Levofloxacin And Azithromycin Combination Tablet: Comprehensive Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Blood in stool or vomit
- Severe abdominal pain
- Chest pain or difficulty breathing
- Severe headache with visual changes
- Sudden swelling of face, lips, or throat
- Yellowing of skin or eyes
- Decreased urine output
- Pain, swelling, or rupture of a tendon
- Numbness or tingling in hands or feet
- Irregular heartbeat or fainting
If experiencing severe symptoms, call emergency services immediately.
What is levolve z 500 mg/500 mg tablet used for?
This medicine is a prescription antibiotic combination of levofloxacin and azithromycin used to treat serious bacterial infections. It works by killing bacteria through two different mechanisms. It should only be taken under a doctor's supervision.
- Generic Name: Levofloxacin (500mg) + Azithromycin (500mg)
- Manufacturer: Koye Pharmaceuticals Pvt ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 levolve z 500 mg/500 mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा लेवोफ्लोक्सासिन और एज़िथ्रोमाइसिन का संयोजन है, जिसका उपयोग गंभीर बैक्टीरियल संक्रमणों के इलाज के लिए किया जाता है। यह डॉक्टर के पर्चे पर ही ली जानी चाहिए। यह निमोनिया, त्वचा संक्रमण, और कुछ अन्य संक्रमणों में प्रभावी हो सकती है।
साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, दस्त, पेट दर्द, सिरदर्द, चक्कर आना और स्वाद में बदलाव शामिल हैं। गंभीर दुष्प्रभावों में टेंडन टूटना, तंत्रिका क्षति, गंभीर एलर्जी, यकृत की क्षति और हृदय ताल की समस्याएं शामिल हो सकती हैं। कोई भी असामान्य लक्षण होने पर तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को डॉक्टर के निर्देशानुसार ही लें। शराब का सेवन न करें। पर्याप्त पानी पिएं। धूप से बचें और सनस्क्रीन का उपयोग करें। एंटासिड, दूध, या खनिज सप्लीमेंट्स को इस दवा से 2 घंटे पहले या बाद में लें। यदि टेंडन में दर्द, सूजन, या कमजोरी महसूस हो, तो तुरंत डॉक्टर से मिलें।
💊 levolve z 500 mg/500 mg tablet Uses & Benefits
- [{"condition":"Community-acquired pneumonia","description":"Used when a clinician determines that combination antibiotic therapy is needed for severe or complicated cases.","evidence":"Well-established for individual components; combination use based on clinical judgment."},{"condition":"Complicated skin and soft tissue infections","description":"May be prescribed for deep or complicated infections caused by susceptible bacteria.","evidence":"Well-established for individual components; combination use based on clinical judgment."},{"condition":"Chronic bronchitis exacerbation","description":"Sometimes used for acute bacterial exacerbations of chronic bronchitis when indicated.","evidence":"Well-established for individual components; combination use based on clinical judgment."},{"condition":"Urinary tract infections","description":"Levofloxacin component is effective against many urinary pathogens; azithromycin may cover atypical organisms.","evidence":"Well-established for levofloxacin; azithromycin not typically used for UTI."},{"condition":"Sexually transmitted infections","description":"Azithromycin is used for certain STIs; levofloxacin may be used for others.
- Combination not standard.","evidence":"Well-established for individual components; combination not standard."}]
Off-label uses: [{"condition":"Mycobacterial infections","description":"Azithromycin and levofloxacin are sometimes used in combination regimens for certain nontuberculous mycobacterial infections.","evidence":"Limited, based on expert opinion and small studies."},{"condition":"Lyme disease","description":"Azithromycin may be used off-label for early Lyme disease in some cases, but not routinely combined with levofloxacin.","evidence":"Limited."}]
Primary treatment for: Bacterial infections
Also treats: Community-acquired pneumonia, Complicated skin infections, Chronic bronchitis exacerbation, Urinary tract infections
📋 Drug Information
| Generic Name(s) | Levofloxacin (500mg) + Azithromycin (500mg) |
| Brand Name | levolve z 500 mg/500 mg tablet |
| Manufacturer | Koye Pharmaceuticals Pvt ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | ANTI INFECTIVES |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Keep in a dry place, away from direct sunlight and moisture. Keep out of reach of children. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two antibiotics with distinct mechanisms. Levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes required for DNA replication, transcription, repair, and recombination. This leads to inhibition of bacterial DNA synthesis and cell death. Azithromycin binds to the 50S ribosomal subunit of susceptible bacteria, inhibiting transpeptidation and translocation steps of protein synthesis, thereby blocking bacterial protein production. The combination provides broad-spectrum coverage and may act synergistically against some organisms.
Mechanism Steps
💡 How to Take levolve z 500 mg/500 mg tablet
Strength: Tablet containing levofloxacin 500 mg and azithromycin 500 mg.
