Levoflox Special Precautions

Care is necessary in patients with impaired hepatic or renal function, glucose-6-phosphate dehydrogenase deficiency, or myasthenia gravis.
An adequate fluid intake should be maintained during the treatment with levofloxacin and excessive alkalinity of the urine avoided because of the risk of crystalluria. Exposure to strong sunlight or sunlamps should be avoided. The ability to drive or operate machinery may be impaired by levofloxacin, especially when alcohol is also taken.
Levofloxacin should be avoided in methicillin-resistant and Staphylococcus aureus infections because of the high level of resistance.
Administration in children: Since levofloxacin and other fluoroquinolones can cause degenerative changes in weight-bearing joints of young animals they should only be used in children and adolescents where their use may be justified if the benefits outweigh the risk.
Exposure to ultraviolet light: Loss of antibacterial activity has been reported following irradiation of levofloxacin solutions by ultraviolet light. In addition to the possible hazard of photosensitivity reactions, a reduction in both cutaneous and circulating levels of levofloxacin was predicted in patients exposed to sunlight through window glass or longer wavelength ultraviolet (UVA) radiation from sun beds.
Interference of diagnostic tests: Levofloxacin did not interfere with determination of urinary-glucose concentrations carried out with Clinitest, Diastix or Tes-Tape, but pseudoglycosuria false-positive reactions for glucose in urine, has been reported with BM-Test-7 in elderly patients given levofloxacin for urinary tract infections.
Myasthenia gravis: Caution is advised in patients with myasthenia gravis given fluoroquinolones following reports of the possible exacerbation of symptoms in patient, and unmasking of sub clinical myasthenia gravis has also been reported with norfloxacin.