Doxycycline vs. Levaquin

Doxycycline is a tetracycline antibiotic used to treat respiratory tract infections caused by Streptococcus pneumoniae, Hemophilus influenzae, or Mycoplasma pneumoniae. It is also used to treat nongonococcal urethritis, Rocky Mountain spotted fever, cholera, chancroid, typhus, brucellosis, anthrax, syphilis, acne, and periodontal disease.

Levaquin (levofloxacin) is a fluoroquinolone antibiotic used to treat infections of the sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible bacteria. It is also used to treat urinary infections, prostatitis, infectious diarrhea caused by E. coli, Campylobacter jejuni, and Shigella bacteria, obstetric infections including mastitis, inhalational anthrax exposure, and plague caused by Yersinia pestis.

What are the side effects of doxycycline and Levaquin?

Doxycycline

Doxycycline is generally well-tolerated. The most common side effects are:

• Exaggerated sunburn can occur with doxycycline; therefore, minimize sunlight exposure during treatment.

Levaquin

Serious side effects and warnings include:

• Levaquin can cause tendinitis and rupture of tendons, particularly the Achilles tendon.
• Levaquin can worsen muscle weakness in individuals with myasthenia gravis.

The most frequently reported side effects are:

Less common side effects include:

Rare allergic reactions that have been described are:

Possible serious side effects of Levaquin include:

• Peripheral neuropathy
• Central nervous system effects
• Hypoglycemia
• Hyperglycemia
• Clostridium difficile-associated diarrhea
• Abnormal heart beats
• Liver dysfunction
• Sun sensitivity

Other serious side effects and adverse events of Levaquin include:

• Levaquin should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Levaquin.
• Levaquin should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.
• Many antibiotics, including Levaquin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting Levaquin (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.
• Patients taking Levaquin can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.
• Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas (for example, glyburide).
• Because of serious side effects associated with fluoroquinolones, they should not be used for treating uncomplicated urinary tract infections, acute bacterial exacerbation of chronic bronchitis, or acute bacterial sinusitis unless there are no other alternatives.

What is the dosage of doxycycline vs. Levaquin?

Doxycycline

• For most infections, doxycycline is taken once or twice daily for 7 to 14 days.
• The usual dose of oral doxycycline is 200 mg on the first day of treatment (100 mg every 12 hours) followed by a dose of 100 to 200 mg/day as a single dose or divided and administered twice daily.

Levaquin

• The usual dose is 250 to 750 mg given once daily for 3 to 14 days depending on the type of infection.
• Anthrax is treated with 500 mg daily for 60 days.
• It is important to take oral formulations at least 2 hours before or 2 hours after any antacid or mineral supplement containing iron, calcium, zinc, or magnesium, since these bind Levaquin and prevent its absorption into the body.

What drugs interact with doxycycline and Levaquin?

Doxycycline

• Do not take doxycycline at the same time as aluminum-, magnesium-, or calcium-based antacids or minerals, or with bismuth subsalicylate.
• Doxycycline may enhance the activity of warfarin (Coumadin) and cause excessive bleeding, necessitating a reduction in the dose of warfarin. Phenytoin (Dilantin), carbamazepine (Tegretol), and barbiturates (such as phenobarbital) may enhance the metabolism of doxycycline, thus making it less effective.
• Doxycycline may interfere with the action of penicillins.
• Doxycycline may reduce the effectiveness of oral contraceptives.
• Combining tetracycline and methoxyflurane may reduce kidney function.

Levaquin

• Iron, calcium, zinc, or magnesium can attach to Levaquin and prevent its absorption from the intestine into the blood. Therefore, products that contain these minerals should be taken at least 2 hours before or 2 hours after Levaquin. Other drugs that contain these minerals and can similarly interact with Levaquin include sucralfate and didanosine.
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) with Levaquin may increase the risk of central nervous system stimulation, resulting in over-excitation.
• Fluoroquinolones may increase the effect of warfarin.

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Are doxycycline and Levaquin safe to use while pregnant or breastfeeding?

Doxycycline

• Tetracycline antibiotics, such as doxycycline, can have toxic effects on development of bone in the fetus. Therefore, tetracyclines are not recommended during pregnancy unless there is no other appropriate antibiotic.
• Doxycycline is secreted into breast milk but the extent of absorption by the breastfed infant is not known. Since tetracyclines can cause toxic effects on bone, the use of tetracyclines in nursing mothers is of concern. The doctor must decide whether to recommend that a nursing mother discontinue nursing during treatment with tetracyclines or change to a different antibiotic.

Levaquin

• Levaquin is not recommended for use in pregnant women, since Levaquin causes joint and bone deformities in juvenile animals of several species.
• Levaquin is excreted in breast milk. Mothers should decide whether to stop breastfeeding or discontinue Levaquin.

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Summary

Doxycycline and Levaquin are antibiotics used to treat bacterial infections. Doxycycline is a tetracycline antibiotic and Levaquin is a fluoroquinolone antibiotic.