Drug interactions
Levofloxacin + Tolazamide
Severity: Moderate
Levofloxacin and Tolazamide: moderate 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
Levofloxacin can provoke severe hypoglycemia, and this risk is increased in patients taking sulfonylureas such as tolazamide. Hyperglycemia can also occur, and elderly or renally impaired patients are most vulnerable.
What this interaction means in plain words
Levofloxacin and Tolazamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Levofloxacin belongs to Anti Bacterial; Tolazamide belongs to Endocrine.
Why it happens
Fluoroquinolones stimulate insulin secretion through pancreatic beta-cell potassium channel effects, adding to sulfonylurea-induced insulin release.
What to do
Monitor blood glucose closely when starting levofloxacin and counsel the patient on hypoglycemia symptoms. Reduce the sulfonylurea dose if low glucose develops, or change the antibiotic.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Tolazamide
- Disopyramide + Tolazamide Major
- Insulin degludec-liraglutide + Tolazamide Major
- Aceclofenac + Tolazamide Moderate
- Acemetacin + Tolazamide Moderate
- Acetylsalicylic acid + Tolazamide Moderate
- Albiglutide + Tolazamide Moderate
Frequently asked questions
Can I take Levofloxacin with Tolazamide?
MediHelp rates the interaction as moderate. Levofloxacin and Tolazamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Levofloxacin can provoke severe hypoglycemia, and this risk is increased in patients taking sulfonylureas such as tolazamide. Hyperglycemia can also occur, and elderly or renally impaired patients are most vulnerable.
How serious is the interaction between Levofloxacin and Tolazamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely when starting levofloxacin and counsel the patient on hypoglycemia symptoms. Reduce the sulfonylurea dose if low glucose develops, or change the antibiotic.
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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