Did you know that the FDA has issued a safety notification about a class of popular antibiotics called fluoroquinolones (FQs)? The announcement involves the following drugs:

  • Ciprofloxacin (Cipro)
  • Gemifloxacin (Factive)
  • Levofloxacin (Levaquin)
  • Moxifloxacin (Avelox)
  • Norfloxacin (Noroxin)
  • Ofloxacin (Floxin)

According to the FDA, over 21 million people get a prescription for one of these drugs each year. That makes this class of antibiotics among the most popular in the pharmacy. Doctors love to prescribe FQs because they are effective for a wide range of infections including bronchitis, pneumonia, sinusitis, urinary tract infections, prostatitis and skin infections.

These drugs have been around for decades. Cipro, for example, has been on the market for over 25 years. After all this time, one would think that the FDA would have a clear understanding of the benefits and risks of such drugs. In fact, you might assume that doctors would have been warned about complications of FQ drugs like Levaquin or Cipro from the very beginning. Au contraire. It comes as a great shock to patients to discover that serious fluoroquinolone warnings continue to be issued, decades after these drugs were originally approved.

The most recent FDA announcement relates to nerve damage, aka peripheral neuropathy. Here is the official safety communication issued on 8-15-2013:

“This serious nerve damage potentially caused by fluoroquinolones may occur soon after these drugs are taken and may be permanent… Peripheral neuropathy is a nerve disorder occurring in the arms or legs. Symptoms include pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain or temperature, or the sense of body position. It can occur at any time during treatment with fluoroquinolones and can last for months to years after the drug is stopped or be permanent. Patients using fluoroquinolones who develop any symptoms of peripheral neuropathy should tell their health care professionals right away.”

In other words, patients can experience this potentially irreversible nerve damage within days of starting drugs like ciprofloxacin or levofloxacin. Even if the drugs are stopped promptly, the side effects can last.

Doctors and pharmacists may not always describe the symptoms patients need to watch out for. And people may not associate weakness, numbness or tingling with an antibiotic, since it doesn’t seem logical that a medicine designed to overcome an infection would damage nerves. Such symptoms may not seem that bad, but in some cases peripheral neuropathy can be permanently disabling.

OTHER KINDS OF NERVE DAMAGE:

We first became aware of unusual problems brought on by fluoroquinolone antibiotics in July of 1994 after receiving this question:

“I often have side effects from medicines, but have never experienced anything like Floxin. I took it for a severe sinus infection followed by pneumonia last winter. After three days of utter misery and a rash on my back, I started hallucinating. Are there other people who have had a bad reaction to this antibiotic?”

We had to do some digging, but we finally discovered that FQs can cause “hallucinations, visual disturbances confusion, dizziness and seizures.”

We talked to journalist Stephen Fried about his wife’s experience with Floxin. In the book Bitter Pills, the Frieds describe how one Floxin pill for a urinary tract infection led to debilitating neurological symptoms that lasted for years.

At the time, a lot of doctors didn’t believe such long-lasting neurological complications could happen so quickly. It has taken the FDA over 25 years to alert physicians to just such a possibility.

The same can be said about tendinitis or tendon rupture. This is another very serious adverse reaction triggered by FQ antibiotics. The first published report of an Achilles tendon problem appeared in 1983. Thereafter there were many case reports linking drugs like ciprofloxacin and levofloxacin to tendinitis and tendon rupture. These can also be disabling complications of FQ antibiotics. It took the FDA until 2008 to issue “black box” warnings about this problem, 20 years after Cipro was first introduced.

FLUOROQUINOLONE SIDE EFFECTS & COMPLICATIONS:

  • Digestive distress, nausea, diarrhea, constipation, stomach pain, heartburn, vomiting
  • Headache, dizziness
  • Agitation, anxiety, irritability, restlessness, confusion
  • Insomnia
  • Tendon problems, tendinitis, tendon rupture
  • Retinal detachment
  • Nerve damage, peripheral neuropathy, nerve tingling, numbness
  • Allergic reactions, skin rash, anaphylaxis (life-threatening reaction requiring immediate medical attention!)
  • Super-infections including C. diff diarrhea
  • Hallucinations, psychosis, seizures
  • Depression, suicidal thoughts or actions
  • Irregular heart rhythms, torsades de pointes, QT prolongation
  • Kidney or liver damage
  • Blood disorders
  • Arthritis, muscle pain, weakness

READER REACTIONS:

Here are some stories from visitors to our website. Add your own FQ experience below. If these antibiotics have worked well for you without side effects we would like to hear about that. If you have suffered, we would like to see your story as well. Please comment below.

