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Buy Levaquin (Levofloxacin) No Prescription 250\500\750mg

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Buy Levofloxacin Online

Levofloxacin is authorised in the world under the following brand names: Cravit, Cravit Ophthalmic, Elequine, Floxel, Iquix, Leroxacin, Lesacin, Levaquin, Levokacin, Levox, Levoxacin, Mosardal, Nofaxin, Quixin, Reskuin, Tavanic, Volequin.

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Levofloxacin [Levaquin 250, 500, 750mg Tablets]

Generic Name: Levofloxacin

Levofloxacin is a fluoroquinolone anti-infective agent. Like other commercially available fluoroquinolones, levofloxacin contains a fluorine at the C-6 position of the quinolone nucleus. Like some other fluoroquinolones (ciprofloxacin, gatifloxacin, lomefloxacin, norfloxacin, ofloxacin, sparfloxacin), levofloxacin contains a piperazinyl group at C-7. The piperazinyl group in levofloxacin results in increased activity against gram-negative bacteria. Levofloxacin is the levorotatory isomer of ofloxacin and is 8-128 times as active against susceptible gram-positive and gram-negative bacteria as the dextrorotatory isomer and approximately twice as active as racemic ofloxacin.

Levofloxacin is more active in vitro against gram-positive bacteria, including Streptococcus pneumoniae and anaerobes than some other currently available fluoroquinolones (e.g., ciprofloxacin, lomefloxacin, norfloxacin, ofloxacin). Levofloxacin also is active against other organisms, including Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, Legionella pneumophila, Chlamydia pneumoniae, and Mycoplasma pneumoniae. Levofloxacin is less active in vitro than ciprofloxacin against Pseudomonas aeruginosa. Levofloxacin is active in vitro against some mycobacteria, including Mycobacterium tuberculosis, and M. fortuitum, and is active against some strains of M. tuberculosis resistant to isoniazid and/or rifampin.

Like other fluoroquinolone anti-infectives, levofloxacin inhibits DNA synthesis in susceptible organisms via inhibition of type II DNA topoisomerases (DNA gyrase, topoisomerase IV). In susceptible S. pneumoniae, levofloxacin principally targets topoisomerase IV. For additional information on the mechanism of action of fluoroquinolones. Cross-resistance can occur between levofloxacin and other fluoroquinolones, but some bacteria resistant to other fluoroquinolones may be susceptible to levofloxacin.

SumMon®. For additional information on this drug until a more detailed monograph is developed and published, the manufacturer's labeling should be consulted. It is essential that the labeling be consulted for detailed information on the usual cautions, precautions, and contraindications.

Under what local brands and in what dosages is generic Levofloxacin sold in pharmacies of Britain, United States, and Canada?

In pharmacies of the United States, Great Britain and Canada the pharmacists offer you to buy Levofloxacin according to your prescription or without a prescription under such brand names and in such strengths and dosage forms:

UK US Canada
Evoxil 250mg film-coated tablets

Evoxil 500mg film-coated tablets

Evoxil 5mg/ml solution for infusion

Levofloxacin 250mg Tablets

Levofloxacin 500mg Tablets

Levofloxacin 5mg/ml Solution for Infusion

Tavanic I.V. 5 mg/ml

Tavanic 250 mg Tablets

Tavanic 500 mg Tablets

Levaquin 250 mg Tablets

Levaquin 500 mg Tablets

Levaquin 750 mg Tablets

Levaquin Solution 250mg/10ml

Levaquin Injectable 500mg/20ml

Levaquin Injectable 750mg/30ml

Levofloxacin 250 mg Tablets

Levofloxacin 500 mg Tablets

Levofloxacin 750 mg Tablets

Levaquin 250 mg Tablets

Levaquin 500 mg Tablets

Levaquin 750 mg Tablets

Novo-Levofloxacin 250 mg Tablets

Mylan-Levofloxacin 500 mg Tablets

Apo-Levofloxacin 750 mg Tablets

Levofloxacin Solution 250mg/10ml

Levofloxacin Injectable 500mg/20ml

Levofloxacin Injectable 750mg/30ml

Levofloxacin is a fluoroquinolone anti-infective agent.

Administration

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Levofloxacin is administered orally or by IV infusion. Commercially available levofloxacin injection for IV infusion and the concentrate for injection are for IV use only and are not for IM, subcutaneous, intrathecal, or intraperitoneal administration.

IV therapy with the drug generally is reserved for patients who do not tolerate or are unable to take the drug orally and for other patients in whom the IV route offers a clinical advantage.

Patients receiving levofloxacin orally or IV should be well hydrated and should be instructed to drink fluids liberally.

Oral Administration

Oral levofloxacin may be given without regard to meals. Food does not appreciably affect the rate or extent of absorption of the drug.

