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Antacids, Sucralfate, Metal Cations and Multivitamins: There are no data concerning an interaction of intravenous quinolones with oral antacid, sucralfate, multivitamins, or metal cation. However, no quinolones should be co-administered with any solution containing multivitamin cation, e.g. magnesium, through the same intravenous line.
Theophylline, Fenbufen, or similar non-steroidal anti-inflammatory drugs (phenylacetic acid/propionic acid derivatives): No pharmacokinetic interactions of levofloxacin were found with theophylline in a clinical study. However, there are indications of a pronounced lowering of the cerebral seizure threshold when quinolones are given concurrently with other drugs that lower seizure threshold (e.g. theophylline) or with fenbufen or similar non-steroidal anti-inflammatory drugs.
Antidiabetic agents: Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. Therefore, careful monitoring of blood glucose is recommended when these agents are co-administered.
Anticoagulant drug (warfarin and its derivatives): Coadministration of warfarin and its derivatives has been reported that the effect of warfarin was potentiated (hepatic metabolism of warfain may be inhibited, or free warfarin may be increased by competitive displacement from the protein-binding site) and therefore prothrombin time prolonged.
Class IA antiarrythmics and Class III antiarrythmics: Levofloxacin should be used with caution in patients receiving drug known to cause QT prolonged, Class IA antiarrythmics (e.g. quinidine sulfate and procainamide hydrochloride), Class III antiarrythmics (e.g. amiodarone hydrochloride and sotalol hydrochloride) QT prolongation may occur.
