Two medicines, side by side
Amikacin vs levofloxacin
Amikacin and levofloxacin are both labeled for bacterial infections. Drugs@FDA records approvals of amikacin since 2018 and of levofloxacin since 1996. Pharmacies paid $2.33 per mL (Amikacin sulf 500 mg/2 mL vial) and $0.259 per levofloxacin 750 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, amikacin is an aminoglycoside antibacterial and levofloxacin a fluoroquinolone antibacterial.
Check it at the source: the amikacin FDA label on DailyMed (effective December 10, 2025); the levofloxacin FDA label on DailyMed (effective July 10, 2024).
Highlights of the amikacin record
Amikacin (Arikayce) · label of December 10, 2025
Patients treated with parenteral aminoglycosides should be under close clinical observation because of the potential ototoxicity and nephrotoxicity associated with their use. Safety for treatment periods which are longer than 14 days has not been established.
Used for
From the label: indicationsAmikacin Sulfate Injection is indicated in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria, including Pseudomonas species, Escherichia coli, species of indole-positive and indole-negative Proteus, Providencia species, Klebsiella-Enterobacter-Serratia species, and Acinetobacter ( Mima-Herellea ) species. […]
On the market
- Earliest approval on file
- September 28, 2018
- Generic labelers
- 6 labelers
- Pharmacy cost
- $2.33 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 4
Highlights of the levofloxacin record
Levofloxacin (Levaquin) · label of July 10, 2024
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsLevofloxacin is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with infections caused by designated, susceptible bacteria and in pediatric patients where indicated ( 1 , 12.4 ). […]
On the market
- Earliest approval on file
- December 20, 1996
- Generic labelers
- 44 labelers
- Pharmacy cost
- $0.259 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 13
Source: FDA drug labels via openFDA (Amikacin label of December 10, 2025, Levofloxacin label of July 10, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do amikacin and levofloxacin differ on the record?
In FDA's classes, amikacin is an aminoglycoside antibacterial and levofloxacin a fluoroquinolone antibacterial.
Half-life, in each label's words: Amikacin, “General Pharmacokinetic studies in normal adult subjects reveal the mean serum half-life to be slightly over 2 hours …”; Levofloxacin, “The mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single …”
Both labels carry a boxed warning; the records quote them.
Generics: amikacin since 1981; levofloxacin since 2010 (Drugs@FDA).
| Amikacin | Levofloxacin | |
|---|---|---|
| Labeled for | Bacterial infections | Bacterial infections, Urinary tract infections |
| Pharmacologic class | Aminoglycoside Antibacterial | Fluoroquinolone Antibacterial |
| How it works (label) | n/a | Levofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. |
| Half-life (label) | General Pharmacokinetic studies in normal adult subjects reveal the mean serum half-life to be slightly over 2 hours with a mean total apparent volume of distribution of 24 liters (28% of the body weight). | The mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single or multiple doses of levofloxacin given orally or intravenously. |
| Earliest approval on file (Drugs@FDA) | September 28, 2018 | December 20, 1996 |
| First generic approved | January 22, 1981 | December 20, 2010 |
| Generic labelers (NDC) | 6 labelers | 44 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $2.33 per mL (Amikacin sulf 500 mg/2 mL vial) | $0.259 per tablet (Levofloxacin 750 mg tablet) |
| 12-month price change | -23% | -11% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 4 | 13 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 18,617 | 59,954 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to amikacin
- every medicine labeled for the same conditions