Dosage Information
| Adult Dosage | The usual adult dose of this combination is one tablet taken orally once daily, but the exact dose and duration depend on the type and severity of the infection, your kidney and liver function, and other factors. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not self-medicate. Always follow your doctor's prescription. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. Fluoroquinolones are generally not recommended for children due to potential effects on cartilage development. |
| Elderly Dosage | Elderly patients may require dose adjustment based on renal function. Levofloxacin is primarily excreted by the kidneys, and renal function declines with age. Monitor renal function and adjust dose accordingly. Elderly patients are also at higher risk of tendon rupture, cardiac arrhythmias, and central nervous system effects. Use with caution. |
| Renal Impairment | Levofloxacin dose adjustment is required in patients with renal impairment. For creatinine clearance (CrCl) 20-49 mL/min, the usual dose may be adjusted. For CrCl 10-19 mL/min, further adjustment is needed. Azithromycin does not require renal dose adjustment. Consult your doctor for specific dosing based on your renal function. |
| Hepatic Impairment | No specific dose adjustment is provided for levofloxacin in hepatic impairment, as it is primarily renally excreted. Azithromycin is metabolized in the liver, and caution is advised in severe hepatic impairment. Monitor liver function. Consult your doctor for individualized dosing. |
| Maximum Daily Dose | The maximum recommended daily dose for this combination is one tablet (levofloxacin 500 mg + azithromycin 500 mg) once daily. Do not exceed the prescribed dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of levolve z 500 mg/500 mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Warfarin | Major | |
| Amiodarone | Major | |
| Antacids | Major | |
| NSAIDs | Major | |
| Theophylline | Major | |
| Cyclosporine | Major | |
| Digoxin | Major | |
| Ergotamine | Major | |
| Corticosteroids | Moderate | |
| Insulin | Moderate |
🚨 Major Interactions
- QT-prolonging drugs (e.g., amiodarone, sotalol, quinidine, procainamide)
- Warfarin
- Antacids, sucralfate, iron, zinc, magnesium, aluminum salts
- NSAIDs (e.g., ibuprofen, naproxen)
- Theophylline
- Cyclosporine
- Digoxin
- Ergot alkaloids (e.g., ergotamine)
⚡ Moderate Interactions
- Corticosteroids
- Diabetes medications (insulin, sulfonylureas)
- Probenecid
- Cimetidine
- Amiodarone
🍷 Alcohol Interaction
Alcohol should be avoided while taking this medicine. Alcohol can increase the risk of liver damage, central nervous system side effects such as dizziness and drowsiness, and may worsen gastrointestinal irritation. It can also increase the risk of QT prolongation. It is best to abstain from alcohol during the entire course of treatment.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known hypersensitivity to levofloxacin, azithromycin, other fluoroquinolones, or macrolides.","History of tendon disorders related to fluoroquinolone use.","Myasthenia gravis (may exacerbate muscle weakness).","Concurrent use with QT-prolonging drugs that are contraindicated.","Severe hepatic impairment.","Pregnancy and lactation unless benefits outweigh risks.","Children and adolescents (fluoroquinolones not recommended for growing children)."]
⚠️ Warnings & Precautions
["Fluoroquinolones, including levofloxacin, have been associated with disabling and potentially irreversible serious adverse reactions, including tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects. Reserve for patients with no alternative treatment options.","May exacerbate muscle weakness in patients with myasthenia gravis. Avoid use in these patients.","Serious hypersensitivity reactions, including anaphylaxis, have been reported. Discontinue immediately if allergic reaction occurs.","Clostridioides difficile-associated diarrhea may occur. Evaluate if diarrhea develops.","May cause blood glucose disturbances, including severe hypoglycemia. Monitor blood glucose in diabetic patients.","May cause photosensitivity. Avoid excessive sun exposure and use sunscreen.","Prolonged QT interval may occur. Avoid in patients with known QT prolongation or risk factors.","Not recommended for use in children under 18 years except for specific indications.","Elderly patients are at higher risk of tendon rupture, renal impairment, and cardiac effects.","Do not use for viral infections. Inappropriate use increases antibiotic resistance."]
🤱 Lactation Safety
Levofloxacin is excreted in human breast milk and may cause serious adverse reactions in nursing infants. Azithromycin is also excreted in breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor.
💊 Overdose Management
There is no specific antidote for overdose with this medicine. In case of overdose, discontinue the drug and provide symptomatic and supportive care. Monitor vital signs, ECG, and electrolytes. Activated charcoal may be considered if ingestion is recent. Levofloxacin is not effectively removed by hemodialysis or peritoneal dialysis. Azithromycin is not removed by dialysis. Contact a poison control center or emergency department immediately.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time to make up for a missed dose. If you are unsure, consult your doctor or pharmacist.
