Levofloxacin Risk: What You Need to Know About Side Effects and Interactions

When you take levofloxacin, a powerful antibiotic in the fluoroquinolone class used for bacterial infections like pneumonia, urinary tract infections, and sinusitis. Also known as Levaquin, it works fast—but it comes with risks that many patients don’t realize until it’s too late. Unlike common antibiotics, levofloxacin doesn’t just kill bacteria. It can damage tendons, nerves, and even affect your mood or blood sugar. The FDA has issued multiple black box warnings for this drug, and yet it’s still prescribed widely—often without proper warning.

The biggest red flag? tendon rupture, a sudden, painful tear that can happen even in healthy people, often without warning. This isn’t rare—it’s documented in over 1 in 100 users, especially those over 60, on steroids, or with kidney problems. Another hidden danger is peripheral neuropathy, nerve damage that causes burning, tingling, or weakness, sometimes lasting months or years after stopping the drug. These aren’t side effects you can just tough out—they can change your life. And if you’re taking antacids, like Tums or omeprazole, or iron supplements, they can block levofloxacin from working, making your infection worse. Even caffeine can spike side effects like jitteriness or heart palpitations. You can’t just take this drug and hope for the best. You need to know who’s most at risk and what to watch for.

Some people are told to avoid levofloxacin entirely—like those with myasthenia gravis, a history of tendon issues, or kidney disease. Others need to be monitored closely, especially if they’re also on corticosteroids or blood thinners. The truth? There are safer antibiotics for many common infections. If your doctor prescribes levofloxacin, ask: Is this really the best option? Are there alternatives with fewer risks? And what signs should I call you about right away? The posts below cover real cases, drug interactions you might not know about, and what to do if you’ve already started taking it. You’ll find practical advice from people who’ve been through it—and what to ask your pharmacist before the next prescription.