From the FDA Drug Label
In addition to the events reported in pediatric patients in clinical trials, events reported in adults during clinical trials or postmarketing experience [see Adverse Reactions (6)] may also be expected to occur in pediatric patients. Cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias and weakness have been reported in patients receiving fluoroquinolones, including levofloxacin. An increased incidence of musculoskeletal disorders (arthralgia, arthritis, tendinopathy, and gait abnormality) compared to controls has been observed in pediatric patients receiving levofloxacin
Levaquin induced generalized weakness and gait instability may be related to the use of levofloxacin, as cases of sensory or sensorimotor axonal polyneuropathy and musculoskeletal disorders, including gait abnormality, have been reported in patients receiving fluoroquinolones, including levofloxacin 1, 1.
- Generalized weakness and gait instability may be symptoms of these conditions.
- The FDA drug label warns of the potential for musculoskeletal disorders and peripheral neuropathy associated with levofloxacin use.
- Patients should be informed of this potential side effect and advised to discontinue levofloxacin and contact their healthcare provider if any symptoms occur 1.
From the Research
Levaquin (levofloxacin) can indeed cause generalized weakness and gait instability as adverse effects, and if you're experiencing these symptoms, you should contact your healthcare provider immediately as these may be signs of a serious side effect called fluoroquinolone-associated disability (FQAD). These symptoms occur because fluoroquinolones like Levaquin can damage peripheral nerves and affect the central nervous system, potentially causing neurotoxicity 2. The risk increases in patients over 60, those with kidney problems, and individuals taking corticosteroids.
Key Considerations
- If your doctor confirms these symptoms are related to Levaquin, they will likely discontinue the medication and switch you to an alternative antibiotic.
- Recovery time varies from weeks to months, and some patients may benefit from physical therapy to improve strength and balance 3.
- To manage symptoms, ensure adequate rest, maintain proper nutrition, and avoid activities that could lead to falls while experiencing gait instability.
- Report any worsening symptoms, such as severe pain, numbness, or difficulty breathing, to your doctor immediately.
Important Factors to Note
- The risk of cardiovascular death associated with levofloxacin is rare, but it should be considered when making prescription decisions 4.
- A study on the treatment of Helicobacter pylori eradication found that levofloxacin-based triple therapy achieves an H. pylori eradication rate comparable to that of standard twice-daily triple therapy, but is associated with higher patient compliance and might even be better tolerated 5.
- In the geriatric population, generalized weakness is a common complaint and requires a thorough approach to initial management, including laboratory and imaging testing, and consideration of a wide differential with attention to geriatric-specific concerns 3.
Next Steps
- Do not abruptly stop the medication without medical guidance.
- Contact your healthcare provider immediately if you experience any symptoms of generalized weakness or gait instability while taking Levaquin.
- Follow your doctor's instructions for managing symptoms and recovering from potential side effects.