Levaquin IV and Hypotension

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.
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

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.

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

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

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...