Levolet R infusion solution 5mg/ml 100ml

Composition

100 ml of the solution contains: Active ingredient: levofloxacin hemihydrate 512 mg, equivalent to 500 mg of levofloxacin. Auxiliary substances:  dextrose 5000 mg, hydrochloric acid 0.117 ml, sodium hydroxide 2,857 mg, water for injection up to 100 ml

Pharmacological action

Levofloxacin is a broad-spectrum antimicrobial bactericidal agent from the group of fluoroquinolones. It blocks DNA gyrase (topoisomerase II) and topoisomerase IV, disrupts supercoiling and crosslinking of DNA breaks, suppresses DNA synthesis, and causes deep morphological changes in the cytoplasm, cell wall, and membranes. Levofloxacin is active against the following strains of microorganisms, both in vitro and in vivo. Sensitive microorganisms (MPC ≤ 2 mg/ml). Aerobic gram-positive microorganisms: Bacillus anrthracis, Corynebacteriun diphtheriae, Corynebacterium jeikeium, Enterococcus faecalis, Enterococcus spp., Listeria monocytogenes, Staphylococcus coagulase-negative methi-S(I) (methicillin-sensitive/moderately sensitive strains), Staphylococcus aureus methi-S (methicillin-sensitive strains), Staphylococcus epidermidis methi-S (methicillin-sensitive strains), Staphylococcus spp. CNS (coagulase-negative), Group C and G Streptococci (including Streptococcus agalactiae, Streptococcus pneumoniae peni-S/I/R (penicillin-sensitive/moderately sensitive/resistant strains)), Streptococcus pyogenes, Viridans streptococci peni-S/R (penicillin-sensitive/ resistant strains). Aerobic gram-negative microorganisms: Acinetobacter baumannii, Acinetobacter spp., Actinobacillus actinomycetemcomitans, Citrobacter freundii, Eikenella corrodens, Enterobacter spp. (including Enterobacter cloacae, Enterobacter aerogenes), Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae ampi-S/R (ampicillin-sensitive / resistant strains), Haemophilus parainfluenzae, Helicobacter pylori, Klebsiella spp. (including Klebsiella oxytoca, Klebsiella pneumoniae), Moraxella catarrhalis β+/β – (beta-lactamase producing and non-producing strains), Morganella morganii, Neisseria gonorrhoeae non-PPNG/PPNG (penicillinase producing and non-producing strains), Neisseria meningitidis, Pasteurella spp. (including Pasteurella sapis, Pasteurella dagmatis, Pasteurella multocida), Proteus mirabilis, Proteus vulgaris, Providencia spp. (including Providencia rettgeri, Providencia stuartii), Pseudomonas spp. (including Pseudomonas aeruginosa-hospital infections caused by Pseudomonas aeruginosa may require combined treatment), Salmonella spp., Serratia spp. (including Serratia marcescens). anaerobic microorganisms: Bacteroides fragilis, Bifidobacterium spp., Clostridium perfringens, Fusobacterium spp., Peptostreptococcus spp., Propionibacterium spp., Veilonella spp. Other microorganisms: Bartonella spp., Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp., Mycobacterium spp. (including Mycobacterium leprae, Mycobacterium tuberculosis), Mycoplasma hominis, Mycoplasma pneumoniae, Rickettsia spp., Ureaplasma urealyticum. Moderately sensitive microorganisms (BMD ≥ 4 mg/l). Aerobic gram-positive microorganisms: Corynebacterium urealiticum, Corynebacterium xerosis, Enterococcus faecium, Staphylococcus epidermidis methi-R (methicillin-resistant strains), Staphylococcus haemolyticus methi-R (methicillin – resistant strains). Aerobic gram-negative microorganisms: CamPylobacter jejuni, CamPylobacter coli. Anaerobic microorganisms: Prevotella spp., Porphyromonas spp. Resistant microorganisms (MPC ≥ 8 mg/l): Aerobic gram-positive microorganisms: Staphylococcus aureus methi-R (methicillin-resistant strains), Staphylococcus coagulase-negative methi-R (coagulase – negative methicillin-resistant strains). Aerobic gram-negative microorganisms: Alcaligenes xylosoxidans. Anaerobic microorganisms: Bacteroides thetaiotaomicron. Other microorganisms: Mycobacterium avium. Resistance to levofloxacin develops as a result of a step-by-step process of mutation of the genes encoding both type II topoisomerases:  DNA gyrase and topoisomerase IV. Other mechanisms of resistance, such as the mechanism of influence on the penetration barriers of the microbial cell (characteristic of Pseudomonas aeruginosa) and the efflux mechanism, can also reduce the sensitivity of the microorganism to levofloxacin. Due to the specific mechanism of action of levofloxacin, there is usually no cross-resistance between levofloxacin and other antimicrobial agents. Clinical efficacy (efficacy in clinical trials in the treatment of infections caused by the following microorganisms)Aerobic gram-positive microorganisms: Enterococcus faecalis, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes;Aerobic Gram-negative microorganisms: Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella (Branhamella) catarrhalis, Morganella morganii, Proteus mirabilis, Pseudomonas aeruginosa, Serratia marcescens;Others: Chlamydia pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae. PHARMACOKINETICSPHARMACOKINETICS of levofloxacin with single and multiple use of the drug is linear. The plasma profile of levofloxacin concentrations after intravenous use is similar to that of tablets. Therefore, the oral and intravenous routes of use can be considered interchangeable. The average volume of distribution (Vd) of levofloxacin is 89 to 112 liters (after single and multiple intravenous use at a dose of 500 mg). Plasma protein binding is 30-40%. After an intravenous one-hour infusion of levofloxacin at a dose of 500 mg to healthy volunteers, the average peak plasma concentration (Cmax) was 6.2±1.0 mcg / ml, the time to reach the peak concentration (Tmax) was 1.0±0.1 h. It penetrates well into organs and tissues: lungs, bronchial mucosa, sputum, organs of the genitourinary system, polymorphonuclear leukocytes, alveolar macrophages. In the liver, a small portion is oxidized and / or deacetylated. After a single intravenous dose of 500 mg, the half-life (T1/2) is 6.4±0.7 hours. It is mainly excreted by the kidneys through glomerular filtration and tubular secretion. Renal clearance is 70% of the total clearance. Less than 5% of levofloxacin is excreted as metabolites. In the urine for a period of 24 hours,70% is found unchanged, and for 48 hours – 87% of the administered dose. In the feces for a period of 72 hours,4% of the administered dose is detected. Pharmacokinetics in individual patient groups, the pharmacokinetics of levofloxacin in men and women do not differ. The pharmacokinetics in elderly patients do not differ from those in young patients, with the exception of differences associated with differences in creatinine clearance (CC). In patients with renal insufficiency, the pharmacokinetics of levofloxacin are altered. As renal function worsens, renal excretion and renal clearance (CIR) decrease and T 1/2 increases.

