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Levofloxacin side effects: what 59,938 FDA adverse event reports show

Levofloxacin · 1,245 reaction terms · 240,223 drug–reaction co-reports · data 2026-09-14
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Drug class

Fluoroquinolone Antibacterial

FDA label (Established Pharmacologic Class)

Who reports

59,938 reports · 88% serious · 8,134 with death outcome · 51% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Levofloxacin is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with infections caused by designated, susceptible bacteria and in pediatric patients where indicated (1, 12.4). • Pneumonia: Nosocomial (1.1) and Community .

FDA label, Indications and Usage

What it is

Levofloxacin tablets, USP are synthetic antibacterial agents for oral administration.

FDA label, Description section

Boxed warning

SECTION WARNING: SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS • Fluoroquinolones, including levofloxacin,.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled — boxed warning 1Labeled adverse reaction 1Labeled (related wording) 3Reporting / coding artifact 2Lab value / disease marker 5Not in label — unassessed 28
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,205 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Congenital hiatus hernia113366.9
281.5–478.1ROR 367.6 · calibrated p 3e-12 ✓
172.9 EB05 147.8 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=113 · ♀ 0% (drug 51%)no trial arm names this drug
Spirometry abnormal262283.5
240.8–333.8ROR 284.8 · calibrated p 2e-11 ✓
154.2 EB05 139.1 · IC025 +6.7
3/3 methods agree
Lab value / disease markerserious n=262 · ♀ 0% (drug 51%)no trial arm names this drug
Pulmonary vasculitis230271.1
228.1–322.1ROR 272.1 · calibrated p 3e-11 ✓
150.2 EB05 134.6 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=230 · ♀ 0% (drug 51%)no trial arm names this drug
Mite allergy255234.0
199.6–274.3ROR 235.0 · calibrated p 1e-10 ✓
138.3 EB05 124.6 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=254 · ♀ 0% (drug 51%)no trial arm names this drug
Total lung capacity abnormal139201.8
163.7–248.8ROR 202.3 · calibrated p 5e-10 ✓
125.4 EB05 108.9 · IC025 +6.2
3/3 methods agree
Not in label — unassessedserious n=139 · ♀ 0% (drug 51%)no trial arm names this drug
Mycotic allergy256153.0
132.0–177.2ROR 153.6 · calibrated p 4e-9 ✓
105.4 EB05 95.0 · IC025 +6.3
3/3 methods agree
Not in label — unassessedserious n=255 · ♀ 0% (drug 51%)no trial arm names this drug
Dust allergy260129.3
112.1–149.1ROR 129.9 · calibrated p 2e-8 ✓
93.6 EB05 84.5 · IC025 +6.1
3/3 methods agree
Not in label — unassessedserious n=259 · ♀ 0% (drug 51%)no trial arm names this drug
Capillaritis63107.3
80.9–142.4ROR 107.4 · calibrated p 1e-7 ✓
80.1 EB05 64.9 · IC025 +5.2
3/3 methods agree
Not in label — unassessedserious n=63 · ♀ 0% (drug 51%)no trial arm names this drug
Sedation complication46880.5
72.8–89.0ROR 81.2 · calibrated p 6e-7 ✓
65.3 EB05 60.5 · IC025 +5.8
3/3 methods agree
Reporting / coding artifactserious n=466 · ♀ 100% (drug 51%)no trial arm names this drug
Conjunctivitis allergic27079.1
69.4–90.3ROR 79.5 · calibrated p 7e-7 ✓
64.3 EB05 58.1 · IC025 +5.7
3/3 methods agree
Not in label — unassessedserious n=270 · ♀ 0% (drug 51%)no trial arm names this drug
Tendon discomfort13173.4
60.8–88.7ROR 73.6 · calibrated p 1e-6 ✓
60.2 EB05 52.0 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=120no trial arm names this drug
Antineutrophil cytoplasmic antibody positive11666.2
54.3–80.7ROR 66.3 · calibrated p 3e-6 ✓
55.2 EB05 47.3 · IC025 +5.2
3/3 methods agree
Lab value / disease markerserious n=116 · ♀ 0% (drug 51%)no trial arm names this drug
Neuritis23161.7
53.7–71.0ROR 62.0 · calibrated p 4e-6 ✓
52.3 EB05 46.9 · IC025 +5.3
3/3 methods agree
Not in label — unassessedserious n=230 · ♀ 0% (drug 51%)no trial arm names this drug
Disseminated mucormycosis5760.2
45.4–79.7ROR 60.2 · calibrated p 6e-6 ✓
50.5 EB05 40.5 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=57 · 100% clinicianno trial arm names this drug
Dysbiosis11055.6
45.5–68.0ROR 55.7 · calibrated p 8e-6 ✓
47.6 EB05 40.6 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=110no trial arm names this drug
Delusion of grandeur6155.1