Additional Safety Advice
Take this medicine exactly as prescribed by your doctor. Do not share it with others. Do not skip doses or stop early unless told to do so. Avoid alcohol while taking this medicine as it may increase the risk of liver problems and central nervous system side effects. Inform your doctor if you have kidney or liver disease, heart rhythm problems, diabetes, or myasthenia gravis. Avoid excessive sunlight and use sunscreen, as this medicine can make your skin more sensitive to sunlight. Drink plenty of water to stay hydrated. If you experience pain, swelling, or rupture of a tendon, stop taking this medicine and seek medical attention immediately. Do not take antacids, sucralfate, or iron/zinc supplements within 2 hours before or after this medicine, as they can reduce its absorption. Inform your doctor about all other medicines you are taking, especially blood thinners, diabetes medicines, and heart rhythm medicines.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are at higher risk of tendon rupture, renal impairment, and cardiac arrhythmias. Dose adjustment may be needed based on renal function. Monitor closely for side effects.
🤰 Pregnancy Planning (TTC)
If you are planning pregnancy, consult your doctor before taking this medicine. Both ingredients are FDA category C and should be used only if clearly needed. Discuss alternative antibiotics if appropriate.
🏥 Post-Surgery Considerations
This medicine may be prescribed after surgery to prevent or treat infection. Follow your surgeon's instructions carefully. Monitor for signs of infection and report any unusual symptoms.
🦷 Dental Procedures
Inform your dentist if you are taking this medicine. It may interact with other medications used during dental procedures. No specific precautions are required, but maintain good oral hygiene.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
While taking this medicine, avoid strenuous exercise or high-impact activities that could increase the risk of tendon injury. If you experience joint or tendon pain, stop exercising and consult your doctor. Gentle stretching and low-impact activities are generally safe.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness, drowsiness, or confusion. Avoid driving or operating heavy machinery until you know how it affects you. It may also cause photosensitivity, so take precautions if you work outdoors. Inform your employer if you need to take time off for recovery.
🛑 When to Stop This Medicine
Do not stop taking this medicine without consulting your doctor, even if you feel better. Stopping early can lead to incomplete treatment and antibiotic resistance. If you experience serious side effects, contact your doctor immediately; they may advise you to stop.
📅 Long-Term Use Effects
Long-term use of this medicine can lead to antibiotic resistance, gut flora imbalance, and an increased risk of Clostridioides difficile infection. Rarely, it can cause persistent peripheral neuropathy, tendon damage, or cardiac effects. Regular monitoring of renal and hepatic function may be required if used for prolonged periods. It should only be used for the prescribed duration.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Depending on the infection, other antibiotics or combinations may be prescribed.
Evidence: Well-establishedRest, hydration, and symptomatic treatment can complement antibiotic therapy.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Antibiotics do not interfere with vaccines. However, if you are acutely ill, vaccination may be postponed until you recover. Consult your doctor for specific advice.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage to avoid temperature extremes. Store at room temperature and protect from moisture. If crossing time zones, continue taking it at the same interval as prescribed; consult your doctor for specific advice. Check customs regulations for carrying prescription medicines.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: You may start feeling better within 24 to 48 hours, but it is important to complete the full course as prescribed.
A: Yes, you can take it with food to reduce stomach upset. However, avoid taking it with dairy products or antacids within 2 hours.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.
A: It is best to avoid alcohol as it can increase the risk of liver problems and central nervous system side effects.
A: Consult your doctor. Both ingredients are FDA category C and should be used only if the benefit outweighs the risk.
🤔 Common Patient Concerns
🔄 Substitutes for levolve z 500 mg/500 mg tablet
View AllAlternative brands with exact same active ingredient:
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qulef z 500 mg/500 mg tabletHetero Drugs Ltd ₹97.03 17.2% CHEAPER
-
azibact l 500 mg/500 mg tabletIpca Laboratories Ltd ₹119.03 1.6% COSTLIER
-
xuv 500 mg/500 mg tabletMedley Pharmaceuticals ₹121.88 4% COSTLIER
-
levomac az tabletMacleods Pharmaceuticals Pvt Ltd ₹136.13 16.2% COSTLIER
-
zithrox lx 500 mg/500 mg tabletMacleods Pharmaceuticals Pvt Ltd ₹136.13 16.2% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine can cure any infection.
Fact: This medicine only treats bacterial infections. It is not effective against viral infections like colds or flu. - Myth: You can stop taking this medicine once you feel better.
Fact: You must complete the full prescribed course to prevent resistance and relapse. - Myth: This medicine is safe to take without a prescription.
Fact: This is a prescription-only medicine and should only be taken under a doctor's supervision due to serious risks.
🔄 Alternative Options
Generic Alternatives
- Levofloxacin 500 mg + Azithromycin 500 mg tablet (generic)
Brand Alternatives
- Levofloxacin 500 mg + Azithromycin 500 mg tablet (various brands)