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Harm Reduction Levaquin and xanax

Sertürner

Sertürner

Bluelight Crew
Joined
Apr 5, 2018
Messages
1,324
I have made a thread in ADD about this but haven't gotten fast responses so I decided to bring it here to OD as well. I have been diagnosed with pneumonia and put on levofloxacin (Levaquin) to treat it. I take alprazolam 1mg 3x daily. Upon doing research I found out that the levofloxacin inhibits gaba binding. Is there any cause of concern for this interaction? I am worried that my Xanax will not be able to work while I am on this medication and I am a little scared that I might go into WD's even if I am taking the Xanax. I could be completely misinterpreting what I read but I hope someone more educated on the subject could give me some insight as to what all this means.
Thank you,
Mr. Deeds.
 
I'm going to bump this as nobody has responded yet. Still very sick and have tremors in my hands at the moment.
 
Not seeing much as to the possible CYP 450 3A4 inducing effects of Levofloxacin. There's a little that suggests the inhibition of CYP1A2 and CYP2C9 but that would have the opposite effect of fast metabolising of Alprazolam if it were on 3A4.

https://www.ncbi.nlm.nih.gov/pubmed/19026171

Do you have anything that would suggest LF induces 3A4?
 
Wow, that was disturbing. The connection to Norfloxazine, certain NSAIDs and caffeine seems quite profound and the protracted period of duration even more so. Never heard of being "Floxed" before but am glad I know of it now. It would seem you have found what looks to be your answer, now if you can just get your Doc to swap out the AB or up the Alprazolam. Neither of which are all that all that appealing, well the latter maybe.


Hence, it is hardly a surprise that coffee drinkers who are prescribed a benzodiazepine are at an even higher risk for fluoroquinolone-induced seizures and neuropsychiatric disturbances.
~
It is an unfortunate truth that many healthcare practitioners outside the realm of neuroscience are unaware of these lesser-known facts about fluoroquinolone antibiotics. Most pharmacists are not aware of the issue either..
Click to expand...
 
Well I am on day 2 of a 7 day levofloxacin regemine. So far I feel fine but have noticeable hand tremors if I wait to long before my next dose. It has a Half-Life of close to 7hrs so I know it's slowly building up in my system. Also getting moments of light confusion but nothing serious. I hope it doesn't build up enough to do some real damage.
 
Oh and I drink coffee and am prescribed amphetamines. Which I have stopped taking as soon as I read that article yesterday.
 
This came from the Pubmed link listed above and LevoFloxacin doesn't inhibit CYP1A2 so the coffee isn't so much of a worry but that doesn't stop the antagonism/ inverse agonism of the GABA-A receptor.

Ciprofloxacin showed weak inhibition on both the activity of CYP1A2 (IC50 135 micromol/L) and CYP2C9 (IC50 180 micromol/L), whereas levofloxacin inhibited only CYP2C9 (IC50 210 micromol/L).
Click to expand...

The note of "at high enough concentrations" isn't the best metric for determining a dose of LevoFloxacin that is going to knock half the alprazolam off it's target either. Or if it's accumulative and hits on day 5?
I doubt the inhibition is very strong as the text mentioned a larger dose of benzos would override the blocking effect, still, even a third of a dose lost is going to be quite rough, if not dangerous.

Kind of a Sophie's choice, benzo WD or delayed healing of the malady the LF was prescribed for. :\
 
I would much rather deal the benzo WE temporarily as I have a few extra that I can take during this time. I have pneumonia and this is the 3rd antibiotic I have been prescribed for it and it is working. I just looked at the bottle, it's a 10 day course not 7 day. I hope they don't get severe. I'm wondering about sending this article over to my doc and see what he thinks. He might not even know about this...
 
Sorry to keep double posting but for some reason the mobile app isn't letting me edit. I think the effect must be cumulative as it has a half life long enough to ensure that decent amounts will be built up over a 10 day course. And I haven't had TOO many problems yet. But I'm only on day 2 like previously mentioned so I will keep updating on this treatment.
 
That sounds about right or you might have been in more trouble already.

There's nothing on the usual med sites that has anything about it and I'm doubting your pharmacist mentioned anything when you picked up the meds. I'm assuming not as the computers will usually show something at the pharmacy even if the pharm or pharm tech doesn't catch it.

This wouldn't be the first thing to go under the radar, interaction-wise. (no worries about double posting, and thank you in advance for keeping us up to date on this)
 
Ok day 3 and I've noticed my anxiety has risen considerably. That's about all that has changed. Kratom has been helping quite a bit with the physical and mental symptoms. My tremors will not stop for even a second thogh. It's quite irritating.
 
Day 5 now. Definitely noticing withdrawal now. Tremors in my hands are visible and the benzos only help the first few hours after taking them. Pulse and BP are elevated and headaches are photosensitivity are beginning to show up as well. I don't feel like I'm near a seizure but I can tell that my meds aren't nearly as effacious as they were before the levofloxacin. Kratom is helping. Adding an extra mg or 2 of alprazolam isn't that effective in helping the symptoms.
 
Sorry to hear it's going downhill so quickly. Would you say it's cutting out like maybe 40% of your benzo dose now?

Seizures can strike without warning so hopefully it doesn't get too much worse. Did you ever forward the article to your Doctor?
 
No I have decided I will bring in the article next time I see him, assuming I am fine throughout this treatment.
Now to answer your question regarding efficacy, that is a tricky thing to measure I have noticed. I just took 2mg of Xanax. I have been having larger muscle spasms in my arms and legs and increased anxiety and dizziness, starting to clench my jaw as well. I cannot determine a percentage of how much it is working compared to normal. But I have noticed that after I take it I get back to normal for about 2hrs then I start sliding back into the WD symptoms. It is definitely taking less and less time for the symptoms to come back.
If I had to throw out a percentage, I would say they work 80-90% as well as they normally would, but for a much shorter time period than supposed to.
Maybe the Levaquin is knocking the benzos off my receptors shortly after i take them?
 
I am finally off the levofloxacin! Well I finished my course just the other day. By the end of my treatment my hands were shaking very bad and headaches, confusion, and anxiety were constant. Very unpleasant. I am getti g back to normal and can feel my meds working better. But I noticed that he tremors haven't gone away completely yet...

Very scary combination. I would definitely recommend consulting a doctor before take levaquin if you are benzo dependant!
 
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