What are the side effects of ofloxacin vs. levofloxacin?

Ofloxacin

The most common side effects of ofloxacin include:

Allergic reactions have been described, such as hives and anaphylaxis (shock).

Other important side effects include symptoms of nervous system stimulation, such as:

Ofloxacin may cause low or high blood sugar levels especially in people with diabetes who are taking insulin or oral hypoglycemic drugs.

Patients taking ofloxacin can develop skin sensitivity (photsensitivity) to direct sunlight and should avoid exposure to sunlight or use sun protection and sunscreens.

Ofloxacin as well as other antibiotics in the fluoroquinolone class of antibiotics, has been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon. Some physicians recommend that patients discontinue vigorous exercise while they are taking fluoroquinolone antibiotics.

Ofloxacin should be used with caution in patients with central nervous system diseases such as seizures because rare seizures have been reported in patients receiving this medication.

Ofloxacin should be avoided in children and adolescents under 18 years of age, as safe use in these patients have not been established.

Many antibiotics, including ofloxacin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon (Clostridium difficile, pseudomembranous colitis). Pseudomembranous colitis can cause fever, abdominal pain, diarrhea, and sometimes even shock.

Ofloxacin should not be used in patients with myasthenia gravis because it can increase muscle weakness.

Levofloxacin

Serious side effects and warnings include:

Levofloxacin as well as other antibiotics in the fluoroquinolone class of antibiotics have been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon.

Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.

The most frequently reported side effects are:

Less common side effects include:

Rare allergic reactions have been described are:

  • Hives
  • Anaphylaxis (shock)

Possible serious side effects of levofloxacin include:

Other serious side effects and adverse events of levofloxacin include:

Levofloxacin should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Levaquin.

Levofloxacin should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.

Many antibiotics, including levofloxacin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting Levaquin (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

Patients taking Levofloxacin can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.

Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]).

Because of serious side effects associate with fluoroquinolones, they should not be used for treating uncomplicated urinary tract infections, acute bacterial exacerbation of chronic bronchitis or acute bacterial sinusitis unless there are no other alternatives.