Fluoroquinolones increase risk of tendon rupture in elderly, transplant recipient, steroid users

I've been on Levaquin sometimes 4-5X a year for diagnosed urinary tract infections with kidney stones (Have had full workup and a diagnosis of MSK/Medullary Sponge Kidney and under care of great NYC Urologist).  

I have asked about this Levaquin/Tendon association many times and have been brushed off by most of my doctors when I bring it up.  Yet I have a serious tibial tendonitis problem in my right ankle which was a Grade II-III (diangosed out of the blue 1.5yrs ago).  Siince diagnosis 1.5yrs ago and ltd. phys. therapy and orthotics and change of life (wearing high top sneakers) it has gotten somewhat better, but the ? has always remained in my mind if the Levaquin was a key player in the serious tendon problem as I woke up with it one morning out of the blue!!!  (I was 47 at the time).

My tendon did not rupture but was close to that at the time & confirmed diagnosis via MRI along with arthritis & specially trained orthopedists who only do ankle/foot orthopedics trained out of Hosp for Special Surgery.  Both thought no corelation between the Levaquin and my tendon issue.

Hindsight is 20/20 (I've read this on my inserts) for me, and I'll never know.  But thank you so much for posting this for others to see this info  .... many on the new MSK (medullary sponge kidney) site here on MedHelp have to use these antibiotics often for specific cultured UTI's and it becomes the good 'ol risk benefit thing.  I was just talking about this association the other day via PM with a member who had no idea about the tendon association warning on the label.

When I get sinusitis, I always ask for the absolute lowest type of antibiotic that will do the trick for me .. and stay away from levaquin unless absolutely necessary.

Have you ever seen it happen with any of your patients?

C~

i haven't seen it myself, but always consider it, since they released data showing concerns about this in the last decade.

-e

I too read about these problems back in 2004. I was on Levaquin after my breast cancer surgery and failed reconstruction. I was afraid to go back to racquetball and other sports for fear of tendon problems.  I was brushed off by the Dr. too.
I suffered from "plantar fasciitis in both feet for the next 3 1/2 years. I did the whole drill of inserts/shoes etc. not to forget the CO-PAY involved with a podiatrist.
No one would listen to me when I suggested it was from taking that drug on/off over a period of 14 months. (Had other surgery that necessitated more Levaquin).
As I sit here typing this, I am just sick to my stomach...LITERALLY.  I am on Cipro right now, due to a bout with diverticulitis.  Cipro is on that list!
It's kinda hell getting old, but beats the alternative!

My life has been hell since this antibiotics. My doctors brushed me off too. Not only did I have tendon problems but I had neuropathies too. I was told I had anxiety. My problems started with cipro, then 6 months later avolex, then levaquin is the one that the tendon problems kicked in. I have spent so much money on exstensive blood work because I have thought I had lupus or some auto immune problem. My doctor thought I was crazy and so did all the specialists. Its amazing that all of these symptoms I have just came on suddenly when I had been completly healthy and normal up til then. Another thing every time I was prescribed this poison it was for a sinus infection and a urinary tract infection which I never had. It was kidney stones. This drug is over prescribed and not used for the serious infections it should be fighting. All I know is I will never take this drug again and nobody in my family or friends will either. I guess this is the only way to fight it is word of mouth.

I wanna toss something in here.

HCV and Floraquinalones - I think the Floraquinalone caused the rupture I had for Plantar Faciitis - which was just one of the many things that went wrong that lead to the diagnosis of HCV.

Floraquinalones are the DEVIL in a pill form!     I developed derealization/depersonalization and panic attacks  after taking Tequin in 2005 for a "sinus infection",  that is so bad it has left me disabled.

I am allergic to penicillin, E-myacin, C-clor so Cipro is about the only one I can take.

Question: Can the effects of the tendon dabilitation continue after the therapy is over? The last time I had Cipro was in 2001, but I was treated several times prior to that, and as you can imagine, I've been on lots of antibiotics over the years being allergic to all those others.

I had an achilles tendon rupture in 2004, and an overly seperated Sacriatic joint that ended in dablilitating back pain after my third child was born in 2006. And recently bruised my tailbone (2008) by sliding down a children's slide with my little one (not hitting the ground or anything, just simply sliding down it).

reactive EBV, Elev LFTs, seizures, hair, weight loss, thyroid nodules, light stool

I have all of the above symptoms plus a strange hive like rash that comes and goes. I took dairy and wheat out of my diet and have seen marked improvement in seizure activity, stool color, uirine color and rash, and a complete turn around in weight loss and noticed hair regrowth. Not really any symptoms of CFS, but sometimes just need to take a 2 hour nap, especailly after physical activity.

