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Levaquin vs Avelox
Introduction
For patients with bacterial infections, certain antibiotics that inhibit the growth or kill off bacteria can help in alleviating symptoms and curing the infection. Levaquin and Avelox are two such drugs that are prescribed for treating a variety of bacterial infections. They each interfere with different enzymes that play key roles in bacterial replication but both aid in reducing the number of bacteria causing an infection. Levaquin (levofloxacin) is a broad-spectrum fluoroquinolone antibiotic effective against both gram-negative and some gram-positive bacteria. On the other hand, Avelox (moxifloxacin) is another type of fluoroquinolone antibiotic which has wider coverage for gram-positive pathogens while also being effective on some gram-negative ones.
Levaquin vs Avelox Side By Side
| Attribute | Levaquin | Avelox |
|---|---|---|
| Brand Name | Levaquin | Avelox |
| Contraindications | Should not be taken with drugs that prolong the QT interval, in patients with a history of tendon rupture, or those with a known hypersensitivity to levofloxacin or other quinolones. | Should not be used in patients with a history of tendon disorders or tendon rupture, those with a known hypersensitivity to moxifloxacin or other quinolones, and should be used with caution in patients with known QT interval prolongation. |
| Cost | For brand name, around $150 for 10 tablets of 500 mg. Generic levofloxacin costs between $0.70 and $2 per day. | For brand name, approximately $100 for 5 tablets of 400 mg. Generic moxifloxacin costs range from about $1.50 up to nearly $4 per day. |
| Generic Name | Levofloxacin | Moxifloxacin |
| Most Serious Side Effect | Tendon rupture, peripheral neuropathy, and potential psychiatric effects. | Tendon rupture, peripheral neuropathy, and severe allergic reactions. |
| Severe Drug Interactions | Drugs that prolong the QT interval can lead to life-threatening arrhythmias. | Similar to Levaquin, drugs that prolong the QT interval can lead to life-threatening arrhythmias. |
| Typical Dose | 250-750 mg/day, depending on the infection. Maximum daily dose should not exceed 750 mg. | 400 mg once per day, with the duration depending on the type and severity of the infection, usually between 5 to 21 days. |
What is Levaquin?
Levofloxacin (the generic name for Levaquin) and Moxifloxacin (the generic name for Avelox) belong to the fluoroquinolone class of antibiotics, a significant advancement from earlier classes of antibiotics. Levofloxacin was first approved by the FDA in 1996, while Moxifloxacin received approval in 1999. Both drugs work by inhibiting bacterial enzymes needed for DNA replication, effectively disrupting bacterial growth and multiplication. They are prescribed mainly for respiratory tract infections among other types of infections. While both have broad-spectrum activity against a wide range of bacteria, Moxifloxacin exhibits superior potency towards certain pathogens like Streptococcus pneumoniae compared to Levofloxacin but tends to have more side effects such as QT prolongation leading to heart rhythm disorders than Levofloaxin which is less cardiotoxic.
What conditions is Levaquin approved to treat?
Levaquin is approved for the treatment of several bacterial infections:
- Sinusitis, chronic bronchitis exacerbation and community-acquired pneumonia
- Skin and skin structure infections (uncomplicated and complicated)
- Chronic bacterial prostatitis
- Urinary tract infection (complicated)
- Inhalational Anthrax (post-exposure)
It is also used in combination with other drugs to treat abdominal infections.
How does Levaquin help with these illnesses?
Levaquin helps to treat bacterial infections by inhibiting the enzymes topoisomerase IV and DNA gyrase, which are essential for bacteria to replicate their DNA and thus multiply. Levaquin binds these enzymes in a stable, binary complex with the enzyme-DNA substrate, preventing strand rejoining and causing double-strand breaks that lead to rapid cell death. This is how Levaquin works as an antibacterial agent.
On the other hand, Avelox also acts against these same two enzymes but it tends to be more effective against certain strains of bacteria that might not respond well to other antibiotics including Levaquin. Both drugs belong to fluoroquinolones class of antibiotics known for broad-spectrum activity against Gram-positive and Gram-negative bacteria. However, due to their side effects such as potential risk of tendon rupture or damage on nervous system they should only be used when no alternative treatments are available.
