Drug interactions
Levofloxacin + Quinine
Severity: Major
Levofloxacin and Quinine: major interaction.
Last updated
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
Quinine prolongs the QT interval and levofloxacin has a similar effect, so combined use increases the risk of torsades de pointes. Serious arrhythmias have been reported with quinine alone, particularly with other risk factors.
What this interaction means in plain words
Levofloxacin and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Additive blockade of cardiac potassium channels with delayed repolarization.
What to do
Avoid the combination when possible. If it is unavoidable, correct electrolytes, obtain a baseline ECG and monitor the QTc.
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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Other interactions of Levofloxacin
- Dronedarone + Levofloxacin Contraindicated
- Ibutilide + Levofloxacin Contraindicated
- Levofloxacin + Thioridazine Contraindicated
- Levofloxacin + Vandetanib Contraindicated
- Levofloxacin + Ziprasidone Contraindicated
- Adagrasib + Levofloxacin Major
Other interactions of Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Frequently asked questions
Can I take Levofloxacin with Quinine?
MediHelp rates the interaction as major. Levofloxacin and Quinine 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. Quinine prolongs the QT interval and levofloxacin has a similar effect, so combined use increases the risk of torsades de pointes. Serious arrhythmias have been reported with quinine alone, particularly with other risk factors.
How serious is the interaction between Levofloxacin and Quinine?
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 when possible. If it is unavoidable, correct electrolytes, obtain a baseline ECG and monitor the QTc.
What other medicines interact with Levofloxacin?
MediHelp also lists interactions of Levofloxacin with, for example, Dronedarone, Ibutilide, Thioridazine. The full list is on the Levofloxacin page.
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