42.1–72.2ROR 55.2 · calibrated p 1e-5 ✓
47.0 EB05 37.9 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=61 · ♀ 0% (drug 51%) · 100% clinicianno trial arm names this drug
Creatinine renal clearance decreased46345.3
41.2–49.9ROR 45.7 · calibrated p 2e-5 ✓
40.1 EB05 37.1 · IC025 +5.1
3/3 methods agree
Lab value / disease markerserious n=462 · ♀ 100% (drug 51%)no trial arm names this drug
Eosinophilic granulomatosis with polyangiitis20038.4
33.2–44.4ROR 38.5 · calibrated p 7e-5 ✓
34.5 EB05 30.7 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=200 · ♀ 0% (drug 51%)no trial arm names this drug
Multiple drug therapy6837.7
29.3–48.4ROR 37.7 · calibrated p 9e-5 ✓
33.8 EB05 27.6 · IC025 +4.4
3/3 methods agree
Reporting / coding artifactserious n=68 · ♀ 100% (drug 51%)no trial arm names this drug
Normochromic normocytic anaemia29137.5
33.2–42.3ROR 37.7 · calibrated p 8e-5 ✓
33.8 EB05 30.7 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=291 · ♀ 0% (drug 51%)no trial arm names this drug
Tendon disorder63237.4
34.5–40.6ROR 37.8 · calibrated p 7e-5 ✓
33.8 EB05 31.7 · IC025 +4.9
3/3 methods agree
Labeled adverse reaction
exact term
serious n=586no trial arm names this drug
Small fibre neuropathy6835.8
27.9–46.0ROR 35.9 · calibrated p 1e-4 ✓
32.3 EB05 26.3 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=67 · 100% consumerno trial arm names this drug
Computerised tomogram thorax abnormal6234.1
26.3–44.2ROR 34.1 · calibrated p 2e-4 ✓
30.8 EB05 24.9 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=62 · ♀ 100% (drug 51%) · 100% clinicianno trial arm names this drug
Bloody discharge10033.2
27.1–40.8ROR 33.3 · calibrated p 2e-4 ✓
30.2 EB05 25.6 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=100 · ♀ 100% (drug 51%)no trial arm names this drug
Creatinine renal clearance increased6533.0
25.6–42.6ROR 33.1 · calibrated p 2e-4 ✓
30.0 EB05 24.4 · IC025 +4.2
3/3 methods agree
Lab value / disease markerserious n=65 · ♀ 100% (drug 51%) · 100% clinicianno trial arm names this drug
Chronic kidney disease-mineral and bone disorder8931.5
25.3–39.1ROR 31.5 · calibrated p 2e-4 ✓
28.8 EB05 24.1 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=89no trial arm names this drug
Rebound acid hypersecretion24430.2
26.5–34.4ROR 30.3 · calibrated p 3e-4 ✓
27.8 EB05 25.0 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=244 · 100% consumerno trial arm names this drug
Tendonitis1,14527.7
26.1–29.4ROR 28.3 · calibrated p 4e-4 ✓
25.7 EB05 24.5 · IC025 +4.6
3/3 methods agree
Labeled — boxed warning
synonym match
serious PRR 19.8no trial arm names this drug
Crystal nephropathy4327.6
20.2–37.7ROR 27.6 · calibrated p 5e-4 ✓
25.4 EB05 19.6 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=43 · ♀ 100% (drug 51%) · 100% clinicianno trial arm names this drug
Nephrogenic anaemia34127.5
24.6–30.7ROR 27.6 · calibrated p 4e-4 ✓
25.5 EB05 23.3 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=341no trial arm names this drug
Sputum purulent4827.3
20.3–36.6ROR 27.3 · calibrated p 6e-4 ✓
25.1 EB05 19.7 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=48 · ♀ 0% (drug 51%)no trial arm names this drug
Hypocoagulable state6826.0
20.3–33.3ROR 26.1 · calibrated p 7e-4 ✓
24.1 EB05 19.7 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=68no trial arm names this drug
Collagen disorder3925.5
18.4–35.3ROR 25.5 · calibrated p 8e-4 ✓
23.5 EB05 18.0 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=38 · ♀ 100% (drug 51%) · 100% consumerno trial arm names this drug
Hyperparathyroidism secondary16624.5
20.9–28.7ROR 24.6 · calibrated p 8e-4 ✓
22.9 EB05 20.1 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=166no trial arm names this drug
Malignant melanoma in situ8224.3
19.4–30.4ROR 24.3 · calibrated p 9e-4 ✓
22.6 EB05 18.8 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=82 · ♀ 0% (drug 51%)no trial arm names this drug
Contrast media allergy11323.5
19.4–28.4ROR 23.5 · calibrated p 0.001 ✓
22.0 EB05 18.8 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=113 · ♀ 100% (drug 51%)no trial arm names this drug
International normalised ratio fluctuation13223.5
19.7–28.0ROR 23.5 · calibrated p 1e-3 ✓
22.0 EB05 19.0 · IC025 +4.1
3/3 methods agree
Lab value / disease markerserious n=132 · ♀ 100% (drug 51%)no trial arm names this drug