Antacids containing magnesium or aluminum, sucralfate, metal cations such as iron or zinc, and didanosine (Videx®) chewable/dispersible tablets or unbuffered pediatric powder for oral solution prepared for administration as an admixture with antacids may interfere with oral absorption of levofloxacin resulting in subtherapeutic systemic concentrations of the quinolone. To minimize the possibility of an interaction, patients should be instructed not to ingest antacids containing magnesium or aluminum, sucralfate, metal cations such as iron or zinc (including multivitamin preparations containing zinc), or didanosine (Videx®) chewable/dispersible tablets or unbuffered pediatric powder for oral solution prepared for administration as an admixture with antacids concomitantly with or within 2 hours of a levofloxacin oral dose.

IV Infusion

Prior to IV infusion, commercially available levofloxacin concentrate for injection in single-use vials containing 25 mg/mL must be diluted with a compatible IV solution to provide a solution containing 5 mg/mL. Alternatively, commercially available levofloxacin injection for IV infusion containing 5 mg/mL in 5% dextrose injection may be used without further dilution. Because commercially available levofloxacin concentrate for injection and levofloxacin injection for IV infusion contain no preservative, any unused portions of the solutions should be discarded.

IV infusions of levofloxacin should be infused slowly. Levofloxacin doses of 250 or 500 mg should be administered over a period of 60 minutes. Levofloxacin doses of 750 mg should be administered over a period of 90 minutes. Because of the risk of hypotension, more rapid or bolus IV infusion should be avoided. Levofloxacin solutions should be inspected visually for particulate matter prior to administration whenever solution and container permit.

Because only limited information is available on the physical and/or chemical compatibility of levofloxacin and other drugs, levofloxacin should not be admixed with other drugs or infused simultaneously through the same tubing with other drugs. Fluoroquinolones, including levofloxacin, should not be infused through the same tubing with any solution containing multivalent cations (e.g., magnesium). If a Y-type administration set is used, the other IV solution flowing through the tubing should be discontinued while levofloxacin is being infused. If the same administration set is used for sequential infusion of several different drugs, the tubing should be flushed before and after administration of levofloxacin with an IV solution that is compatible with both levofloxacin and the other drug(s).

Dosage

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Dosage of oral and IV levofloxacin is identical.

When levofloxacin therapy is initiated using IV levofloxacin, therapy may be changed when appropriate to oral levofloxacin given in the same dosage to complete the course of therapy. The timing of the change from IV to oral therapy should be individualized, taking into account the clinical status of the patient.

Dosage of levofloxacin does not need to be modified in geriatric patients based on age alone. However, the dosage of levofloxacin for geriatric patients should be selected carefully because renal function is more likely to be decreased in these patients, such that monitoring renal function may be useful.

Because levofloxacin, like most other fluoroquinolones, causes arthropathy in immature animals of various species, the manufacturer states that the drug should not be used in children and adolescents younger than 18 years of age. The American Academy of Pediatrics (AAP) states that use of quinolones in children younger than 18 years of age may be justified in special circumstances after careful assessment of the risks and benefits for the individual patient.

Respiratory Tract Infections

For the treatment of acute maxillary sinusitis, acute bacterial exacerbations of chronic bronchitis, or community-acquired pneumonia in adults, the usual dosage of levofloxacin is 500 mg once every 24 hours. The usual duration of therapy is 10-14 days for the treatment of acute maxillary sinusitis, 7 days for acute bacterial exacerbations of chronic bronchitis, and 7-14 days for community-acquired pneumonia.

For the treatment of nosocomial pneumonia in adults, the usual dosage of levofloxacin is 750 mg once daily for 7-14 days.

Skin and Skin Structure Infections

For the treatment of uncomplicated skin and skin structure infections in adults, the usual dosage of levofloxacin is 500 mg once every 24 hours for 7-10 days. The usual dosage for the treatment of complicated skin and skin structure infections in adults is 750 mg once every 24 hours for 7-14 days.

Urinary Tract Infections and Prostatitis

The usual dosage of levofloxacin for the treatment of uncomplicated urinary tract infections, complicated urinary tract infections, or acute pyelonephritis in adults is 250 mg once every 24 hours. The usual duration of therapy is 3 days for the treatment of uncomplicated urinary tract infections and 10 days for complicated urinary tract infections and acute pyelonephritis.

The usual dosage of levofloxacin for the treatment of chronic prostatitis in adults is 500 mg once daily for 28 days.

GI Infections

For the treatment of travelers' diarrhea that is severe or associated with fever or bloody stools, some clinicians recommend that 500 mg of levofloxacin be given once daily for up to 3 days. Although the use of anti-infectives for prophylaxis of travelers' diarrhea is generally discouraged, if levofloxacin is used, the recommended oral dosage of the drug is 500 mg once daily during the period of risk (for up to 3 weeks).

Treatment of Active Tuberculosis

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If oral levofloxacin is used as an alternative agent in multiple-drug regimens for the treatment of active tuberculosis, the US Centers for Disease Control and Prevention (CDC), American Thoracic Society (ATS), and Infectious Diseases Society of America (IDSA) recommend that adults and children 15 years of age or older receive 0.5-1 g daily. These experts state that data are not available to support intermittent regimens of levofloxacin for the treatment of tuberculosis.

