Recommended Dosage of Levofloxacin Tablets for Adults
The usual dose of levofloxacin tablets for adults is 500 mg administered orally once daily (every 24 hours), with dosage adjustments to 250 mg or 750 mg based on the specific infection being treated. 1
Standard Adult Dosing
Levofloxacin tablets are available in three strengths:
- 250 mg tablets
- 500 mg tablets
- 750 mg tablets
The FDA-approved dosing for adults with normal renal function (creatinine clearance ≥50 mL/min) is:
- 500 mg once daily as the standard dose 1
- 250-1000 mg once daily depending on the infection type 2, 3
- High-dose regimen of 750 mg once daily for certain infections 1
Infection-Specific Dosing
Different infections require different dosing regimens:
- Community-acquired pneumonia: 500 mg once daily for 7-14 days or 750 mg once daily for 5 days 4, 5
- Tuberculosis treatment (second-line): 500-1000 mg once daily 2, 3
- Acute bacterial sinusitis: 500 mg once daily for 10-14 days or 750 mg once daily for 5 days 5
- Complicated urinary tract infections: 250-500 mg once daily for 7-10 days or 750 mg once daily for 5 days 5
Administration Considerations
- Levofloxacin tablets can be taken with or without food 1
- Should be administered at least two hours before or two hours after:
Renal Dosage Adjustment
Dosage adjustment is required for patients with impaired renal function:
- No adjustment needed for creatinine clearance ≥50 mL/min
- For creatinine clearance <50 mL/min, dose reduction or increased dosing interval is necessary 1
- For severe renal impairment, the CDC recommends 750-1000 mg three times weekly rather than daily 3
Hydration Requirements
Adequate hydration should be maintained in patients receiving levofloxacin tablets to prevent the formation of highly concentrated urine, as crystalluria and cylindruria have been reported with quinolones 1
Important Considerations
- Levofloxacin has excellent bioavailability approaching 100%, making oral dosing nearly equivalent to intravenous administration 6
- The plasma elimination half-life ranges from 6-8 hours in individuals with normal renal function 6
- Approximately 80% of levofloxacin is eliminated as unchanged drug in urine through glomerular filtration and tubular secretion 6
- The high-dose, short-course regimen (750 mg once daily for 5 days) maximizes concentration-dependent bactericidal activity and may reduce the potential for resistance development 7
By following these dosing recommendations, clinicians can optimize the efficacy of levofloxacin while minimizing the risk of adverse effects and antimicrobial resistance.