Levaquin IV and Hypotension

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Specializes in Emergency.

Just out of curiosity, have any of you ever had a pts blood pressure drop dramatically after starting Levaquin? I have had it happen twice in the past month but never before that. The first time I was afraid my pt. had turned septic on me or something BP 70/45 but then no, his HR was okay, and he seemed just fine, I stopped the Levaquin and he came back around, the Dr. did not believe me when I told him it was the Levaquin. I restarted it and his pressure was okay after that. Then this week my pt. dropped from 160/90 to 100/50 about 10 min. after I started the Levaquin, he was pale, cool, clammy, and literally pouring sweat, I thought he had poured water over his head when I first looked at him. He had that "I don't feel right, and I need to poop" thing going on, which also indicates impending doom to me... I thought he was having an MI or something. His HR never dropped so I really don't think he vagaled. I turned off the Levaquin, started fluids and put his head down a little and he came back around like nothing had ever happened before I even had time to go get the Dr. This time the Dr. believed me when I told her I had read in the drug book "may cause hypotension if infused too quickly" I double checked my rate and it was infusing properly and everything. I ended up slowng it down to half the normal rate and the pt. tolerated the rest of the Levaquin just fine.

Anyway, I was just wondering if ya'll had experienced this as well.

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no, but i've always infused within the guidelines. slowing it down even more was the right thing to do, some pts are just super-sensitive

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I have never experienced that with Levaquin. I will be on the lookout now. One thing I have experienced with Levaquin though is that some pt.'s can become confused. A few times the Levaquin had to be d/cd for that reason.

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Specializes in Nephrology, Cardiology, ER, ICU.

Our policy is to run it over one hour per pump. However, hypotension can be a problem with Levaquin.

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Specializes in Med-Surg, Wound Care.

So can psychosis! We're seeing this alot more. I've had patients hallucinate with Levaquin.

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Specializes in ER/Trauma.

Sorry to drag up an old thread.

I haven't really noticed hypotension with my pts. getting IV Levaquin.

But I have noticed phlebitis! I'd say 1 out of every 30-50 patients I give IV Levaquin to develop some form of phlebitis/vein-irritation (even when the IV is in the AC). Not an anaphalactic/allergic reaction - just that their veins don't seem to like IV Levaquin.

Never noticed a similar problem with IV Ciprofloxacin - ever.

And curiously enough, the very few patients I managed to follow up on (maybe 5) - all tolerated PO Levaquin just fine.

Hmph... maybe I should do a study...

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