Comprehensive medication guide to Levofloxacin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic levofloxacin; typically Tier 1–2 on most commercial insurance and Medicare Part D plans. Prior authorization is rarely required.
Estimated Cash Pricing
$15–$80 retail for generic levofloxacin without insurance; as low as $8–$15 with a GoodRx or SingleCare coupon for a 7-10 day course at participating pharmacies.
Medfinder Findability Score
74/100
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Levofloxacin is a broad-spectrum antibiotic belonging to the fluoroquinolone drug class. Originally sold under the brand name Levaquin (now discontinued), it is available only as a generic in the United States. It received FDA approval in 1996 and is included on the World Health Organization's List of Essential Medicines.
Levofloxacin is FDA-approved to treat a wide range of bacterial infections including community-acquired pneumonia, hospital-acquired pneumonia, urinary tract infections, pyelonephritis, acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, acute bacterial prostatitis, skin and skin structure infections, and is used for anthrax prophylaxis and plague treatment.
It is available as oral tablets (250 mg, 500 mg, 750 mg), oral solution (25 mg/mL), intravenous (IV) solution, and ophthalmic eye drops. Levofloxacin is active against both gram-positive and gram-negative bacteria, making it one of the most versatile antibiotics in clinical practice.
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Levofloxacin is a bactericidal antibiotic — it actively kills bacteria rather than simply slowing their growth. It works by inhibiting two essential bacterial enzymes: DNA gyrase and topoisomerase IV, both of which are type II topoisomerases required for DNA replication, transcription, repair, and recombination.
By binding to and jamming these enzymes in an intermediate state where they have cut bacterial DNA but cannot rejoin it, levofloxacin causes catastrophic double-strand DNA breaks throughout the bacterial genome. The bacteria's repair machinery is overwhelmed, triggering cell death.
Levofloxacin preferentially binds topoisomerase IV in gram-positive bacteria and DNA gyrase in gram-negative bacteria. This dual targeting — and the corresponding requirement for multiple resistance mutations — is why levofloxacin has broader coverage than earlier fluoroquinolones. It is particularly effective against respiratory pathogens including Streptococcus pneumoniae, which makes it a preferred agent for community-acquired pneumonia.
250 mg — tablet
Used for uncomplicated UTIs and lower-severity infections
500 mg — tablet
Most common dose; used for pneumonia, sinusitis, UTIs, skin infections
750 mg — tablet
High-dose short-course regimens for pneumonia, sinusitis, and skin infections
25 mg/mL — oral solution
For patients unable to swallow tablets
250 mg/50 mL — IV solution
Intravenous premixed bag — hospital use
500 mg/100 mL — IV solution
Most common IV dose — hospital use (currently on ASHP shortage)
750 mg/150 mL — IV solution
High-dose IV — hospital use (currently on ASHP shortage)
0.5% — ophthalmic solution
Eye drops for bacterial conjunctivitis
The answer depends on the formulation. Oral levofloxacin tablets (250 mg, 500 mg, 750 mg) are generally available at most retail pharmacies and are not in a national shortage as of 2026. Patients may encounter localized stocking gaps, particularly for the 750 mg strength or during high-demand periods such as winter respiratory illness season.
The intravenous (IV) levofloxacin injection in 5% dextrose (premixed bags) is on active shortage as of April 2026 per the ASHP Drug Shortage Database. Baxter has discontinued its premixed bag products, and Hikma has back orders across all sizes. Pfizer, Sagent, and WG Critical Care have limited supply available. This shortage primarily affects hospitalized patients and institutional settings.
If you are having difficulty finding oral levofloxacin at your pharmacy, medfinder calls pharmacies in your area to find which ones can fill your prescription and texts you the results — saving you from making dozens of calls yourself.
Levofloxacin is not a controlled substance and has no DEA scheduling requirements. Any licensed prescriber with prescribing authority in your state can write a levofloxacin prescription without additional approvals, DEA registration, or special documentation.
Healthcare providers who commonly prescribe levofloxacin include:
Levofloxacin is widely available via telehealth for appropriate indications such as uncomplicated UTIs, acute bacterial sinusitis, and mild respiratory infections. Platforms including Teladoc, MDLive, and Wisp can evaluate and prescribe levofloxacin via video visit.
No. Levofloxacin is not a controlled substance and is not scheduled by the DEA. There are no special federal prescribing requirements, no DEA registration needed to prescribe it, and no mandatory restrictions on the number of refills from a regulatory perspective.
Any licensed prescriber with prescribing authority in your state — including primary care physicians, urgent care providers, nurse practitioners, and physician assistants — can write a levofloxacin prescription. It can also be prescribed via telehealth for appropriate indications such as uncomplicated UTIs and sinus infections.
Common, generally mild side effects include:
Serious side effects (FDA Boxed Warnings — stop medication and seek medical care immediately):
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Ciprofloxacin (Cipro)
Closest fluoroquinolone alternative; stronger gram-negative coverage including Pseudomonas; twice-daily dosing vs. levofloxacin's once-daily; widely available and inexpensive
Moxifloxacin (Avelox)
Newer fluoroquinolone with better gram-positive and anaerobic coverage; preferred for respiratory infections; not suitable for UTIs due to insufficient urinary concentration; once-daily dosing
Azithromycin (Zithromax/Z-Pak)
Macrolide antibiotic; covers atypical respiratory pathogens; no fluoroquinolone boxed warning; short 3-5 day courses; good for mild pneumonia and sinus infections; does not cover gram-negatives
Amoxicillin-Clavulanate (Augmentin)
Beta-lactam combination antibiotic; safe alternative for sinus, respiratory, and mild UTI infections; not effective against Pseudomonas; cannot be used in penicillin-allergic patients
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Antacids (Mg/Al), sucralfate, iron, zinc, calcium supplements
moderateBind to levofloxacin in the gut, dramatically reducing absorption. Separate by at least 2 hours before or after levofloxacin.
QT-prolonging drugs (antiarrhythmics, antipsychotics, azithromycin, hydroxychloroquine)
majorAdditive QT prolongation risk, potentially leading to fatal arrhythmias. Use with extreme caution and cardiac monitoring if unavoidable.
Warfarin (Coumadin)
majorLevofloxacin enhances anticoagulant effect, increasing bleeding risk. Monitor INR closely during treatment and for several days after.
Insulin and sulfonylureas (glipizide, glyburide)
majorIncreased risk of hypoglycemia and hyperglycemia in diabetic patients. Monitor blood sugar closely.
NSAIDs (ibuprofen, naproxen)
moderateMay increase risk of CNS stimulation and seizures. Avoid concurrent use if possible, especially in patients with seizure history.
Corticosteroids (prednisone, methylprednisolone)
majorSignificantly increases risk of tendon rupture, particularly the Achilles tendon. High-risk combination in elderly patients.
Levofloxacin is a powerful and versatile antibiotic with a broad spectrum of activity that makes it valuable for treating serious bacterial infections. Its once-daily dosing, excellent oral bioavailability, and wide coverage of both gram-positive and gram-negative pathogens have made it a clinical staple for decades.
However, its serious side effect profile — including FDA boxed warnings for tendon rupture, peripheral neuropathy, and CNS effects — means it should be used judiciously and reserved for infections that cannot be adequately treated with safer alternatives. Patients should always complete the full course, stay hydrated, avoid strenuous activity, and be alert to the warning signs that require stopping the drug.
If you have been prescribed levofloxacin and are having trouble filling your prescription, medfinder can help you quickly identify which pharmacies in your area have it in stock — so you can start your treatment without delay.
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