Drug & supplement interaction

Manganese + Levofloxacin

Levofloxacin brand names: Levaquin, Levaquin Injection, Leva-pak.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Manganese has a moderate interaction with Levofloxacin. Theoretically, manganese might reduce the absorption of quinolone antibiotics.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Manganese and Levofloxacin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

QUINOLONE ANTIBIOTICS

Why this applies to Levofloxacin

Levofloxacin falls under QUINOLONE ANTIBIOTICS — the group Manganese interacts with.

Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: manganese can grab onto levofloxacin in your gut and keep some of it from being absorbed. Levofloxacin isn't a prodrug, so this isn't about activating it. The concern is simpler. Manganese is a charged mineral, and antibiotics in this family (the same way they react with calcium, iron, magnesium, and antacids) can bind to it and form clumps your body can't take up well. Less drug absorbed means a weaker dose fighting your infection.

This particular pairing is theoretical, based on how related minerals behave rather than direct studies, but it's a reasonable worry. A practical fix is timing: ask your pharmacist about spacing your manganese supplement a few hours away from your levofloxacin dose so the antibiotic can do its job. Please don't stop either one on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Manganese Also Interacts With Other Medications

Manganese has 82 moderate known drug interactions in our database — the Levofloxacin one above is one of them. If you take anything else, check it against the full list below.

Moderate 82 No known interaction 2,748 (incl. Levofloxacin)
Taking anything else?

Check Another of Your Medications Against Manganese

Covers the 2,830 medications we’ve checked against Manganese. Pick one to open its full report.

From our Q&A

Questions About Manganese or Levofloxacin

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Manganese or Levofloxacin, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Levofloxacin

This page covers Manganese only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levofloxacin page lists 155 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Apple (major), Arsenic (major) and Asarabacca (major).

By severity: 13 major · 121 moderate · 21 minor.

From our pharmacist’s overview on the Levofloxacin page

“Levofloxacin (Levaquin) is a potent fluoroquinolone antibiotic, and its supplement list deserves real respect, with 13 of the 155 entries rated major. The most everyday hazards are fruit juices.”

Reviewed by 2 · Jul 18, 2026

Open the Levofloxacin interaction page

One more smart check

Taking Manganese as Part of a Dietary Supplement Product? Check It for Interactions

We hold 16,006 real supplement products containing Manganese, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Manganese. Your product may carry other ingredients that interact with Levofloxacin too, on top of Manganese — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Manganese and Levofloxacin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Manganese
Top 5%

#18 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Levofloxacin
Top 25%

#435 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Manganese

What is Manganese?

Manganese
  • Bone health support
  • Antioxidant and enzyme support
  • Filling dietary gaps
  • Metabolism support
  • Wound healing

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements may help if you have a genuine deficiency, but too much can be harmful—especially to the nervous system—so do not take high doses without guidance from a pharmacist or doctor.

Read the full Manganese monograph & all interactions
Medication

About Levofloxacin

What Is Levofloxacin Used For?

Brand names: Levaquin, Levaquin Injection, Leva-pak

Levofloxacin treats bacterial infections in adults, including pneumonia (both community-acquired and hospital-acquired), skin infections, urinary tract infections, kidney infections, chronic bacterial prostatitis, and sinus infections. It is also used after exposure to inhalational anthrax and for plague.

Because levofloxacin carries significant risks, it should only be used for uncomplicated urinary tract infections, acute bacterial worsening of chronic bronchitis, and acute bacterial sinusitis when no other treatment option is available. Always use it only for infections confirmed or strongly suspected to be bacterial.

See full Levofloxacin drug information
Keep checking

Other Drugs & Manganese

Browse every other medication we’ve checked against Manganese — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
82Moderate
0Minor
2,747No known interaction
82 Moderate 2,747 No interaction
Moderate

82 interactions

Showing 60 of 82 moderate interactions — see all 82 on the Manganese page.

No interaction 2,747 drugs checked — show the list

We also checked Manganese against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,747 medications checked with no known interaction — see the full Manganese list.

See the full Manganese interactions page
See every supplement checked against Levofloxacin, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Manganese monograph › Uses, safety, and every drug interaction in one place Levofloxacin supplement interactions › Every supplement checked against Levofloxacin, ranked by severity Levofloxacin drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Manganese and Levofloxacin Together: Common Questions

Can you take Manganese with Levofloxacin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Manganese and Levofloxacin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Levofloxacin and Manganese?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.