Clinical concept groups

MedDRA splits one clinical problem across several terms (e.g. "neutropenia", "neutrophil count decreased", "agranulocytosis"), which dilutes term-level signals. These rows count reports with any term in a concept group (an exact union, not a sum), compared with all other drugs. Groups are hand-built and listed in the methods.

ConceptReportsPRR 95% CIReading
Tendon disorder3,01230.028.9–31.1signal
Severe cutaneous reaction1,5257.36.9–7.7signal
Neutropenia / agranulocytosis3,0284.34.2–4.5signal
Kidney injury4,8253.73.6–3.8signal
Interstitial lung disease9543.53.3–3.7signal
Thrombocytopenia2,0873.33.2–3.5signal
Arrhythmia / qt1,5732.92.7–3.0signal
Liver injury2,3672.82.7–2.9signal
Serious infection5,9012.72.6–2.8signal
Anaemia2,1372.52.4–2.6signal
Rhabdomyolysis / myopathy5442.42.2–2.6signal
Hyponatraemia5402.42.2–2.6signal
Opportunistic infection8822.32.1–2.4signal
Anaphylaxis / angioedema6621.91.7–2.0raised
Venous thromboembolism1,1411.81.7–2.0raised
Hypoglycaemia4931.81.7–2.0raised

Trial evidence (ClinicalTrials.gov)

ClinicalTrials.gov returned results-bearing trials mentioning Levofloxacin only as a background or rescue medication (NCT02800785, NCT03032510); no trial listing it as the tested intervention was cached, so no trial cross-check is shown.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Off label use (used outside approved label)3,2871.3
1.3–1.4ROR 1.3 · calibrated p 0.538
1.3 EB05 1.3 · IC025 +0.3Reporting / coding artifactage-adj. PRR 1.3 · serious PRR 1.4no trial arm names this drug
Drug ineffective (drug did not work)3,0870.8
0.8–0.8ROR 0.8 · calibrated p 0.189
0.8 EB05 0.8 · IC025 -0.3
PRR-only: not supported by EBGM or IC
Reporting / coding artifactage-adj. PRR 1.1 · serious PRR 1.4no trial arm names this drug
Dyspnoea (shortness of breath)3,0471.9
1.8–2.0ROR 1.9 · calibrated p 0.909
1.9 EB05 1.8 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.6 · serious PRR 1.6no trial arm names this drug
Pneumonia (lung infection)2,9643.2
3.1–3.3ROR 3.3 · calibrated p 0.525
3.2 EB05 3.1 · IC025 +1.6
3/3 methods agree
Labeled — boxed warning
synonym match
age-adj. PRR 2.7 · serious PRR 2.1no trial arm names this drug
Nausea2,9031.3
1.2–1.3ROR 1.3 · calibrated p 0.510
1.3 EB05 1.2 · IC025 +0.3Labeled adverse reaction
exact term
age-adj. PRR 1.2 · serious PRR 1.4no trial arm names this drug
Pyrexia (fever)2,8002.8
2.7–2.9ROR 2.9 · calibrated p 0.648
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
age-adj. PRR 2.6 · serious PRR 2.2no trial arm names this drug
Fatigue (tiredness)2,7561.2
1.2–1.3ROR 1.3 · calibrated p 0.476
1.2 EB05 1.2 · IC025 +0.2Labeled — boxed warning
synonym match
age-adj. PRR 1.1 · serious PRR 1.3no trial arm names this drug
Diarrhoea (diarrhea)2,5531.4
1.3–1.4ROR 1.4 · calibrated p 0.580
1.4 EB05 1.3 · IC025 +0.4Labeled adverse reaction
exact term
age-adj. PRR 1.2 · serious PRR 1.3no trial arm names this drug
Pain2,4691.4
1.4–1.5ROR 1.4 · calibrated p 0.590
1.4 EB05 1.4 · IC025 +0.4Labeled adverse reaction
exact term
age-adj. PRR 1.5 · serious PRR 1.3no trial arm names this drug
Arthralgia (joint pain)2,3202.0
1.9–2.0ROR 2.0 · calibrated p 0.945
2.0 EB05 1.9 · IC025 +0.9Labeled adverse reaction
exact term
age-adj. PRR 1.8 · serious PRR 2.0no trial arm names this drug
Pain in extremity1,9582.3
2.2–2.4ROR 2.4 · calibrated p 0.869
2.3 EB05 2.2 · IC025 +1.1
3/3 methods agree
Not in label — unassessedage-adj. PRR 2.1 · serious PRR 2.3no trial arm names this drug
Vomiting1,9451.5
1.4–1.5ROR 1.5 · calibrated p 0.621
1.5 EB05 1.4 · IC025 +0.5Labeled adverse reaction
exact term
age-adj. PRR 1.3 · serious PRR 1.3no trial arm names this drug
Death1,8340.7
0.7–0.8ROR 0.7 · calibrated p 0.149
0.7 EB05 0.7 · IC025 -0.5
PRR-only: not supported by EBGM or IC
Outcome field, not a reaction
boxed warning mentions mortality
age-adj. PRR 0.7 · serious PRR 0.5no trial arm names this drug

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Levofloxacin (fluoroquinolones) ↔ Aortic aneurysm / dissection.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Levofloxacin?

In FDA FAERS, the most frequently co-reported reaction terms for Levofloxacin are dyspnoea, pneumonia, nausea, pyrexia, fatigue, acute kidney injury. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Levofloxacin have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: SECTION WARNING: SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS • Fluoroquinolones, including levofloxacin,.

Do FAERS signals prove that Levofloxacin causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.