History:
8 years ago - Extreme fatigue with RS pain during first pregnancy
5 years ago - "dizzy spells" later found out to be simple partial (petit mal) seizures Elev LFTs found
3 years ago - second child born more "dizzy spells," notice soy increases incidence of "dizzy spells" cut out soy
2 years ago - third child born "dizzy spells (seizures)," 125 lb. weight loss starts and goes over next 11 months, hair starts falling out
7 months ago - First grand mal seizure, "dizzy spells" finally diagnosed as petit mal (simple partial) seizures, reactivated EBV infection found, low Vit D found, small thyriod nodules found (too small to biopsy), liver biopsy negative, all other scans (CT, MRI, chest Xray) negaitve
5 months ago - Cut wheat, dairy and corn
2 months ago - reintoduced corn, no ill effects
1 month ago - reintroduced dairy (cheese, ice cream), tastes bad, stomach ache and "dizzy" feeling (seizure?) cut dairy immediatly

What do I have? Can anyone tell me? I've been to 2 GPs, 2 gastro doctors, one allergy, one endocrine, one hemotologist, and a dermatologist and no one can tell me anything, that is except that I need a phsyc consult.

PS - I've also had things like boils, yeast infections on and off over the years

would like to know if you know any thing about hpv?

Was on Cravit and Cipro for about 2 weeks....  tendons started to act up....


The bad news is, I just found out I am TB positive (latent), and the docs want me to take INH, but I have NASH hepatitis, and so the alternative drug is cipro for 6 months....

I don't think I will survive the treatment.

Interesting On the Hepatitis point Wear a Jimmy.

I honestly believe those with HCV or any type of liver disease should NOT be on Floraquinalones.

I think THAT might be the mitigating factor.

But whatta I know? Eh? I'm just a patient... LOL!

Meki

Hello you all,

My daughter of 13 got for one year cipro every day after 4 year other antibiotica.
She is now 16. We lived for 3 years in a hell.
She went from top to bottem.
She lost 12 kg, slept 17 hours, hallucinated, trembled with her legs and feet, had burning hands and feet, verry low bloodpreassure, concentrationproblems, got bad eyes and theet and now I have 2 lawyers.
I found a wonderfull site of victims in amerika where my voice is heard.
We live in the Netherlands.
Veronica.

MY HEART AND MY UNDERSTANDING OF THE FRUSTRATION YOU ALL HAVE BEEN GOING THROUGH GO OUT TO EACH OF YOU. I AM LOOKING FOR SOME ANSWERS MYSELF IN SEEKING HELP  FOR MY STEP-FATHER AN A STRANGE HEALTH ISSUE. IF YOU ,ANY ONE OF YOU HAS ANYTHING TO OFFER PLEASE DO SO.
HE IS 75 AND STILL WORKING ,UP AT 5:30 EVERYDAY, THE PERSONAL INHOUSE ACCOUNTANT FOR A PROPERTY INVESTMENT COMPANY AFTER OWNING HIS OWN CPA FIRM THAT ONE OF THE BIG THREE BOUGHT OUT. HE IS THE TREASURER OF OUR CHURCH OF OVER 8,000 MEMEBERS, TREASURER OF A COUNTRY CLUB, HEAD OF FININCE FOR A LOARGE NURSING HOME AND ALL THIS HE HAS DONE SINCE 1998. THE MAN HAS ONLY BEEN SICK ONCE IN 26 YEARS THEN NOW ALL THE SUDDEN HE IS HAVING SURATIC EVENINGS OF SWELLING UP IN TH EFACE AND NECK, AND BY MORNING LIPS INSIDE HIS MONTH AND AREMS ARE SWOLLWN, TORSO ID WELPED UP IN HIVES AND HE HAS FEVER. THE DAY BE FORE HE BREAKS OUT AT NIGHT HE FEELS BADLY ENOGH THAT HE MISSES WORK...............TOTALLY A NEW CONCEPT FOR US ALL TO HANDLE. TREATMENTS HAVE BEEN EXTENSIVE COURSES OF PREDNISONE, DECONGESTANTS AND BENEDRYL.
ALLERGIST BELIEVED IT WAS ASPRIN AND A SUDDEN CHANGE IN HIS BODY DUE TO AGE THE CAUSED IT.  WRONG -  AFTER DISCONTINUEING ASPRIN AND FINISHING THE PREDNISONE COURSE TWO DAYS AGO, THE FEVER AND TIREDNESS STARTED TODAY AND BY TONIGHT HE IS ALL PUFFED UP IN HIS FACE MONTH AND ARMS HAD HIT AGAIN. ALSO THIS HAS BEEN PRECEEDED BY "HEAVEYNESS" AND TIGHTNESS" IN HIS CHEST BEFORE HE GETS OPUT OF THE BED IN THE MORNINGS AND IT GOES AWAY ABOUT NOON AS THE TIREDNESS HITS HIM.  BUT HE CAN HAVE A ROW OF GREAT DAYS WORKING ALL DAY AND MEETINGS AT NIGHT. DO YOU, ANY OF YOU, HAVE ANY IDEAS OR THOUGHT ABOUT THIS..I AM WONDERING IF THE FACT HE HAD AN EMERGENCY ROOM TRIP THIS YEAR THAT RESULTED IN FINDING AN OLD, GANG GREEN , INFECTE4D GALLBLADDER THAT WAS REMOVED COULD HAVE ANYTHING TO DO WITH HIS BODY AND ITS "ISSUES" NOW?  HELP AND PRAY.

