Lefamulin
Brand names: Xenleta
Lefamulin is a pleuromutilin antibacterial, available in oral and intravenous forms, used for community-acquired pneumonia in adults.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
It inhibits bacterial protein synthesis by binding the peptidyl transferase centre of the 50S ribosomal subunit.
Prescribing in practice
- It can prolong the QT interval, so avoid use with other QT-prolonging drugs and in patients with significant pre-existing QT prolongation.
- It is contraindicated in pregnancy unless effective contraception is used, based on reproductive toxicity findings.
- It is a CYP3A4 substrate, so review interacting medicines that may alter its levels.
Monitoring
Consider ECG monitoring in patients at risk of QT prolongation and review concomitant medicines and liver function as clinically indicated.
Counselling the patient
- Diarrhoea, nausea and injection-site reactions can occur.
- Tell your clinician about heart-rhythm problems and all other medicines you take.
- Complete the full course even if you feel better.
Evidence & guidelines
Non-inferiority to moxifloxacin in community-acquired pneumonia was shown in the LEAP 1 and LEAP 2 trials.
Reference: File et al. NEJM 2019 (LEAP-1); Paukner et al. NEJM 2019 (LEAP-2); MHRA SPC Xenleta; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.