Itraconazole and levofloxacin

[Shrek12468]

My doc suspected a bacterial infection before and He told me to have levofloxacin after culture I have aspergillosis and he gave me itraconazole for that. I took the morning dose of levofloxacin but after checkup he told me to stop it. Should I take the evening dose or begin from tomorrow as levofloxacin and itraconazole together have side effects. Please waiting for your advise Thanks. I dont have access to a pharmacist right now

[Hidden]

With the caveat I’m not medically qualified. If the doc told you to stop it, you stop it from when they say: don’t take any more. I’m assuming he told you to stop it because of the culture results - levofloxacin is only useful for bacteria, where aspergillus is a fungus and so needs an antifungal like itraconazole. The levofloxacin won’t do anything for aspergillus, and taking antibiotics when they’re not needed worsens the global antibiotic resistance problem we have.

[Shrek12468 in reply to Hidden]

Yeah but my question was regarding the clearance of levofloxacin from the body as Google says its renal clearance is 30-40 hours so it would be in my body if I took the medicine itraconazole in the night.

I took the forst dose in the morning. 30-40 hours wait means maybe leave a day and then start itraconazole. As presence of both drugs in body makes you at increased risk of some side effects. I just dont want that. Thanks

[Hidden in reply to Shrek12468]

Apologies: that wasn’t at all clear from your post. Unfortunately, I’d suggest no one here can answer your question. My understanding is total clearance time can vary between individuals due to a number of different factors and the elimination rate is only a guide as a result. However, my understanding is also that clearance time is not necessarily tied to side effects, so it doesn’t follow that taking the itra now is going to increase - or decrease - the likelihood of side effects. In part because it also depends on a) what side effects you’re concerned about, and b) to what extent side effects actually manifest out of the nocebo effect. Studies have demonstrated that if given a list of side effects, people will consistently experience more side effects than someone that hasn’t been told what might occur. There should also be a point c) in saying side effects in a patient info leaflet are correlative NOT causative, documenting any symptom that was reported at the time a drug was being taken. Which is why even normal saline has a side effect list totalling 14 different symptoms. The exception to this would be clinically quantative side effects like changes to haematological markers, but in many cases you would only know about those through testing rather than symptoms. The two drugs in question are not listed as interacting in the BNF, and for the little it’s worth when everyone is individual, my daughter has taken cipro and itra together previously without issue 🤷‍♂️

Personally, if it were me, and unless you’ve got past experience of a bad interaction specifically between levofloxacin and itraconazole, I’d be more worried about leaving aspergillus untreated for a further day. My daughter is permanently stuck with it as the result of not treating it quickly enough, and it’s a proper pain in the backside.

[Shrek12468 in reply to Hidden]

Thank you very much Charlie G. You have given me a satisfactory answer. Much appreciated

[Janlyn1953]

Hi

I take Itraconazole one tablet every night.

I feel okay on it, I take it after tea as it can make you feel a little tired but I'm okay in a morning.

I have been advised by my specialist to take 2 5mg Prednisone every other day, but I'm not taking them as I do get side effects with Prednisone.

I have felt a lot better on Itraconazole, but still have infectionsfrom time to time.

I hope this helps.

Take care.

Janet.