Indications

Infectious and inflammatory diseases of mild and moderate severity caused by levofloxacin-sensitive pathogens:

• community-acquired pneumonia;
• complicated kidney and urinary tract infections, including pyelonephritis;
• uncomplicated urinary tract infections;
• chronic bacterial prostatitis;
• infections of the skin and soft tissues;
• as part of the complex therapy of drug-resistant forms of tuberculosis;
• prevention and treatment of anthrax in the airborne pathway of infection.

When using Levolet® P Official national guidelines for the appropriate use of antibacterial agents, as well as the sensitivity of pathogens in a particular country, should be taken into account.

Contraindications

• Epilepsy;
• a history of tendon damage associated with quinolone use; 
• children and adolescents under 18 years of age;
• pregnancy;
• lactation (breastfeeding);
• hypersensitivity to levofloxacin, other quinolones, as well as to any of the excipients of Levolet® P;
• pseudoparalytic myasthenia gravis.

With caution: 

• In patients predisposed to seizures, including those receiving medications such as fenbufen, theophylline.
• In patients with glucose-6-phosphate dehydrogenase deficiency (increased risk of hemolytic reactions).
• In patients with impaired renal function (see section “Dosage and use”).
• In patients with known risk factors for prolongation of the QT interval: in elderly patients; in female patients; in patients with uncorrected electrolyte disorders (hypokalemia, hypomagnesemia); with congenital prolongation of the QT interval; with heart diseases (heart failure, myocardial infarction, bradycardia); while taking medications that can prolong the QT interval (class IA and III antiarrhythmics, tricyclic antidepressants, macrolides, neuroleptics).
• Patients with diabetes mellitus who are treated with oral hypoglycemic drugs, such as glibenclamide or insulin preparations (the risk of hypoglycemia increases).
• In patients with severe adverse reactions to other fluoroquinolones, such as severe neurological reactions (increased risk of similar adverse reactions with levofloxacin).
• In patients with psychosis or in patients with a history of mental illness.

