Drug Interaction Report

Levofloxacin and Rasagiline: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Rasagiline

Azilect
+

Levofloxacin

Levaquin Levaquin®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 406 documented Levofloxacin interactions, 297 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
established
Severity
Major

What happens

Increased rasagiline exposure

Interaction Deep Dive

Rasagiline AUC increased by 83% when ciprofloxacin, a CYP1A2 inhibitor, was added to a rasagiline 2 mg/day regimen in healthy subjects (n=12). Use caution with concomitant use of rasagiline, a CYP1A2 substrate, with ciprofloxacin or other CYP1A2 inhibitors, as up to 2-fold increases in rasagiline plasma levels may occur. Do not exceed doses of rasagiline 0.5 mg once daily if concurrent use is clinically indicated1.

Why it happens (mechanism)

Inhibition of CYP1A2-mediated rasagiline metabolism

Literature reports

2 reports — tap to read

a) A 69-year-old man with a history of Parkinson's disease was admitted to the hospital with pyelonephritis and acute kidney injury. The patient had emphysematous pyelonephritis, hydronephrosis, and nephrolithiasis on CT scan. Additional history included kidney transplant, hypertension, transient ischemic attack, and recurrent UTIs, for which he was receiving prophylactic ciprofloxacin 500 mg 3 times weekly. Other medications included rasagiline 1 mg daily, allopurinol, carbidopa-levodopa, carvedilol, furosemide, magnesium oxide, megestrol, pantoprazole, prednisone, sertraline daily, spironolactone, tacrolimus, tamsulosin, and insulin glargine. Physical examination revealed increased resting tremor, cogwheel rigidity, and dystonia. Ciprofloxacin was discontinued and improvement in dopaminergic effects were observed throughout the hospital admission. The episode of acute kidney injury also resolved. The patient was discharged on ertapenem in addition to all prior home medications with the exception of ciprofloxacin 2.

b) Rasagiline AUC increased by 83% when ciprofloxacin 1000 mg/day was added to a rasagiline 2-mg/day regimen in healthy subjects (n=12) 1.

Common questions

Can I take Levofloxacin and Rasagiline together?

Increased rasagiline exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Levofloxacin and Rasagiline interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.

Questions for your pharmacist

  • Does my dose of Levofloxacin or Rasagiline 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 (2)

  1. Product Information: AZILECT(R) oral tablets, rasagiline mesylate oral tablets. Teva Pharmaceuticals (per FDA), North Wales, PA, 2014. DailyMed
  2. Chappell KB, Shah SP, Cutshall BT, et al: Ciprofloxacin-rasagiline drug interaction leading to dopaminergic effects. Nurse Pract 2020; 45(5):11-12. PubMed
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Beyond drug–drug

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.