Levofloxacin 750mg Concentrated Formulation Dilution
Yes, levofloxacin 750mg in 30ml concentrated formulation can be safely mixed with 100ml of 0.9% sodium chloride for intravenous administration. This dilution is compatible and stable, resulting in a final concentration well within the acceptable range for IV infusion.
Compatibility and Stability Evidence
- Levofloxacin is stable and compatible with 0.9% sodium chloride injection at concentrations ranging from 0.5 mg/mL to 5 mg/mL when stored in polyvinyl chloride bags 1
- Your proposed dilution (750mg in approximately 130ml total volume) yields approximately 5.8 mg/mL, which falls within the tested and validated concentration range 1
- Stability is maintained for at least 3 days at 25°C and 14 days at 5°C in normal saline 1
Administration Parameters
- Infusion time: The standard IV formulation should be infused over 60 minutes for a 500mg dose 2
- For the 750mg dose, maintain the 60-90 minute infusion duration to ensure proper administration and minimize infusion-related reactions 3, 4
- The oral and IV formulations are bioequivalent, allowing seamless transition between routes 2, 5
Critical Administration Precautions
Do NOT administer levofloxacin concurrently with:
- Aluminum- or magnesium-containing antacids
- Ferrous sulfate (iron supplements)
- Multivitamins containing zinc or divalent cations
- These agents must be separated by at least 2 hours before or after levofloxacin administration, as they significantly decrease absorption 2, 6
Incompatible Diluents to Avoid
- 20% mannitol injection causes precipitation at both 0.5 mg/mL and 5 mg/mL concentrations 1
- 5% sodium bicarbonate injection at 0.5 mg/mL forms precipitate when stored frozen 1
Renal Dosing Considerations
- No adjustment needed if creatinine clearance ≥50 mL/min 6
- For CrCl <50 mL/min, reduce to 750mg three times weekly 6
- Levofloxacin is 80% renally cleared, making dose adjustment critical in renal impairment 2, 6
Clinical Context for 750mg Dosing
The 750mg once-daily regimen is specifically approved for:
- Community-acquired pneumonia (5-day course) 7
- Acute bacterial sinusitis (5-day course) 3
- Complicated urinary tract infections and acute pyelonephritis (5-day course) 3, 5
- This high-dose, short-course regimen maximizes concentration-dependent bactericidal activity and may reduce resistance development 3, 4