What is Avelox?
Avelox, the brand name for moxifloxacin, is a fluoroquinolone antibiotic that interferes with bacterial enzymes called DNA gyrase and topoisomerase IV. This interference prevents bacteria from repairing their DNA, leading to death of the bacterial cells. Moxifloxacin was first approved by the FDA in 1999. Unlike some other antibiotics like Levaquin (levofloxacin), Avelox does not need adjustments for renal impairment as it has a different route of elimination which avoids excessive accumulation in patients with decreased kidney function. Furthermore, its broad spectrum activity makes it suitable for treating various types of infections including skin infections and intra-abdominal infections among others. However, Avelox's side-effect profile is also different to that of Levaquin; while both can cause nausea or diarrhea among common side effects, specific rare but serious adverse events such as tendon rupture and peripheral neuropathy have been associated more often with levofloxacin use than moxifloxacin.
What conditions is Avelox approved to treat?
Avelox is a potent antibiotic, approved by the FDA for several specific conditions:
- Acute bacterial sinusitis (ABS)
- Acute bacterial exacerbation of chronic bronchitis (ABECB)
- Community-acquired pneumonia (CAP)
- Skin and skin structure infections
- Intra-abdominal infections
How does Avelox help with these illnesses?
Avelox, like Levaquin, is a fluoroquinolone antibiotic used for treating various bacterial infections. It functions by inhibiting the enzymes necessary for bacterial DNA replication, transcription, repair and recombination thereby eradicating the infection in the body. Avelox has an advantage over Levaquin due to its broader spectrum of activity against bacteria including atypical pathogens as well as its lower potential to interact with other drugs. Just like how Wellbutrin acts on norepinephrine levels without significantly affecting serotonin levels making it suitable for patients who do not respond well to typical SSRIs; Avelox can be prescribed when a patient does not respond favourably to other antibiotics or if they are dealing with certain types of resistant bacteria.
How effective are both Levaquin and Avelox?
Both levofloxacin (Levaquin) and moxifloxacin (Avelox) have established track records of success in treating bacterial infections, and they were initially approved only 2 years apart by the FDA. Since they act on different types of bacteria, they may be prescribed under different circumstances. The effectiveness of levofloxacin and moxifloxacin in combating common types of respiratory tract infection was directly studied in a double-blind clinical trial; the two drugs exhibited similar efficacy as well as similarly promising safety profiles.
A review from 2004 highlighted that levofloxacin is effective at treating pneumonia and other lower respiratory tract infections starting from the first few days of treatment due to its broad-spectrum antimicrobial activity. Its side effect profile is comparable to many other antibiotics, generally manifesting mild gastrointestinal disturbances which are transient.
Moxifloaxcin has been shown through various meta-analysis studies conducted over the years to be more effective than placebo for acute sinusitis, chronic bronchitis exacerbations, and community-acquired pneumonia with an excellent tolerability profile. Nonetheless, it's typically considered a second-line treatment option when compared to Levofloxacin because it lacks sufficient activity against some gram-negative pathogens while Levofloaxin has broader coverage including Pseudomonas aeruginosa.
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At what dose is Levaquin typically prescribed?
Oral dosages of Levaquin range from 250-750 mg/day, depending on the type and severity of the infection. For most bacterial infections, a dose of 500 mg/day is often sufficient for adults. Children's dosage should be determined by their doctor. In both populations, if there is no response after a few days to one week, consult with your healthcare provider about possibly increasing the dosage or switching medications. The maximum daily dose that should not be exceeded in any case is 750 mg/day.
Avelox (Moxifloxacin) is usually given at an oral dosage of 400mg once per day in adults for varying durations depending on the infection being treated but typically ranges from 5 to 21 days. Avelox isn't generally recommended for use in children and adolescents under the age of 18 due to potential side effects affecting joints and surrounding tissues.
At what dose is Avelox typically prescribed?
Avelox treatment is typically initiated with a 400 mg dose taken once per day. The duration of the therapy depends on the type and severity of infection, ranging usually between 5 to 21 days. It's essential not to exceed this daily dosage or length of treatment without consulting your doctor first as it can increase the risk for certain side effects. Avelox displays its peak effect about one to two hours after oral administration, which allows convenient single-dose daily scheduling. If there is no noticeable improvement in symptoms after a few days into the regimen, you should contact your healthcare provider for further evaluation.
