Drug interactions
aluminum hydroxide/magnesium hydroxide + levofloxacin
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Polyvalent-cation antacids markedly decrease oral levofloxacin absorption, lowering serum levels and risking treatment failure.
Mechanism of action
Chelation/complexation of levofloxacin by aluminum/magnesium in the GI tract → reduced absorption (↓AUC/↓Cmax).
Clinical management
Avoid coadministration when possible; administer levofloxacin at least 2 hours before or 2 hours after the antacid. Monitor clinical response; consider IV levofloxacin if separation not feasible in serious infections.
Drug reference
References
- LEVAQUIN (levofloxacin) Prescribing Information — FDA Label
- Levofloxacin: Drug Interactions (polyvalent cations) — Lexicomp
- Fluoroquinolones: Drug interactions — UpToDate
Frequently asked questions
Can I take aluminum hydroxide/magnesium hydroxide with levofloxacin?
The interaction is rated: Moderate. Polyvalent-cation antacids markedly decrease oral levofloxacin absorption, lowering serum levels and risking treatment failure.
How serious is the interaction between aluminum hydroxide/magnesium hydroxide and levofloxacin?
The interaction is rated: Moderate. Evidence level: High.
How is the interaction between aluminum hydroxide/magnesium hydroxide and levofloxacin managed?
Avoid coadministration when possible; administer levofloxacin at least 2 hours before or 2 hours after the antacid. Monitor clinical response; consider IV levofloxacin if separation not feasible in serious infections.
Why do aluminum hydroxide/magnesium hydroxide and levofloxacin interact?
Chelation/complexation of levofloxacin by aluminum/magnesium in the GI tract → reduced absorption (↓AUC/↓Cmax).
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