Side effects

The following side effects are presented according to the following frequency gradations: very frequent (≥1/10); frequent (≥1/100, <1/10); infrequent (≥1/1000, <1/100); rare (≥1/10000, <1/1000); very rare (Data obtained in clinical trials and post-marketing use of the drug Disorders of the heart are rare: sinus tachycardia, palpitation sensation. Unknown frequency (post-marketing data): prolongation of the QT interval, ventricular arrhythmias, ventricular tachycardia, ventricular tachycardia of the “pirouette” type, which can lead to cardiac arrest. Disorders of the blood and lymphatic system are common: leukopenia (a decrease in the number of white blood cells in the peripheral blood), eosinophilia (an increase in the number of eosinophils in the peripheral blood). Rare: neutropenia (a decrease in the number of neutrophils in the peripheral blood), thrombocytopenia (a decrease in the number of platelets in the peripheral blood). Unknown frequency (post-marketing data): pancytopenia (decrease in the number of all formed elements in the peripheral blood), agranulocytosis (absence or sharp decrease in the number of granulocytes in the peripheral blood), hemolytic anemia. Nervous system disorders are common: headache, dizziness. Infrequent: drowsiness, tremor, dysgeusia (perversion of taste). Rare: paresthesia, convulsions (see section “Special instructions”). Unknown frequency (post-marketing data): peripheral sensory neuropathy, peripheral sensory-motor neuropathy (see section “Special instructions”), dyskinesia, extrapyramidal disorders, ageusia (loss of taste sensations), parosmia (odour sensation disorder, especially subjective odour sensation, objectively absent), including loss of smell; syncope, benign intracranial hypertension. Visual disturbances Very rare: visual disturbances, such as blurring of the visible image. Unknown frequency: transient vision loss, uveitis. Hearing disorders and labyrinthine disorders are common: vertigo (feeling of deflection or whirling, or of one’s own body or surrounding objects). Rare: tinnitus. Unknown frequency (post-marketing data): hearing loss. Respiratory, thoracic and mediastinal disorders Infrequent: shortness of breath. Unknown frequency (post-marketing data): bronchospasm, allergic pneumonitis. Gastrointestinal disorders are common: diarrhea, vomiting, nausea. Infrequent: abdominal pain, dyspepsia, flatulence, constipation. Unknown frequency (post-marketing data): hemorrhagic diarrhea, which in very rare cases can be a sign of enterocolitis, including pseudomembranous colitis (see section “Special instructions”), pancreatitis. Renal and urinary tract disorders: Frequent: increased serum creatinine. Rare: acute renal failure (for example, due to the development of interstitial nephritis). Skin and subcutaneous tissue disorders Infrequent: rash, pruritus, urticaria, hyperhidrosis. Unknown frequency (post-marketing data): toxic epidermal necrolysis, Stevens-Johnson syndrome, exudative erythema multiforme, photosensitization reactions (hypersensitivity to sunlight and ultraviolet radiation) (see the section “Special instructions”), leukocytoclastic vasculitis, stomatitis. Reactions from the skin and mucous membranes can sometimes develop even after taking the first dose of the drug. Musculoskeletal and connective tissue disorders Infrequent: arthralgia, myalgia. Rare: tendon involvement, including tendinitis (such as Achilles tendon), muscle weakness that can be particularly dangerous in patients with pseudoparalytic myasthenia gravis (see section “Special instructions”). Unknown frequency (post-marketing data): rhabdomyolysis, tendon rupture (for example, Achilles tendon. This side effect may occur within 48 hours after starting treatment and may be bilateral in nature( see also the section “Special instructions”)), ligament rupture, muscle rupture, arthritis. Metabolic and nutritional disorders Infrequent: anorexia. Rare: hypoglycemia, especially in patients with diabetes mellitus (possible signs of hypoglycemia: “wolfish” appetite, nervousness, perspiration, trembling). Unknown frequency: hyperglycemia, hypoglycemic coma (see section “Special instructions”). Infectious and parasitic diseases Infrequent ones:  fungal infections, development of resistance of pathogenic microorganisms. Vascular disorders are frequent: phlebitis. Rare: low blood pressure. General disorders and disorders at the injection site Often: reaction at the injection site (soreness, hyperemia of the skin). Infrequent: asthenia. Rare: pyrexia (increased body temperature). Unknown frequency: pain (including back, chest, and limb pain). Immune system disorders are rare: angioedema. Unknown frequency (post-marketing data): anaphylactic shock, anaphylactoid shock. Anaphylactic and anaphylactoid reactions can sometimes develop even after taking the first dose of the drug. Liver and biliary tract disorders are common: increased activity of “liver” enzymes in the blood (for example, alanine aminotransferase (AlAT), aspartate aminotransferase (AsAT)), increased activity of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT). Infrequent: increased bilirubin concentration in the blood. Unknown frequency (post-marketing data): severe hepatic insufficiency, including cases of acute hepatic insufficiency, sometimes fatal, especially in patients with a severe underlying disease (for example, in patients with sepsis); hepatitis, jaundice. Mental disorders are frequent: insomnia. Infrequent: feelings of restlessness, anxiety, confusion. Rare: mental disorders (such as hallucinations, paranoia), depression, agitation (agitation), sleep disorders, nightmares. Unknown frequency (post-marketing data): mental disorders with self-harm behavioral disorders, including suicidal thoughts and suicide attempts. Other possible adverse effects related to all fluoroquinolones are very rare: attacks of porphyria (a very rare metabolic disease) in patients with porphyria

