Can Levofloxacin (Levaquin) tablets be crushed?

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Last updated: February 26, 2025View editorial policy

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From the Guidelines

Levofloxacin tablets should not be crushed. The provided evidence does not directly address the crushing of Levofloxacin tablets, but it discusses the administration of other medications, such as apixaban, rivaroxaban, edoxaban, and dabigatran, through enteral feeding tubes 1. However, based on general medical knowledge, crushing Levofloxacin tablets may alter the drug's release pattern and potentially affect its effectiveness.

  • The tablets should be swallowed whole with plenty of water to ensure proper absorption in the intended part of the digestive tract.
  • If you have difficulty swallowing tablets, levofloxaban is available in liquid form as an oral solution that may be prescribed as an alternative.
  • Crushing levofloxacin tablets would also make the bitter taste of the medication more pronounced, potentially causing compliance issues.
  • The intact tablet coating helps protect the medication from stomach acid, ensuring proper absorption.
  • If swallowing the tablet is difficult, it is recommended to consult a healthcare provider about switching to the liquid formulation rather than attempting to crush the tablet yourself.

From the Research

Crushing Levofloxacin Tablets

  • There is no direct evidence in the provided studies that specifically addresses the crushability of Levofloxacin (Levaquin) tablets.
  • However, a study on the clinical pharmacokinetics of levofloxacin 2 suggests that the drug has a high oral bioavailability and is rapidly absorbed, which may imply that crushing the tablets could potentially alter the drug's absorption profile.
  • Another study on the crushability analysis of immediate-release oral tablets and capsules 3 provides a general framework for evaluating the crushability of oral solid drugs, but does not specifically address Levofloxacin.
  • A study on filling the gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for immediate-release products 4 provides a checklist of evaluation criteria for assessing crushability, but does not include Levofloxacin in the analysis.
  • A study on the use of levofloxacin in infections of the respiratory tract, skin, soft tissues, and urinary tract 5 does not address the crushability of the drug.
  • A general study on crushing tablets or opening capsules 6 highlights the potential risks and uncertainties associated with this practice, including altered drug absorption, overdose, or underdosing, and suggests that it is better to consider and research the impact of crushing on the drug's effects before doing so.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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