Drug interactions
Levofloxacin + Prednisone
Severity: Major
Levofloxacin and Prednisone: major interaction.
Last updated Sources: US FDA label
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.
Summary
Fluoroquinolones given with systemic corticosteroids raise the risk of tendinitis and tendon rupture, particularly of the Achilles tendon. Risk is greater in older adults and transplant recipients.
What this interaction means in plain words
Levofloxacin and Prednisone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Levofloxacin belongs to Anti Bacterial; Prednisone belongs to Endocrine.
Why it happens
Additive tendon toxicity through fluoroquinolone effects on tenocytes and corticosteroid inhibition of collagen synthesis.
What to do
Avoid the combination if another antibiotic is suitable, especially in patients over 60. Stop levofloxacin and rest the limb at the first sign of tendon pain.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Prednisone - FDA drug label (DailyMed) — openFDA / DailyMed
Other interactions of Prednisone
- Bcg vaccine live + Prednisone Contraindicated
- Measles vaccine + Prednisone Contraindicated
- Mifepristone + Prednisone Contraindicated
- Prednisone + Radium-223 dichloride Contraindicated
- Prednisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Prednisone Major
Other interactions of Levofloxacin
- Dronedarone + Levofloxacin Contraindicated
- Ibutilide + Levofloxacin Contraindicated
- Levofloxacin + Thioridazine Contraindicated
- Levofloxacin + Vandetanib Contraindicated
- Levofloxacin + Ziprasidone Contraindicated
- Adagrasib + Levofloxacin Major
Frequently asked questions
Can I take Levofloxacin with Prednisone?
MediHelp rates the interaction as major. Levofloxacin and Prednisone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fluoroquinolones given with systemic corticosteroids raise the risk of tendinitis and tendon rupture, particularly of the Achilles tendon. Risk is greater in older adults and transplant recipients.
How serious is the interaction between Levofloxacin and Prednisone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if another antibiotic is suitable, especially in patients over 60. Stop levofloxacin and rest the limb at the first sign of tendon pain.
What other medicines interact with Prednisone?
MediHelp also lists interactions of Prednisone with, for example, Bcg vaccine live, Measles vaccine, Mifepristone. The full list is on the Prednisone page.
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