Interaction

Increases T1 / 2 of cyclosporine. The degree of absorption of levofloxacin is reduced by drugs that inhibit intestinal motility, sucralfate, antacid drugs containing aluminum and magnesium salts, as well as drugs containing iron salts (a break between use is required for at least 2 hours). NSAIDs, theophylline increase convulsive readiness. Corticosteroids increase the risk of tendon rupture. Cimetidine and drugs that block tubular secretion slow down excretion. When used concomitantly with indirect anticoagulants (including warfarin), blood clotting should be monitored.

How to take, course of use and dosage

The drug is administered intravenously. The dose is determined by the nature and severity of the infection, as well as the sensitivity of the suspected pathogen. Considering that the bioavailability of levofloxacin when taken in tablets is 99%, in the case of transferring a patient from an intravenous infusion of Levolet® Application for Levolet ® tablets P continue treatment at the same dose as the intravenous infusion.Recommended dosage regimen and duration of treatment in patients with normal or mildly impaired renal function (creatinine clearance greater than 50 ml / min). Community-acquired pneumonia: 500 mg 1-2 times / day. The course of treatment is 7-14 days. Uncomplicated urinary tract infections: 250 mg 1 time/day. The course of treatment is 3 days. Complicated urinary tract infections 500 mg 1 time / day. The course of treatment is 7-14 days. Pyelonephritis: 500 mg 1 time/day – 7-10 days. Chronic bacterial prostatitis: 500 mg 1 time/day. The course of treatment is 28 days. As part of the complex therapy of drug-resistant forms of tuberculosis: 500 mg 1-2 times / day (500-1000 mg of levofloxacin per day), depending on the severity of the disease and the treatment regimen used. The course of treatment is up to 3 months. Infections of the skin and soft tissues: 500 mg of levofloxacin 1-2 times a day (respectively, the daily dose of 500-1000 mg of levofloxacin) – 7-14 days. Prevention and treatment of anthrax in the airborne pathway of infection: 500 mg of levofloxacin once a day (respectively, the daily dose of 500 mg of levofloxacin) – for up to 8 weeks. Use in patients with impaired renal functionin patients with slightly impaired renal function (creatinine clearance > 50 ml / min), no dose adjustment is required. Patients with impaired renal function need to adjust the dosage regimen depending on the value of creatinine clearance. No additional doses are required after hemodialysis or continuous outpatient peritoneal dialysis. Use in patients with hepatic dysfunctionwhen liver function is impaired, no special dose selection is required, since levofloxacin is metabolized in the liver to an extremely small extent. Use in elderly patients For elderly patients, no dosage adjustment is required, except in cases of a decrease in creatinine clearance to 50 ml / min or lower. Levolet®preparation P in the form of an infusion solution is administered intravenously drip slowly. The duration of use of the drug at a dose of 500 mg (100 ml of infusion solution / 500 mg of levofloxacin) should be at least 60 minutes. Levolet®solution P is compatible with the following infusion solutions: 0.9% sodium chloride solution,5% dextrose solution,2.5% Ringer’s solution with dextrose, combined solutions for parenteral nutrition (amino acids, carbohydrates, electrolytes). The drug solution should not be mixed with heparin or solutions with an alkaline reaction (for example, with a solution of sodium bicarbonate). The duration of treatment, depending on the course of the disease, is no more than 14 days (with the exception of chronic bacterial prostatitis). As with other antibiotics, treatment with Levolet®is recommended. R is recommended to continue for at least 48-72 hours after normalization of body temperature or after reliable eradication of the pathogen.

