Drug interactions
Levofloxacin + Tolbutamide
Severity: Moderate
Levofloxacin and Tolbutamide: 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 cause clinically important hypoglycemia, with higher risk in patients on sulfonylureas such as tolbutamide. Blood glucose may also rise unexpectedly, so control can become unstable.
What this interaction means in plain words
Levofloxacin and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
Fluoroquinolones increase insulin release by affecting beta-cell potassium channels, additive to sulfonylurea action.
What to do
Check blood glucose more frequently during the antibiotic course and educate the patient about hypoglycemia. Lower the tolbutamide dose if needed or choose a different 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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Levofloxacin with Tolbutamide?
MediHelp rates the interaction as moderate. Levofloxacin and Tolbutamide 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 cause clinically important hypoglycemia, with higher risk in patients on sulfonylureas such as tolbutamide. Blood glucose may also rise unexpectedly, so control can become unstable.
How serious is the interaction between Levofloxacin and Tolbutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check blood glucose more frequently during the antibiotic course and educate the patient about hypoglycemia. Lower the tolbutamide dose if needed or choose a different 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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