What are the most common side effects for Levaquin?
Common side effects of Levaquin (levofloxacin) may include:
- Nausea
- Diarrhea
- Headache
- Dizziness
- Lightheadedness
- Trouble sleeping
While Avelox (moxifloxacin) might cause:
- Nausea
- Diarrhea
- Dizziness and lightheadedness
- Headache
With both medications, more serious but less common side effects could occur such as easy bruising/bleeding, signs of a new infection (e.g., fever, persistent sore throat), severe stomach or abdominal pain, yellowing eyes or skin, dark urine. These antibiotics are also known to potentially increase the risk for certain heart rhythm problems. If you experience any unusual symptoms while taking these medications - it's always best to consult with your healthcare provider right away.
Are there any potential serious side effects for Levaquin?
While both Levaquin and Avelox are fluoroquinolone antibiotics, they may have different side effects. Potential severe reactions from taking Avelox include:
- Thoughts of suicide or self-harm
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face, lips, tongue, or throat
- Skin reactions can occur with symptoms such as fever, sore throat, burning eyes, skin pain followed by a red or purple skin rash that spreads especially in the face or upper body causing blistering and peeling
- Vision problems: blurred vision, seeing halos around lights
- Heart rhythm changes - feeling light-headed or fainting (like you might pass out), fast or pounding heartbeats
- Low levels of sodium in the body - headache, confusion and slurred speech which may be accompanied by severe weakness leading to vomiting and loss of coordination making one feel unsteady.
In rare cases it can cause a severe nervous system reaction characterized by very stiff (rigid) muscles leading to high fever resulting in sweating excessively then confusion setting in subsequently experiencing fast/uneven heartbeats tremors giving a sensation like you might pass out.
Any manifestations suggestive of serotonin syndrome should prompt immediate medical attention. These could include agitation hallucinations fever excessive sweating shivering rapid heartbeat muscle stiffness twitching loss of coordination nausea vomiting diarrhea. Always ensure to consult your healthcare provider if these symptoms arise after starting any new medication.
What are the most common side effects for Avelox?
Potential side effects of Avelox (moxifloxacin) may include:
- Upset stomach and vomiting
- Dizziness, headache
- Vision problems such as blurred vision
- Trouble falling asleep or staying asleep (insomnia)
- Nervousness or agitation
- Skin rash
- Accelerated heartbeat
- Unusual body movements or shaking (tremors)
- Dry mouth, sore throat, and congestion -Tinnitus (ringing in the ears) -Muscle or joint pain. Remember to contact your healthcare provider if any of these side effects persist or worsen.
Are there any potential serious side effects for Avelox?
While Avelox is generally considered safe, it's crucial to be aware of potential severe side effects. These may include:
- Signs of a serious allergic reaction such as hives; difficulty breathing or swallowing; swelling in your face, lips, tongue or throat
- Unusual changes in mood or behavior including confusion and hallucinations
- The occurrence of a seizure (convulsions)
- Rapid heart rate or abnormal heartbeat
- Visual disturbances including blurred vision, eye pain and swelling
- Symptoms suggestive of tendon rupture such as sudden severe pain in the back of your ankle (Achilles), shoulder, hand, or other tendon sites.
If any of these symptoms are experienced while taking Avelox, it is important to seek medical help immediately.
Contraindications for Levaquin and Avelox?
Both Levaquin and Avelox, along with many other antibiotics, may cause serious side effects in some people. If you notice symptoms worsening such as severe diarrhea, rash or allergic reactions, please seek immediate medical attention.
Levaquin and Avelox should not be taken if you are using drugs that can prolong the QT interval (a measure of time during the heart's electrical cycle), which could lead to a life-threatening arrhythmia. It is crucial to tell your physician about all medications you are taking; prolonged QT drugs will need a period of clearance from the system before starting Levaquin or Avelox to prevent potentially dangerous interactions.