Overdose

Symptoms: nausea, erosive lesions of the gastrointestinal mucosa, prolongation of the QT interval, confusion, dizziness, convulsions. Treatment: symptomatic, dialysis is ineffective.

Special instructions

Hospital infections caused by Pseudomonas aeruginosa (Pseudomonas aeruginosa) may require combined treatment. The prevalence of acquired resistance of the seeded strains of microorganisms may vary depending on the geographical region and over time. For the treatment of severe infections or if treatment is ineffective, a microbiological diagnosis should be established with the isolation of the pathogen and determination of its sensitivity to levofloxacin. Methicillin-resistant Staphylococcus aureus is highly likely to be resistant to fluoroquinolones, including levofloxacin. Therefore, levofloxacin is not recommended for the treatment of established or suspected infections caused by methicillin-resistant Staphylococcus aureus, if laboratory tests have not confirmed the sensitivity of this microorganism to levofloxacin. Duration of infusions use should be carried out for at least 60 minutes, palpitations and a transient decrease in blood pressure may occur during use, and collapse may rarely develop. With a marked decrease in blood pressure, levofloxacin is discontinued. Patients predisposed to developing seizures Like other quinolones, levofloxacin should be used with great caution in patients with a predisposition to seizures. These patients include patients with previous central nervous system disorders, such as stroke, severe traumatic brain injury;patients receiving concomitant medications that lower the threshold for convulsive readiness of the brain, such as fenbufen and other similar nonsteroidal anti-inflammatory drugs or other drugs that lower the threshold for convulsive readiness, such as theophylline. Pseudomembranous colitis Diarrhea that develops during or after treatment with levofloxacin, especially severe, persistent and/or bloody, may be a symptom of pseudomembranous colitis caused by Clostridium difficile. In this case, treatment with levofloxacin should be stopped immediately and specific antibiotic therapy (vancomycin, teicoplanin or metronidazole orally) should be initiated immediately. Drugs that inhibit intestinal motility are contraindicated. Tendinitis Rarely observed tendinitis with quinolones, including levofloxacin, can lead to tendon rupture, including the Achilles tendon. This side effect may develop within 48 hours of starting treatment and may be bilateral. Older age and concomitant use of glucocorticosteroids may increase the risk of tendinitis and tendon rupture. If tendinitis is suspected, treatment with levofloxacin should be stopped immediately and appropriate treatment should be initiated for the affected tendon, for example, by ensuring that it is sufficiently immobilized. Hypersensitivity Reactionsilevofloxacin can cause serious, potentially fatal, hypersensitivity reactions (angioedema, anaphylactic shock), even with the use of initial doses. Patients should immediately stop taking the drug and consult a doctor. Severe bullous reactions Severe bullous skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, have been reported with levofloxacin. In case of any skin or mucosal reactions, the patient should immediately consult a doctor and not continue treatment until after consultation. Liver and biliary tract disorders Cases of hepatic necrosis, including fatal liver failure, have been reported with levofloxacin, mainly in patients with severe underlying medical conditions, such as sepsis. Patients should be warned to stop treatment and seek immediate medical attention if signs and symptoms of liver damage appear, such as anorexia, jaundice, dark urine, itching, and abdominal pain. Patients with renal insufficiency Since levofloxacin is mainly excreted through the kidneys, in patients with impaired renal function, mandatory monitoring of renal function is required, as well as dosage adjustment (see the section “Dosage and use”). When treating elderly patients, it should be borne in mind that patients in this group often have impaired renal function. Prevention of photosensitization reactions Although photosensitization is very rare when levofloxacin is used, to prevent its development, patients are not recommended to be exposed to strong solar or artificial ultraviolet radiation (for example, to visit a tanning salon) during treatment and within 48 hours after the end of treatment with levofloxacin without special need. Superinfectio Nas with other antibiotics, the