BLESSING TO YOU ALL MIMI

An experience I had, while taking Cipro. Before I start, of course I do not/could not know for certain that Cipro was to blame. That said: the start of last year, I suffered from a U.T.I. with kidney involvement. I was given Cipro. Having taken about half the course of antibiotics, I developed intense pain and tenderness in the area just before my elbow. It was discovered when leaning my forearms on the counter-top. I never experienced any pain or problem in that area before. A few days before I completed treatment, my right eye drooped to the point of obstructing vision but almost as suddenly as it came on did it correct itself. Neither of these have occurred since.
On a positive note, it did knock out the infection.

This seems to be a antibiotic that is considered "taboo" by many in the thyroid forums. I have marginally elevated TgAb and T.S.I. antibodies.

I can not help but wonder why those with thyroid dysfunction (or euthroid but antibodies remain) might be negatively effected by this line of antibiotics.

spiningwheelsI,

For starters, this is the wrong threat to post to. I would search out the "undiagnosed" forum (patient-to-patient). Might consider "Family Medicine" (ask a doctor) followed by "undiagnosed" forum " (ask a doctor).

That said, has your step-father had a CBC with differentials run, as well as nutrional status? He is entitled to receive copies of any/all blood work run.
If given a choice of a doctor to see, I would search out an Internist first (if this hasn't already been done).
How many allergists has he seen and what tests were run?
How's his heart & kidney's doing?

Prednisone (steroids) alone can cause facial swelling (i.e. "moon face" and weight gain) but I wouldn't assume that is the problem beings this is continuing after discontinuation of Prednisone.

Has food allergies and Celiac Sprue been ruled out? http://www.nlm.nih.gov/medlineplus/ency/article/000233.htm
Which is an Auto-immune problem.

Some things to think about. Again, I would post to the forums I mentioned and have him request his blood labs.
If you get ahold of his blood tests, you can pursue this site:  http://www.labtestsonline.org/

Copies of labs is not only good to have for your own viewing but to also have on hand if you seek a "second" opinion.

Good luck to you and your step-father.

Hi.  No wonder the brush off from doctors.  It is my fervent opinion that medications can make us sick and sicker in other parts of our bodies, particularly antibiotics.

Beause of your high use of levoquine and other antibiotics, you (and we all) need to alkalize our bodies because an alkaline body cannot become diseased.

Juice or eat vegetables and fruits.  Recommended by the FDA and medical field, it's no wonder they don't often say why.  It is because if we do become less acidic, we won't need them (drs. and pharmacologists) as much.

May God continue to work through everybody and may he continue to bless doctors everywhere for the really incredi le work they do.  May he continue to bless us with information to help us.

lillybell, I do agree that fruits & vegetables are great for you.  I also ask God to bless my patients, and work thru me.

I don't agree that alkalinization is necessary.  That's irrelevant to the side effect of fluroquinolones: tendonitis.

Thanks so much for sharing this information with us!  I have never before heard about this link between fluoroquinolones and tendon rupture.  Let's hope doctors and patients alike learn about this important safety warning.

Cindy

I was on many courses of Cipro in the late summer/fall of 2007. I began having major problems with my ankles and could hardly walk. I didn't think to mention it to my GP as I did not make the connection. Finally, in late winter 2008 - I realized that everytime I took Cipro I got worse.  The good news is the majority of my symptoms went away - after an orthopedist injected steroids into my ankle and I stopped the Cipro. I am totally convinced the Cipro was the cause of all my ankle tendonitis! How I wish I had known sooner. And if we the consumers don't report these adverse findings  to the FDA - the drug manufacturer does not know there is a problem.