Anthrax

If oral levofloxacin is used as an alternative agent for postexposure prophylaxis following suspected or confirmed exposure to aerosolized anthrax spores (inhalational anthrax) or if oral levofloxacin is used for the treatment of anthrax when a parenteral regimen is not available (e.g., when there are supply or logistic problems because large numbers of individuals require treatment in a mass casualty setting), the US Working Group on Civilian Biodefense suggests that adults can receive a dosage of 500 mg once daily. Because of the possible persistence of anthrax spores in lung tissue following an aerosol exposure, the US Centers for Disease Control and Prevention (CDC) and the Working Group on Civilian Biodefense state that anti-infective therapy for treatment of inhalation anthrax or for postexposure prophylaxis should be continued for 60 days.

Gonorrhea and Associated Infections

If oral levofloxacin is used for the treatment of uncomplicated cervical, urethral, or rectal gonorrhea in adults and adolescents, the CDC recommends a single 250-mg dose. If levofloxacin is used for the treatment of disseminated gonococcal infection in adults and adolescents, the CDC recommends an initial IV dosage 250 mg once daily continued for 24-48 hours after improvement begins; therapy may be switched to an oral levofloxacin regimen of 500 mg once daily to complete at least 1 week of therapy. Unless the presence of coexisting chlamydial infection has been excluded by appropriate testing, patients receiving levofloxacin therapy for uncomplicated or disseminated gonococcal infections also should receive an anti-infective regimen effective for presumptive treatment of chlamydia (e.g., a single dose of oral azithromycin or a 7-day regimen of oral doxycycline).

Nongonococcal Urethritis

If oral levofloxacin is used for the treatment of nongonococcal urethritis, the CDC recommends 500 mg once daily for 7 days.

Chlamydial Infections

For the treatment of urogenital chlamydial infections in adults and adolescents, the CDC recommends oral levofloxacin in a dosage 500 mg once daily for 7 days.

Pelvic Inflammatory Disease

For the treatment of acute pelvic inflammatory disease (PID) in adults and adolescents when a parenteral regimen is indicated, IV levofloxacin may be given in a dosage of 500 mg once daily with or without IV metronidazole (500 mg every 8 hours). The parenteral regimen may be discontinued 24 hours after clinical improvement; however, oral doxycycline (100 mg twice daily) should be continued to complete 14 days of therapy. If an oral levofloxacin regimen is used for the treatment of PID, the drug should be given in a dosage of 500 mg once daily for 14 days with or without oral metronidazole (500 mg twice daily for 14 days).

Dosage in Renal and Hepatic Impairment

Dosage of levofloxacin should be modified according to the degree of renal impairment for patients with creatinine clearances less than 50 mL/minute per 1.73 m. The patient's creatinine clearance (Ccr) can be estimated by using the following formulas:

For the treatment of acute maxillary sinusitis, acute bacterial exacerbations of chronic bronchitis, community-acquired pneumonia, or uncomplicated skin and skin structure in patients with a creatinine clearance of 20-49 mL/minute per 1.73 m, the manufacturer recommends an initial 500-mg loading dose followed by 250 mg every 24 hours for the duration of therapy; patients with a creatinine clearance of 10-19 mL/minute and those undergoing hemodialysis or continuous ambulatory peritoneal dialysis should receive an initial 500-mg loading dose followed by 250 mg every 48 hours for the duration of therapy. For the treatment of complicated skin and skin structure infections in patients with a creatinine clearance of 20-49 mL/minute per 1.73 m, the manufacturer recommends an initial 750-mg loading dose followed by 750 mg every 48 hours for the duration of therapy; patients with a creatinine clearance of 10-19 mL/minute and those undergoing hemodialysis or continuous ambulatory peritoneal dialysis should receive an initial 750-mg loading dose followed by 500 mg every 48 hours for the duration of therapy. For most patients undergoing dialysis, additional supplemental doses of levofloxacin following each dialysis procedure are unnecessary.

For the treatment of complicated urinary tract infections or acute pyelonephritis in patients with a creatinine clearance of 10-19 mL/minute per 1.73 m, the manufacturer recommends an initial 250-mg dose followed by 250 mg every 48 hours for the duration of therapy. Dosage of levofloxacin does not need to be modified when used for the treatment of uncomplicated urinary tract infections in patients with impaired renal function.

Adjustment of levofloxacin dosage in patients with hepatic insufficiency would not be expected to be necessary because most of the drug is excreted unchanged in urine.

Preparations

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Oral Tablets, film- 250 mg (of anhydrous Levaquin®, Ortho-coated levofloxacin) McNeil 500 mg (of anhydrous Levaquin®, Ortho-levofloxacin) McNeil 750 mg (of anhydrous Levaquin®, Ortho-levofloxacin) McNeil Parenteral For injection, equivalent to levofloxacin Levaquin®, Ortho-concentrate, for 25 mg/mL (500 or 750 mg) McNeil IV infusion

Levofloxacin in Dextrose Parenteral Injection, for IV equivalent to levofloxacin 5 Levaquin® in Dextrose infusion mg/mL (250, 500, or 750 mg) Injection Premix, (in flexible in 5% Dextrose containers) Ortho-McNeil

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