Dealing With A Headache Caused By Levaquin

In our latest question and answer, the pharmacist discusses treatment options for a headache caused by Levaquin.

Dealing With A Headache Caused By Levaquin
Jul 15, 2019

hannahlizzz asked

Hello, My boyfriend has been prescribed levofloxacin for cellulitis. He's been having a lot of headaches as a side effect. Can he take ibuprofen or is there another pain killer you'd recommend?

At a glance

  • Levaquin (levofloxacin) should not be taken with NSAIDs (non-steroidal anti-inflammatory drugs) due to increased risk of CNS (central nervous system) stimulation and seizures. NSAIDs include ibuprofen, naproxen and aspirin. Tylenol (acetaminophen) is considered to be a safe alternative for most.


Man With Headache Illustration With Text - Headaches From Levaquin Treatment

Your boyfriend isn't alone is experiencing headaches as a side effect from taking Levaquin (levofloxacin), a drug in the 'fluoroquinolone' class of antibiotics.

In fact, 'headache' is listed as the second most commonly experienced side effect from the drug in its prescribing information, right behind nausea.

Unfortunately, while there are many 'over the counter' (OTC) pain medications that can help provide relief from headaches in general, many have potential interactions with Levaquin and should be avoided.

Nevertheless, there are some options out there, including Tylenol and various topical products.

Headache Drugs With Levaquin

Our goal with picking a medication to help treat a headache brought on by Levaquin is simply to find one that won't interact with it.

There, of course, are other considerations including other medications you may be taking and your overall medical situation, but for the sake of answering your question, we'll simply focus on picking a drug that is considered safe to take with Levaquin.


First and foremost, you, in most cases, want to avoid an entire class of drugs known as NSAIDs (non-steroidal anti-inflammatory drugs). Drugs, that available over the counter, in this class, include:

Taking Levaquin with any NSAID has been associated with an increased risk of central nervous system stimulation and an increase in seizures. Per the prescribing information for Levaquin:

"Many common medicines for pain relief are NSAIDs. Taking an NSAID while you take LEVAQUIN® or other fluoroquinolones may increase your risk of central nervous system effects and seizures."

If you try to treat a headache by taking an NSAID, and you are also taking Levaquin, there is a good chance your headaches will only get worse and there is also the risk of more serious side effects (like seizures).

It is important to look at all the active ingredients in any drug product you are looking at taking to make sure it doesn't include an NSAID. For example, many people don't know that a product like Excedrin, which is very often used to treat migraines, contains aspirin, an NSAID.


Tylenol (acetaminophen) is generally considered safe to with Levaquin. There are no known interactions between the two that are considered clinically significant.

If you are looking to treat a headache and are on Levaquin, Tylenol is likely to be your best (i.e. safest) bet.


Aside from Tylenol (and NSAIDs which generally shouldn't be used), your options are limited.

You certainly can use topical products that you apply to your forehead as they aren't absorbed systemically to the point where they could cause drug interactions. These products would include ones such as Bengay, Tiger Balm and Bio-Freeze.

While several herbal options exist for the treatment of headaches, they aren't well studied and therefore potential interactions with Levaquin aren't known.

For example, feverfew seems to be fairly effective for migraine headache relief... but may work in a way that is similar to NSAIDs. Therefore, we can't be certain it is safe to take.

Final Words

Since NSAIDs should be avoided, your best options for treating a headache while taking Levaquin are essentially Tylenol and topical products.

If the headaches from Levaquin are particularly bad, be sure to discuss them with the doctor so you (or your boyfriend in this case) can be properly evaluated.

  1. Levaquin Prescribing Information. AccessFDA
  2. Fluoroquinolone adverse effects and drug interactions. AccessFDA
  3. Inhibition of the expression of inducible cyclooxygenase and proinflammatory cytokines by sesquiterpene lactones in macrophages correlates with the inhibition of MAP kinases. AccessFDA

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