There is definitely a connection between cipro, levaquin, and all the other quinolones. I'm not a medical expert, but the horrific reactions to these drugs over is something the medical establishment has been hesitant to acknowledge. I took 3 500mg doses of levaquin (prescribed as a "hot new drug" by my former physician) for a bladder infection in early 2005. By the third day, I could no longer walk. I literally would fall over from the pain in my tendons. My shoulder tendons felt like they were on fire. I had difficulty breathing. I stopped taking the doses immediately, as I knew it was a toxic/allergic reaction....and it took me literally a full year to recover from the damage (at some points I never thought I would).

I had a history of taking antibiotics in the past for "every little thing" (colds all the way up to walking pneumonia), so I don't think it was only the levaquin that did it. I do believe it was the proverbial straw that broke the camel's back, however, despite the fact that these drugs have a short shelf-life (8 -10 hours and they're supposed to be out of your system). But repeated use over many years of erythromycin, amoxycillin, ciprocin, and then levaquin creates some sort of condition FOR CERTAIN PEOPLE that causes all the significant problems Dr. Choi describes.

I went to several primary care physicians to discuss this, and finally found one who not only said, "No, you're not crazy....it's not all in your head", but indicated he was involved in a law suit for a former patient/plaintiff whose Achilles' tendons both ruptures after several days' use of prescribed Levaquin. She's 28 (I'm 38 now, and was formerly a competitive masters-level swimmer, competitive swimmer for 20 years, athletic, and healthy). Sad.

Ironically enough, a coworker of mine experienced similar tendon issues by the third day of her use of levaquin, but didn't end up having as severe symptoms as mine. She was prescribed it for pneumonia that would not go away, and we happened to chat about how she was feeling when she told me her prescribed antiobiotic was levaquin. And I only work with 65 other people, so you can imagine this is occurring more frequently than medical practitioners might know of.

Believe in your symptoms, but also trust that if you catch this early enough and make your voice heard to the FDA, things will eventually change.

Today, I am doing much better and believe I am 95% recovered in full from the levaquin episode. I will never take an antibiotic again - and ironically, since this incident, despite the fact that I get periodic colds, what-have-you, I haven't needed to take anything since. The body can heal itself!

By the way, if you're interested in reporting your experience to the FDA, you can do so at: http://www.fda.gov/medwatch/.  

http://www.geocities.com/quinolones/

This website has been around for years warning of the adverse effects of fluoroquinolones.  While all medications have potential side effects, what sets the fluoroquinolones apart is the IGNORANCE of the adverse effects by doctors and the blind eye the FDA has given to thousands of SEVERE ADVERSE REACTIONS.  

When patients report SUDDEN pain in joints, muscles, rashes, anxiety, depression, vision problems,lethargy, etc they do not recognize (or choose not to know) the devastation Levaquin, Cipro, Aveloz, etc can cause.  The patient is not advised to STOP the fluoroquinolones and in many instances encouraged to take another course.  Some folks have recovered, some have not.  Most were given the antibiotics for simple ( or nonexistant) infections.  Then they're hit with pain, ruptures, thyroid problems, etc.

I was given Levaquin for an unspecified female-type "infection".  Seven years later, I still have "fibromyalgia" and am disabled due to fatigue and pain.  Before this I had NO medical problems at all.  I've had the work up for everything.  And I mean everything.  To date, I take pain meds, nothing else..................I'm "healthy" but lost my vigor.  

Only take these fluoroquinolones for a serious infection and KNOW the side effects, even if your doctor does not.  The drug manufacturer has done a fantastic job at hiding what we've known for a long time.  Thank you, and be careful.

My daughter was given the drug Levaquin a year ago for a common UTI...only took too pills and ended up collapsing. Caused her to feel like she was on fire, tremors, rapid heart beat, etc. We hoped things would improve but the joint pain (every joint) worsened, she was admitted to the hospital two weeks later. They all knew it was an ADR to Levaquin, but said this was VERY rare. Personally I have heard too many horror stories to cedit that.

Since taking the medicine in March of 07, she has spent 10 of the previous months either bedridden or in a wheelchair, and has had to take several pain meds on a daily basis. Her joint pain was so severe that at times she could not even hold a fork or pencil, had to use a cane or walker to get out of bed, had to have help with undressing, etc. Today she has improved but still deals with a lot of pain and cannot overdo her activities.  She has PN in both feet and hands, we have no idea if it is permanent. This has been life-altering for a previously very healthy and active 20 year old!

The new warning stresses risk factor in the elderly, but IMO it should include all ages. This drug should ALWAYS be used and dispensed with CAUTION. As long as other, more safer antibiotics are available, those should be used first.