Furthermore, both these antibiotics belong to fluoroquinolones class and carry an increased risk of tendinitis and tendon rupture especially in those over 60 years old or on corticosteroid therapy. Make sure your doctor is aware if you fall into this category before starting treatment.
How much do Levaquin and Avelox cost?
For the brand name versions of these drugs:
- The price of 10 tablets of Levaquin (500 mg) averages around $150, which works out to about $15/day.
- The price of 5 tablets of Avelox (400 mg) is approximately $100, working out to roughly $20/day.
Thus, if you're prescribed a standard course for either drug (typically 7–14 days), then brand-name Levaquin tends to be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which antibiotic is right for your specific condition.
For the generic versions - levofloxacin and moxifloxacin respectively - costs are significantly lower:
- Levofloxacin (500 mg tablets) is available in packs ranging from 10 up to 30 pills with approximate costs between $0.70 and $2 per day depending upon dosage and quantity purchased.
- Moxifloxacin can also be found in similar quantities with daily prices ranging from about $1.50 up to nearly $4.
Again, it's crucially important to understand that the choice between these two antibiotics should primarily depend on the specifics of your bacterial infection rather than cost alone.
Popularity of Levaquin and Avelox
Levofloxacin, in generic form as well as brand names such as Levaquin, was estimated to have been prescribed to about 6 million people in the US in 2020. Levofloxacin accounted for just over 15% of fluoroquinolone antibiotic prescriptions in the US. It has a broad spectrum of activity against both Gram-positive and Gram-negative bacteria as well as atypical pathogens.
Moxifloxacin, commonly known under its brand name Avelox, was prescribed to around 1.2 million people in the USA during the same year. In terms of overall fluoroquinolone prescriptions within the US, moxifloxacin accounts for just under 4%. Moxifloxacin is particularly effective against Gram-positive bacteria and has enhanced activity against Streptococcus pneumoniae compared to other fluoroquinolones.
The prescription rates for both antibiotics have been generally declining since early 2000s due to concerns over their potential adverse effects on heart rhythm and joint health.
Conclusion
Levaquin (levofloxacin) and Avelox (moxifloxacin) are both fluoroquinolones, a class of antibiotics that inhibit bacterial DNA synthesis. They have a long-standing record of usage in treating various bacterial infections, particularly those involving the respiratory tract, urinary tract or skin. Each has been backed by numerous clinical studies and meta-analyses indicating their effectiveness over placebo treatments.
While both drugs share similar mechanisms of action against bacteria, they may be used differently based on the specific type and location of infection in question. For example, Levaquin is often considered for pneumonia or chronic bronchitis exacerbations due to its broad coverage including pseudomonas aeruginosa whereas Avelox could be more ideal for community-acquired pneumonia because of its better activity against streptococcus pneumoniae.
Both medications are available as generics contributing to cost savings especially for patients who must pay out-of-pocket. However it should be noted that these drugs may require an adjustment period as antibiotic therapy typically does not yield immediate results.
The side effect profile between Levaquin and Avelox is generally similar with gastrointestinal disturbances being most common followed by CNS effects such as dizziness or confusion but each patient's experience can vary significantly. Both carry black box warnings regarding tendon rupture, peripheral neuropathy and potential psychiatric effects so close monitoring throughout therapy is essential even though they are usually well-tolerated overall.
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Refrences
- Pal, S., Ramu, V., Taye, N., Mogare, D. G., Yeware, A. M., Sarkar, D., … Das, A. (2016, August 26). GSH Induced Controlled Release of Levofloxacin from a Purpose-Built Prodrug: Luminescence Response for Probing the Drug Release in <i>Escherichia coli</i> and <i>Staphylococcus aureus</i>. Bioconjugate Chemistry. American Chemical Society (ACS).http://doi.org/10.1021/acs.bioconjchem.6b00324
- Urueta-Robledo, J., Ariza, H., Jardim, J. R., Caballero, A., García-Calderón, A., Amábile-Cuevas, C. F., … Vivar-Orozco, R. (2006, September). Moxifloxacin versus levofloxacin against acute exacerbations of chronic bronchitis: The Latin American Cohort. Respiratory Medicine. Elsevier BV.http://doi.org/10.1016/j.rmed.2006.01.013