“I have taken Cipro a number of times over the years and wondered why my tendons, especially the Achilles tendon, were so inflamed. Finally read the side effects and saw it can be a serious side effect to the point of bursting the Achilles tendon. I carry a note with my insurance card in my wallet warning not to give me any of this family of antibiotics.” C.G.


“It’s been eight months and I’ve been to two specialists trying to determine if I have arthritis. They say I do not. I took Cipro and Levaquin within a one month period and it has been eight months since then, and I have pain and stiffness EVERY DAY. What started out as plantar fasciitis and wrist tendinitis then moved into my hips and elbows and is now in my upper back and shoulders.

“I ran a low grade fever for 6 months after taking these drugs. The symptoms started within two days of taking the last dose of Levaquin. I have not even addressed the fatigue, irritability and mood changes I experienced during the first three months after taking the drug. I was healthy, active and exercised regularly. Now I don’t know what to do–stretching generally aggravates my pain. How can the FDA allow this drug to be prescribed?” Augsdi


“In 2000 I had an adverse reaction to Cipro: inflammation of most of my connective tissue to the point of needing help to get up out of bed or get dressed. I was unable to lift much and could not sit for more than 15 minutes due to the pain. My doctors could not believe it was the Cipro. It was 5 years before I was able to hike and ride my bike again.” Jo


“The quinolone drugs, Cipro, Levaquin, Avelox, etc. are extremely strong and dangerous. When they go awry the adverse effects are serious, long term and often permanent.

“The awareness in the medical community of these dangers is extremely poor and often the concerns of patients suffering from adverse effects of these drugs are dismissed as ‘not possible,’ despite studies and literature citing these very effects i.e. neuropathy, tendon ruptures, neuromuscular damage, cartilage damage and others.

“I struggle to heal from 5 days of Cipro given a year ago and have met hundreds of people now who are going through similar struggles due to quinolone antibiotics. These drugs, though tolerated by many, should only be dispensed when there is no safer alternative due to the severity and permanence of adverse effects.” Tao

 

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  1. William
    Los angeles
    Reply

    I took quinolon 30 years ago for many occasion. Since then, I suffer from artritis both my finger thumb, but the doctor said I didn’t have weakness of the feet, suffer from stiff neck, pain over my back, until now. I am 61, but the pain is tolerable for me. Since people are different, I do not know if the pain is tolerable with others.

  2. Lucy
    Ontario, Canada
    Reply

    Why did I trust my doctor and take ten 400g Norfloxacin for a UTI. He only used a test strip and did not even get a lab test. One week after finishing meds I went to bed and the backs if my legs felt on fire, with crawling sensation in my legs and feet.. Woke up with bad pain in shoulder joint…. All day pins and needles in arms and legs.. And feet. Then in hands .. Burning, tingling, and while my inside of hands feel numb, they are ultra sensitive to touch.

    Only after taking I read warning. Also, warning says side effects worse in those over sixty.. I am 72. I feel this will last forever. I am now taking magnesium and b12. I am a cancer survivor of thirty years.. Now my life is horrible after five dollars worth of DANGEROUS medication.

  3. Kelly
    Ohio
    Reply

    I am a professional artist, and rely on my hands. I took TWO ciprofloxacin pills for a bladder/kidney infection after having an allergic reaction to Bactrim. The Bactrim reaction was only hives, but I was told that I had developed a new sulfa-drug reaction, perhaps because of having used them during childhood for bladder issues.

    Hours after I took one Cipro pill, I had stiff joints in my fingers, hands, and toes. After the second dose, the pain was so bad that I could hardly stand or straighten my arms, and that lead to me asking my physician about the effects.

    I did not take a third pill, and eventually the pain in my joints receded from elbows and knees back to small joints in my hands and feet. Years later, I still have vastly reduced range of motion and inflammation in my hands and feet. This is not a normal, ‘age-related’ issue. It was a direct and quick result of this drug.