I had no idea that these types of meds would give me tendonitis ...I have a severe kidney infection that i had to go through several rounds of anti to finally combat through iv and by mouth..A few weeks after all these meds i got a really painful lump on my achillies tendon i didnt know to put the two together so i have been dealing with this big lump that hurts so bad when i walk.. It went down some and i figured that it would go away after time..But its been a few months ago now and its still there then last week i see all this on the meds and the two fell into place.. I have no idea what to do now, i'm really depressed because my job requires me to be on my feet luckily i can sit down and rest my foot when needed but i'm scared that it may not go away so, i'm going to the podiatrist in a few weeks to see what can be done has anyone else had this problem like mine? any suggestions? possible lawsuits?
thanx Bri

Problem is, there isn't any liability for adverse drug reactions, it's not the doctors fault.   The Washington Phat Cats are more interested in protecting the drug companies' bottom lines then our health.     I used to be cynical and think the drug co's only cared about making money off us and could care less what misery they cause,  now I realize it's just that they have no idea what they are giving us,  they just know it does one certain thing.      I developed depersonalization disorder from Tequin,  a toxic evil drug.

I too have had SEVERE achilles tendon pain since January. I also did not put it together that I had taken levaquin the beginning of January for an upper respiratory infection and this probably caused it. I'm a nurse and am on my feet for 13 hours! The pain is debilitating! I have gone through physical therapy and ultra-sound therapy with no help. I have also been seeing a podiatrist for several months. I saw the article at work last week and it FINALLY made sense. I took a copy of this article to my podiatrist and he agrees, LEVAQUIN has caused my debility. He ordered bilateral ankle MRI's and told me I have a lawsuit angainst the drug company. I really don't care as much about a lawsuit as I do fixing my pain. And, Bri, there are lawsuits - one law firm in Texas is especially interested "Schmidt & Clark." Look them up, it may be worth your time. Even though the doctors are "down playing" this, I think it is HUGE! Shame on our FDA for not requiring this "black box" years sooner as France and a few others did. My life is wrecked now and I hope it is not for the rest of my life. Be careful everyone, Diana

Wow, glad you made that information available on here.  

Judy

For a very long time a really close friend of my has been having almost daily migraines.  They have been getting bad to the point of her throwing up and in constant pain.  She has also been experiencing memory loss.  She said that from January until about one month ago, she can not remember anything.  It takes her hours to remember something, and when she does, it results in a migraine or she starts bleeding from the nose.  She also tells me that before January she can remember something, and anything from the most recent month she can also remember.  She has an appointment to see the Neurologist in December, but that is to far for me, I am real concerned and I need some information so that I can give her some comfort.
Thank you for listening, and help would be nice.
-Silas-

I also suffered a SEVERE reaction to Avelox in 2003.  It started with horrible pain in my right wrist.  It then moved around my jaw, knees back ankles etc.  It was horrible painful and I have had 2 children.  It was far worse that having an 8lb 14 oz baby.  I began having weird almost hallucination like things, my hormones, blood pressure all got all out of whack.  I had heart palpatations and other weird things happening.  It has been 5 years and my body still suffers flare ups.  I am pretty sure fluoroquinolones are in our food supply, beef, chix, and pork.  I wonder if this is why I have reactions.  My suspicion is that it causes some mitochondrial dysfunction and that is why it is so hard to figure out.  I have been seen by loads of doctors who have been unable to help me.  I did however read that one man made a almost complete recovery and he thanks glutathione infusions for it.  I may attempt this as well.  I am sick of feeling sick.  I tell everyone I care about to avoid these medications.  Theyt should not be given unless alll others fail.  People have died from these quinolone drugs.

Reading comments here and on other sites, I'm not sure whether to start my Levaquin 500 mg per day prescription, which the doctor just prescribed since the other antibiotic didn't quite entirely clear my pneumonia and (this doctor says) "It's what's usually suggested for patients over 65 [with pneumonia]" (I'm 69). I have used Cipro a couple of times, over the past few years, for bladder infections, without side effects. On the other hand, I am allergic to sulfa, and I already have tendonitis (RSI from computer use). Reading patient comments about levaquin, I'm thinking it might be best to wait a couple of days, perhaps see a different doctor even. Please can the doctor online here give any feedback re the sulfa--levaquin allergy connection, at least.

polly22, only your physician can tell you what to do.  I can reassure you that levaquin is a fluroquinolone, not in the sulfa class and would not cause an allergic reaction in a person with a sulfa allergy.

Cipro is a fluroquinolone.  It's reassuring when a patient has tolerated a medication from the same class, there's less likelihood of a reaction to another from that same class.