use of levofloxacin, especially for a long time, can cause changes in the microflora, which is normally present in humans. As a result, superinfection may develop. Therefore, it is mandatory to re-evaluate the patient’s condition during treatment, and if superinfection develops during treatment, appropriate measures should be taken. Prolongation of the QT interval Very rare cases of QT prolongation have been reported in patients taking fluoroquinolones, including levofloxacin. Caution should be exercised when using fluoroquinolones, including levofloxacin, in patients with known risk factors for prolongation of the QT interval: in patients with uncorrected electrolyte disturbances (hypokalemia, hypomagnesemia); with congenital QT prolongation syndrome; with heart diseases (heart failure, myocardial infarction, bradycardia); while taking medications that can prolong the QT interval, such as class IA and III antiarrhythmics, tricyclic antidepressants, macrolides, antipsychotics. Elderly and female patients may be more sensitive to drugs that prolong the QT interval. Therefore, fluoroquinolones, including levofloxacin, should be used with caution. Patients with glucose-6-phosphate dehydrogenase deficiency have a predisposition to hemolytic reactions when treated with quinolones, which should be taken into account when treated with levofloxacin. Hypo-and hyperlycemia (dysglycemia)As with other quinolones, hyperglycemia and hypoglycemia have been reported with levofloxacin, usually in patients with diabetes mellitus receiving concomitant treatment with oral hypoglycemic drugs (for example, glibenclamide) or insulin preparations. Cases of hypoglycemic coma have been reported. In patients with diabetes mellitus, blood glucose monitoring is required (seesection “Side effects”). Peripheral neuropathy Sensory and sensorimotor peripheral neuropathy has been reported with fluoroquinolones, including levofloxacin. If symptoms of neuropathy appear, levofloxacin should be discontinued. Exacerbation of pseudoparalytic myasthenia gravis Fluoroquinolones, including levofloxacin, are characterized by neuromuscular blocking activity and can increase muscle weakness, including respiratory muscles. The use of levofloxacin in a patient with an established diagnosis of pseudoparalytic myasthenia gravis is not recommended. The use in the airborne route of anthrax infection in humans is based on data on the sensitivity of Bacillus anthracis to it, obtained in vitro studies and in experimental studies conducted on animals, as well as on limited data on the use of levofloxacin in humans. Treating physicians should refer to clinical guidelines that reflect a common point of view on the treatment of anthrax. Psychotic reactions with the use of quinolones, including levofloxacin, in very rare cases progressed to the development of suicidal thoughts and behavioral disorders with self-harm (sometimes after taking a single dose). If such reactions develop, treatment with levofloxacin should be discontinued and appropriate therapy should be prescribed. Caution should be exercised when prescribing the drug to patients with psychosis or a history of mental illness. Visual disturbances If you develop any visual disturbances, you should immediately consult an ophthalmologist. Effects on laboratory tests in patients taking levofloxacin, the determination of opiates in the urine may lead to false positive results, which should be confirmed by more specific methods. Levofloxacin can inhibit the growth of Mycobacterium tuberculosis and subsequently lead to false negative results of the bacteriological diagnosis of tuberculosis. Side effects of levofloxacin such as dizziness or vertigo, drowsiness, and visual disturbances may reduce psychomotor responses and the ability to concentrate. This can pose a certain risk in situations where these abilities are particularly important (for example, when driving a car, when servicing machines and mechanisms, when performing work in an unstable position).

Storage conditions

In a dark place at a temperature not exceeding 25 °C. Do not freeze it. Keep out of reach of children!

Shelf

life is 2 years.

Active ingredient

Levofloxacin

Conditions of release from pharmacies

By prescription

Dosage form

solution for infusions

Purpose

Children as prescribed by a doctor, Adults as prescribed by a doctor

Indications

From infectious diseases, From respiratory tract infections, From sinusitis, From urinary tract infections, From pneumonia, From prostatitis, Bronchitis, From boils, From skin infections, From sinusitis