  4. Rose
    Fresno, CA
    Reply

    I had pneumonia and was prescribed levofloxacin 750 mg, 1 per day for 10 days. My last dose was Aug. 04, 2016. I developed severe ankle/knee/hip pain and difficulty rising from a sitting position, climbing stairs, etc. I feel like an invalid with this sudden onset of joint pain. Have also developed severe itching on ankles/back and extremities. I am just now doing research on effects and wonder WHY these drug companies are able and allowed to continue wrecking the lives of otherwise healthy people. We go in sick and come out disabled! I pray these effects are reverseable.

  5. Martha
    Phoenix,Az
    Reply

    In Dec of 2012 I took a Cipro 500 mg for a UTI and had severe reaction within a few minutes. My heart was racing, my face and neck were numb and I had a very hot face. Eventually I felt better, but stayed hot and clammy all evening. I thought this was only temporary, but it happened over and over from then on. I get a very hot face and neck every other day for at least 24 hours sometimes 36, it varies and then I’m back to normal for a day but that doesn’t give me much time to recover. It leaves me weak and tired. It’s relentless! It’s been 3 and a half years now and has taken a toll on my physical and mental health. I’ve been to Neurologist’s , had acupuncture, chiropractic and lot’s of Homeopathic therapy. I’m miserable and have some confusion. I don’t know how much longer I can stand this. Is there anyone else out there who feels the way I do? If so, let me know.

    • Kathleen
      MI
      Reply

      I have had the very same thing since 2008 when I took antibiotics for pneumonia. My face feels like it’s on fire and my feet and legs also have the same very painful burning sensation. I can’t cover up in bed even tho I keep my temperature at 65 degrees. I also have an irregular heartbeat, my B/P goes from way high to way low and sometimes I’ll be doing nothing and my heart just starts to race for no reason. My feet turn deep purple when I sit or stand for any length of time. I also have tendon and joint pain.

      This has all been going on for years, pain meds do not seem to help and my docs do not seem to know what to do to help me.

    • Heather
      Californa
      Reply

      I took one dose of the (Levaquin) and I felt hot my whole body. I have a tingling sensation that won’t go away in my head.

      I did not take another dose, but I do still feel hot off and on in my legs 3 days later. Dr. prescribed me Z-pak instead, I started to take it.

      Now, I dont know if I should finish.

  6. Adele
    Reply

    What is the antidote to Ciprofloxin side effects? It’s clear we all have the effects, but what is the solution? My daughter suggested taking dairy products because on the medication it says to not take with dairy or it may interrupt the medication’s effectiveness. So, maybe increasing milk may help. I have read that chealated magnesium would help remove toxins in the muscles, but chelated magnesium is difficult to find without zinc–thereby preventing you from taking a high dose…HAS ANYONE had ANY success in recovering from the muscle and tendon pain??? I hate how the 4 doctors I’ve seen want to ignore my symptoms and want to imagine it is something else. I know my body and all of this is from the Ciprofloxin..I pray there is recovery. I pray I will never take any medication without looking up the side effects first.

  7. Julie
    U.S.A
    Reply

    I began to have a burning like itch beginning on my ankles, then passing onto my wrists and finally attacking parts of my body like my abdomen or under arms or under breasts and back. After scratching uncontrollably I would add anti itch cream and it would develop into a dull pain, but better than the itch. It did not hit different places at one time: It attacked one area at a time. I had been taking Metronidazole for 9 1/2 days when this began. I scrutinized to evaluate what had caused it, either something I ingested or something I came in contact with: animals, walks in fields, woolen blankets, fleas. Or eating shellfish or grapefruit with a statin drug for cholesterol. I fear it may have been the Metronidazole’s side effect of causing some form of nerve damage as it’s been over 3 weeks since I stopped and I’ve since stopped coming in contact with all else that could produce the itch. I only hope to God its not the nerve damage that is the side effect of this antibiotic.

  8. Janet
    Queens NY
    Reply

    I was given Levaquin two years ago for pneumonia by IV in the hospital for four days. 10 more days by mouth when I got home about four months later I noticed lots of pain and numbing in my left hand that shot up to my elbow to the ulnar nerve which made it feel like you banged your funny bone

    Pain never went away. I went to see an orthopedic surgeon who suggested surgery of course and I agreed to it because I couldn’t take the pain anymore.

    Well it’s still here. the pain it’s never going away.

    Last month I was prescribed Biaxin for a severe middle ear infection it didn’t clear it up all the way and my doctor gave me Avelox. after one day I was dizzy. I woke up in the morning I could not move I have doctors thinking I have RA tendinitis a crushed nerve in my elbow which had surgery and never recovered I honestly believe it was these two drugs that did this to me. I discovered this today

    http://www.abc2news.com/news/in-focus/johnson-johnson-former-fda-commissioner-among-defendants-in-levaquin-lawsuit

  9. Stacy
    Ga
    Reply

    I got sick with what the doctors thought was pneumonia in the first week in February. They gave me a Z-pak, and the week I started it I began getting twitching in my legs and heart palpitations. I didn’t finish my antibiotic. I stopped taking it the last day. I have been suffering from nerve pain all over my body but especially in my head and pain in my left leg groin area. I have pain when I breathe and what I would consider peripheral neuropathy in both my arms.

    I have been on a roller-coaster ever since trying to rule out all the bad things. I had a head scan and spinal tap followed by a blood patch and a double ear infection. I have pain in my head that comes and goes, burning sensations, and I feel like I can’t think most days.

    The problem is I can still do things, so the doctors don’t feel like it is serious. The neurologist says everything looks good and prescribed me Tramadol. I’m not taking anything, though. I’m only on a steroid for my ear fluid now. But I have muscle aches and pain in my neck, head, back, chest–pretty much everywhere.

    I am currently experimenting with grounding and IV therapy to see if it helps because of some success stories I have heard. I hope this doesn’t last forever. It is really interfering with my life. I have also been keeping away from caffeine because it seems to aggravate things. Anyway, if anyone knows of anything that has helped them please let me know. Until we find something out I will keep on praying.

  10. Lily
    CO
    Reply

    I was prescribed Cipro yesterday for a UTI. I took ONE tablet last night at 6:30pm. I began feeling foggy minded and deeply tired within the first hour. I went to bed early and slept well until a little after 12am. I woke feeling so strange. I don’t know how to describe the hallucination I had. My lower legs felt and appeared to be much longer than normal. My feet appeared to be at the end of the bed. Getting out of bed caused this to stop. I went back to bed and woke around 2am with intense pain in my upper back, left side of my neck and left elbow. I took 2 Advil and slept after awhile. I had a vivid dream that there was a large ball of many colors slowly swirling round and round, making me dizzy. I woke again with pain and nausea. I felt anxiety and started crying.

    When I had to get ready for work, I took my second Cipro. I wasn’t able to get dressed and felt too nauseous to eat. I was still feeling pain in my back and neck. I posted my symptoms on my Facebook and got quite a response from 3 friends who told me what was going on. I flushed the rest of my Cipro tablets down the toilet. I’ve spent the day feeling similar to when I was sedated prior to a surgery. My eyes and head feel heavy. There’s still pain in my back and neck though it’s not as intense as it was this morning. I pray there’s not long-term damage.

    • deborah
      California
      Reply

      I was prescribed the same for a UTI. Went to ER the night before. Spent about 5 hours waiting to be seen, then was given a dose of levofloxacin in the ER, and prescribed cipro for home. Took that dose after dinner that evening. Thought I had nightmares, but don’t remember any specifics because I was so tired since being up all night in ER. Woke up feeling foggy, nauseated, and worst of all my hands, especially the right, felt tight and cramped. Could not open them without some force. Then, popping of middle finger joint in right hand and lots of stiffness. It is hard to type right now. The popping comes and goes. I read on the pharmacy notes that this is one of the side effects and to stop taking immediately and call the doctor. I did. Waiting for a call back.

      I already have joint issues, and this is all in my file. I have an MRI scheduled on my neck because of degeneration and other things. Why the ER doc would give me this med is unclear! I hope this is the extent of the issue and I don’t get any more side effects, but I have been reading terrible things about this drug on the internet. As you said, I hope there is no long term damage.

    • Adele
      CA
      Reply

      On May 18th, 2016 I was prescribed Ciprofloxin for what the doctor ‘thought’ might be a kidney infection. I took a pill that evening before bed and a pill the next morning. But after the second pill I could feel a distinct change in my body. I felt dizzy, headache, sore muscles, agitation, inability to speak properly, stiff and sore neck.

      I stopped the pills from that point and now it is June 22, 2016 and I have seen 4 doctors about this and none of them have had anything to say except, ‘let’s do some blood work’, and the results of that show nothing. But I am in constant muscle and tendon pain. It was mostly in my legs but now it has spread to my arms. A shooting pain through my eyes and slight headache and unbelievable fatigue continues. My question is: have your symptoms shown any sign of improving?

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