What to Do If Your UTI Medication (Levofloxacin) Is Making You Sick
Stop taking levofloxacin immediately and contact your healthcare provider today to switch to a safer alternative antibiotic, as severe side effects from fluoroquinolones warrant discontinuation and these drugs are no longer recommended as first-line therapy for uncomplicated UTIs. 1, 2
Immediate Actions
- Discontinue the medication now if you are experiencing severe gastrointestinal symptoms (nausea, vomiting), allergic reactions (rash, hives), or any other concerning symptoms 1
- Contact your prescriber or seek urgent care if you have severe symptoms including difficulty breathing, severe rash, fever, or signs of allergic reaction 1
- Do not restart the medication without explicit guidance from your healthcare provider 3
Why Levofloxacin May Be Problematic
Fluoroquinolones like levofloxacin are associated with significant adverse effects and are no longer recommended as first-line therapy for uncomplicated UTIs due to:
- High rates of resistance in many communities that preclude their empiric use 4, 5
- Serious adverse effects including tendon rupture, peripheral neuropathy, and central nervous system effects 5
- Gastrointestinal side effects (nausea, vomiting, diarrhea) are common 1
- Need for dose adjustment in kidney impairment, which may not have been properly calculated 6
Recommended Alternative Antibiotics for UTI
Your provider should switch you to one of these first-line options that are safer and equally effective:
Best First-Line Choices:
- Nitrofurantoin 100 mg twice daily for 5 days - preferred option with excellent safety profile 4, 2, 7
- Fosfomycin 3 grams as a single dose - convenient one-time treatment 4, 2, 7
- Trimethoprim-sulfamethoxazole (if local resistance <20%) 160/800 mg twice daily for 3 days - effective but check for drug interactions 2, 8
Important caveat: If you have kidney problems, nitrofurantoin and trimethoprim-sulfamethoxazole require dose adjustments or may need to be avoided entirely 3, 6
Special Considerations Based on Your Situation
If You Have Kidney Disease:
- Levofloxacin requires significant dose reduction when creatinine clearance is impaired, and improper dosing may be causing your symptoms 6
- Your provider should calculate your creatinine clearance (not just look at serum creatinine) to determine safe dosing of any antibiotic 6
- Fosfomycin may be the safest alternative if you have moderate kidney impairment 4, 5
If You're Taking Other Medications:
- Levofloxacin interacts with warfarin (increases bleeding risk) 6
- Trimethoprim-sulfamethoxazole interacts with ACE inhibitors/ARBs (increases potassium dangerously), warfarin (increases bleeding), and phenytoin (increases toxicity) 6
- Inform your provider of all medications you take, especially blood thinners, blood pressure medications, and seizure medications 6
What Your Provider Should Do Next
- Prescribe one of the first-line alternatives listed above based on your kidney function and medication list 2, 7
- Consider obtaining a urine culture if you have recurrent infections, treatment failure, or atypical symptoms to guide antibiotic selection 2
- Provide symptomatic relief with NSAIDs (like ibuprofen) for pain and discomfort while the new antibiotic takes effect 2, 7
Common Pitfalls to Avoid
- Don't assume all antibiotics will make you sick - the side effects you're experiencing are specific to levofloxacin and fluoroquinolones; other antibiotics have different safety profiles 1, 2
- Don't stop all treatment - untreated UTIs can progress to kidney infections, though this risk is relatively low (1-2%) 7
- Don't accept another fluoroquinolone (ciprofloxacin, moxifloxacin) as these have similar side effect profiles 5
When to Seek Emergency Care
Go to the emergency department immediately if you develop: