Levofloxacin and Cholestyramine

Levofloxacin is a fluoroquinolone antibiotic. It is used for the treatment of pneumonia, chronic bronchitis, and sinus, urinary tract, kidney, prostate, and skin infections. 

Cholestyramine is a chemical that binds to bile acids in the gastrointestinal (GI) tract to prevent reabsorption of bile acids. Binding to cholestyramine results in excretion of bile acids in the feces, which results in increased clearance of cholesterol. It has been used to reduce diarrhea in GI diseases.

Cholestyramine and levofloxacin in combination were examined for their efficacy in treating delayed diarrhea in patients with cancer.

Fluoroquinolone antibiotics can increase the risk of ruptures or tears in the aorta for certain patients (U.S. FDA, 2018b). Fluoroquinolone formulations taken by mouth or given by injection can cause certain mental health side effects and blood sugar level disturbances--the low blood sugar levels can lead to coma (U.S. FDA, 2018a). More information can be found at https://www.fda.gov/drugs/drug-safety-and-availability

U.S. Food and Drug Administration. (2018a).  FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-reinforces-s… 

U.S. Food and Drug Administration. (2018b). FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-…

Guideline / Expert Opinion