INN monograph
Levofloxacin eye drops
Fluoroquinolone antibiotic · POM
Verified · Updated 01 Aug 2026 · Source: Local active-ingredient clinical extract; Professional class pharmacology (Fluoroquinolone antibiotic)
Kenya market
Wholesale / list prices where loaded
Risk first
Contraindications
- Hypersensitivity to quinolones.
- History of quinolone-related tendon disorder.
- Avoid in myasthenia gravis (exacerbation).
- Generally avoid in children/adolescents except specific labelled indications.
- Caution pregnancy/lactation — prefer alternatives when possible.
Precautions
- FDA/EMA boxed risks: tendinopathy/rupture, peripheral neuropathy, CNS effects, aortic aneurysm risk in susceptible patients, QT prolongation (esp. moxifloxacin), dysglycaemia, psychiatric effects.
- Avoid in patients with significant risk factors unless benefits outweigh risks.
- Photosensitivity.
- Separate from polyvalent cations (antacids, Fe, Ca, dairy, sucralfate) by several hours.
Point of care
Dosing
Adult
Days 1 and 2: 1-2 drops every 2 hours while awake (max. 8 times /day. Days 3 -7: 1-2 drops every 4 hours while awake (max. up to 4 times / day.
Paediatric
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Renal
Many agents need CrCl-based adjustment (e.g. ciprofloxacin, levofloxacin).
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic
Hepatotoxicity uncommon but reported; moxifloxacin has more hepatic clearance.
Safety
Drug interactions
- Reserve for infections where benefits outweigh class risks.
- Prefer culture-directed therapy.
- Counsel tendon pain stop-drug advice.
- Check ECG risk factors if using QT-prolonging FQ.
- Stewardship: avoid for uncomplicated cystitis/sinusitis when alternatives exist.
Safety
Adverse effects
- GI upset, headache, dizziness, insomnia.
- Serious: tendon rupture, neuropathy, seizures, QT prolongation/TdP, severe hypersensitivity, C. difficile, aortic events (rare), dysglycaemia.
Use
Indications
- Therapeutic use is agent- and indication-specific within the class (Fluoroquinolone antibiotic).
- Use according to culture results, national guidelines (Kenya STG/EML where applicable) and the current product SmPC.
- Bacterial eye infections
Pharmacology
Mode of action
Interferes with bacterial DNA synthesis by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV Fluoroquinolones inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication and transcription.
Full mechanism text
Interferes with bacterial DNA synthesis by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV Fluoroquinolones inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication and transcription. Bactericidal concentration-dependent killing with a post-antibiotic effect.
ADME
Pharmacokinetics & PD
| Onset | 1–2 hours oral |
|---|---|
| Duration | 12–24 hours (agent-dependent) |
| Route | ORAL / IV |
| Distribution | including prostate and bone (agent-dependent). Renal and/or hepatic clearance varies by agent — adjust dose in organ impairment as labelled. |
Full PK/PD text
Excellent oral bioavailability for most agents (near-IV for ciprofloxacin/levofloxacin in many settings). Wide tissue distribution including prostate and bone (agent-dependent). Renal and/or hepatic clearance varies by agent — adjust dose in organ impairment as labelled.
Kenya
Brands & prices
| Brand | Company | Pack | KES |
|---|---|---|---|
| Levotop Eye Drops | Ajanta Pharmaceuticals Ltd | Standard Commercial Pack | — |
| Quixin | Helix Pharma (PVT) Ltd. | Standard Commercial Pack | — |
Special populations
Pregnancy & lactation
Pregnancy
Generally avoid unless no safer alternative; animal arthropathy concerns and limited human data for many agents.
Lactation
Often avoided or used short-term with caution; check agent-specific guidance.
Diet
Food & alcohol
- Food
- Food
Trust
Sources & disclaimer
Source: Local active-ingredient clinical extract; Professional class pharmacology (Fluoroquinolone antibiotic)
Last reviewed: 01 Aug 2026
Decision support only — not a substitute for clinical judgment, product SmPC, or Kenya STG/EML.