance of levofloxacin. Dapagliflozin: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including SGLT2 inhibitors, are coadministered Avoid/Use Alternative. levofloxacin + arsenic trioxide. use alternative or monitor ECG: combo may incr. risk of QT prolongation, cardiac arrhythmias (additive effects) artemether/lumefantrine. Levaquin (levofloxacin) +. artemether/ lumefantrine. 1 interaction Therefore, fluoxetine is able to increase the plasma concentrations of imipramine, leading to QT interval prolongation. Taken with imipramine, levofloxacin can lead to even greater prolongation of the QT interval. Based on the Naranjo probability scale, levofloxacin was possibly associated with cardiac arrhythmias in our patient

Drug-induced QT interval prolongation: mechanisms and

  1. On hospital day 2, an ECG showed a progressive prolongation of the QT interval to 700 ms and a QTc of 666 ms (prolonged in men, >450 ms; Figure 2). Based on this finding, levofloxacin IV therapy was suspended and treatment with ceftriaxone IV was initiated
  2. While QTc prolongation is probably a fluoroquinolone class effect, there is a 10-15 fold difference in ability to cause this among the individual fluoroquinolones. If the patient does not have an inborn prolonged QT interval syndrome, or does not receive antiarrhythmics causing QTc prolongation, levofloxacin appears to have no clinically.
  3. Levofloxacin was chosen as the comparator agent, as it is not generally associated with QTc interval prolongation. The inclusion of levofloxacin in this trial also permits a more thorough evaluation of this fluoroquinolone, as it has not been subjected to rigorous cardiac monitoring due to its introduction to the market prior to new guidance.
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  5. Levaquin With Azithromycin. It is recommended to avoid concurrent use of Levaquin (levofloxacin) and a Z-Pak (azithromycin) due to an increased risk for QT prolongation and torsade de pointes (TdP). QT prolongation and TdP have both been reported during post-marketing surveillance in patients receiving levofloxacin and azithromycin
  6. Halofantrine induces a dose related prolongation of the QT interval whereas mefloquine has no effect on QT interval. w25 However, the risk of significant QT prolongation (> 25% or QTc ⩾ 0.55 s 1/2) was greater if halofantrine was given as a re-treatment following mefloquine failure than as primary treatment. w25 The Committee of Safety of.
Evaluation of the appropriate use of commonly prescribed

Some evidence has shown an association of QTc >500 msec with a 2-3 times higher incidence of TdP1,2,4,5,6,7,8. The presence of bradycardia in addition to QTc prolongation increases the risk of TdP4. If QTc prolongation occurs, offending agents should be identified and removed where possible. Electrolytes should be cor-rected QT Prolongation Caused by blocking of potassium efflux leading to delayed ventricular repolarization Normal QT interval in is <440 msec* in men, <45o msec in women Puts patient at risk for reentry arrhythmias, particularly Torsades de Pointes (TdP) TdP is generally associated with a QT interval > 500 mse

Background: Medications induced QT prolongation could cause ventricular arrhythmia, torsade de pointes, and death. Objective: The purpose of this study was to evaluate the magnitude of QTc interval prolongation as a result of levofloxacin treatment in patients admitted to cardiology wards Prolonged use may result in fungal or bacterial superinfection. Prolongation of QT interval and isolated cases of torsades de pointes; avoid use in patients with known QT prolongation, those with hypokalemia, and those taking other QT-prolonging drugs. May produce false-positive urine opiate screen Levofloxacin has serious interactions with at least 41 different drugs. Prolongation of QT interval and isolated cases of torsades de pointes; avoid use in patients with known QT prolongation, those with hypokalemia, and those taking other QT-prolonging drugs A prospective trial suggested that recommended ciprofloxacin and levofloxacin doses have little effect on QT intervals, while moxifloxacin induces the greatest QT interval prolongation.10 After 7 days of moxifloxacin use, the corrected QT interval was prolonged by 6 ms relative to baseline

QTc Prolongation Associated with Combination Therapy of

Two studies (a QT/QTc study and a study with similar quality to a QT/QTc study) evaluating the effect of levofloxacin on the QT interval in Caucasian and Japanese subjects were compared. Both the Caucasian and the Japanese studies received relevant ethics and regulatory approvals from their respective authorities [ 5 , 6 ] QT prolongation especially when given with QT prolonging drugs. What is a normal QT interval? The QT interval varies with heart rate. A number of Levofloxacin Moxifloxacin sources described above Other Some antiretrovirals Protein kinase inhibitors and some other oncolog Cardiovascular: QTC prolongation, torsades de pointes, arrhythmias . Dosage: Oral: 250mg, 500mg, 750mg tablet. Intravenous: 25mg/ml solution. Opthalmic: 0.5% solution . Adults: Inhalational anthrax, postexposure prophylaxis: 500 mg PO/IV every 24 hr for 60 days . Chronic bronchitis: 500 mg PO/IV every 24 hr for 7 day is not normal (prolonged QT interval). There are many drugs that can do this. Ask the doctor or pharmacist if you are not sure. If your child is breast-feeding a baby: Your child may need to avoid breast-feeding a baby for some time after getting this drug. This is not a list of all drugs or health problems that interact with this drug

