Dexamethasone and Levofloxacin Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Dexamethasone
No brand names on recordLevofloxacin Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of tendon rupture
Interaction Deep Dive
Fluoroquinolones have been associated with an increased risk of tendinitis and tendon rupture. This risk is increased especially in patients over the age of 60, in patients taking concomitant corticosteroids, and in patients with kidney, heart, or lung transplants. Discontinue the fluoroquinolone immediately if the patient experiences pain, swelling, inflammation, or rupture of a tendon2. In several case-control studies evaluating the outcomes of giving a fluoroquinolone and corticosteroid together, tendon rupture incidence rates and odds ratios were significantly increased 1435.
Why it happens (mechanism)
Additive effect of risk for tendon rupture
Literature reports
2 reports — tap to read
a) In a case-control study comparing patients with tendon rupture (n=4836) to matched controls without tendon rupture (n=18,356), systemic fluoroquinolone exposure with concomitant oral corticosteroid exposure was associated with a significant increase in adjusted incidence rate ratios (aIRR) for any tendon rupture and Achilles tendon rupture; aIRRs were 6.88 (95% CI, 3.93 to 12.03) and 19.36 (95% CI, 7.78 to 48.19), respectively 1.
b) The increased risk of developing tendinitis or tendon rupture in patients taking a quinolone and corticosteroid has been established in several case-control studies. In study 1, the odds of developing Achilles tendonitis (n=28,907) was increased 9.1-fold when a quinolone and corticosteroid was given together compared to when a quinolone was given by itself (odd ratio (OR), 9.1; 95% CI, 4.6 to 18). The odds of developing tendon rupture (n=7685) was also increased 3.7 fold when given together, however the difference between the groups was not significant 3. In study 2 (N=127,100), concomitant use of a quinolone and a corticosteroid increased the odds of developing a tendon rupture by 3.1-fold (OR, 3.1; 95% CI, 1.5 to 6.3) and rupture of the Achilles tendon by more than 43-fold (OR, 43.2; 95% CI, 5.5 to 341.1) 4. In study 3 (N=51,367), the odds of developing Achilles tendon disorders in patients 60 years or older was increased 5.3-fold when given a quinolone (OR, 5.3; 95% CI, 1.8 to 15.2) and increased to more than 17-fold when a corticosteroid was added (OR, 17.5; 95% CI, 5 to 60.9) 5.
Common questions
Can I take Dexamethasone and Levofloxacin Injection together?
An increased risk of tendon rupture Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dexamethasone and Levofloxacin Injection interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Dexamethasone or Levofloxacin Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (5)
- Morales DR, Slattery J, Pacurariu A, et al: Relative and absolute risk of tendon rupture with fluoroquinolone and concomitant fluoroquinolone/corticosteroid therapy: population-based nested case-control study. Clin Drug Investig 2019; 39(2):205-213. DOI
- Product Information: LEVAQUIN(R) oral film coated tablets, oral solution, intravenous injection solution, levofloxacin oral film coated tablets, oral solution, intravenous injection solution. Janssen Pharmaceuticals, Inc. (per FDA), Titusville, NJ, 2017. DailyMed
- Wise BL, Peloquin C, Choi H, et al: Impact of age, sex, obesity, and steroid use on quinolone-associated tendon disorders. Am J Med 2012; 125(12):1228-1228. PubMed
- Corrao G, Zambon A, Bertu L, et al: Evidence of tendinitis provoked by fluoroquinolone treatment: a case-control study. Drug Saf 2006; 29(10):889-896. DOI
- van der Linden PD, Sturkenboom MC, Herings RM, et al: Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids. Arch Intern Med 2003; 163(15):1801-1807. PubMed
Keep reading about Dexamethasone
Keep reading about Levofloxacin Injection
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