- The slower the HR, the longer the QT interval is prolonged. QTc stands for: QT interval corrected for HR.-Bazzetts and Fredericia's equations. QTc above this is a high risk for Torsades: Levofloxacin. T or F: The risk of QTc prolongation by antipsychotics is dose dependent and a prolonged QTc interval at baseline has been shown to be a risk factor for drug-induced QT prolongation and life-threatening arrhythmia.8,9 However, no studies have been undertaken to determine whether any specific method of QT measurement does a better job of predicting sudden death.5 In addition to heart rate, age, and sex have a signifi Drugs that cause QT prolongation Antiarrhythmic agents Class IA Class IA antiarrthymic drugs work by blocking sodium and potassium channels. Blocking sodium channels tend to shorten the action potential duration, while blocking potassium channels prolongs the action potential. When the drug concentration is at a low to normal concentration, the potassium channel blocking activity take Levofloxacin (Levaquin) is a fluoroquinolone antibiotic that interferes with bacterial DNA synthesis in susceptible organisms by inhbiting DNA gyrase (topoisomerase II) and topoisomerase IV. Considered a respiratory fluoroquinolone because of its activity versus Streptococcus pneuamoniae, the most common cause of community acquired pneumonia QT Prolongation with Levofloxacin (Levaquin) Three fold increased risk of Sudden Cardiac Death while on Levofloxacin; This appears to be a class effect with most Fluoroquinolones except Ciprofloxacin; Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using levofloxacin,certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death) QTc prolongation was found in 256 (19.4%) out of 1,316 for men and 108 (12.6%) out of 860 for women who had been administrated levofloxacin during their hospitalization Levofloxacin, sold under the brand name Levaquin among others, is an antibiotic medication. It is used to treat a number of bacterial infections including acute bacterial sinusitis, pneumonia, H. pylori (in combination with other medications), urinary tract infections, chronic prostatitis, and some types of gastroenteritis. Along with other antibiotics it may be used to treat tuberculosis. Before using levofloxacin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium.

By inhibiting IKr channels, moxifloxacin can lead to an average QT prolongation (QTcF) of between 6 and 10 ms at a dose of 400 mg and approximately double the increase in prolongation at a dose of 800 mg with very little effect on heart rate [2,8].In contrast, levofloxacin has been shown to have effects on IKr channels at only relatively high. QTc-Prolongation. QTc Calculation: Put away your calipers and find EKG's calculated value. For reference. QTc = QT/RR. RR = square root of the difference between R waves of any two QRS complexes. Definition and Significance. Cut-off values may vary. QTc >450 milliseconds is generally considered prolonged in both males and females Levaquin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away

QT prolongation, Torsades de Pointes and fluoroquinolones

Patient with history of prolonged QT interval, uncorrected electrolyte disorders (e.g. hypokalaemia), risk factors that predispose to seizures or lower the seizure threshold, pre-existing aortic aneurysm and/or dissection, latent or actual defects in G6PD, diabetes mellitus, history or risk factors of psychiatric disorders, history of or risk factors for tendon disorder, severe underlying. PALTOO, B., et al.: Levofloxacin Induced Polymorphic Ventricular Tachycardia with Normal QT Interval. Polymorphic ventricular tachycardia (PVT) is a form of ventricular tachycardia characterized by QRS complexes that seem to change direction during the tachycardia. If associated with a prolonged QT interval, it is called torsades de pointes. In the absence of a congenital long QT syndrome.

Generic Levaquin (Levofloxacin) 750 mg - Antibiotics

QTC interval prolongation and polymorphic ventricular

risk factors for QT interval prolongation (e.g. electrolyte disturbances, acute myocardial infarction, heart failure with reduced left ventricular ejection fraction, bradycardia, congenital long QT syndrome, history of symptomatic arrhythmias) (in adults) Levofloxacin (Quinsair ®) for the. Risk of prolongation of the QT interval, arrhythmia, and rare cases of torsades de pointes; Central nervous system and psychiatric side effects, such as convulsions, confusion, anxiety, depression, and insomnia; Expensive -- not available in generic version; May delay the fracture healing 21. The research data suggests that use of levofloxacin. Levofloxacin prescription and dosage sizes information for physicians and healthcare professionals. Pharmacology, adverse reactions, warnings and side effects Methadone and QTc Prolongation A normalQTc interval is ≤430 msec for men and ≤450 msec for women. 1. Borderline QTc prolongationfor menis classified as 431-450 msec and 451-470 msec for women, while QTc prolongationis defined as >450 msec for men and >470 msec for women. As the QTc interval increases, so does the risk for life

Before taking levofloxacin, tell your doctor and pharmacist if you are allergic or have had a severe reaction to levofloxacin; any other quinolone or fluoroquinolone antibiotic such as ciprofloxacin (Cipro), delafloxacin (Baxdela), gemifloxacin (Factive), moxifloxacin (Avelox), and ofloxacin, or any other medications, or if you are allergic to any of the ingredients in levofloxacin preparations Levofloxacin has also been associated with a risk of QT prolongation; although extremely rare, torsade de pointes (TDP) has been reported during postmarketing surveillance of levofloxacin. Chloroquine: (Major) Concurrent use of chloroquine and levofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes (TdP)

Levofloxacin (Lfx) Therapeutic action - Antibacterial (fluoroquinolone) with bactericidal activity. Presentation - 250 mg and 500 mg tablets. Dosage patients with risk factors for QT interval prolongation (heart failure, bradycardia, hypokalaemia, etc.) or history of psychiatric disorders or seizures Prolonged QT interval is a precursor for fatal arrhythmias such as polymorphic ventricular tachycardia and Torsades de Pointes (TdP), which can eventually lead to sudden cardiac death [5]. According to the leading experts, QT interval ≥ 460 milliseconds (ms) in women and QT > 450 ms in men is considered as prolonged QT interval [6]

Levofloxacin: (Major) Concurrent use of flecainide and levofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes (TdP). Levofloxacin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia

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