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. Susie V.
    Washington DC
    Reply

    Cipro has destroyed by body and my life. It’s been nearly 4 years since I took it for sinusitis. On the 4th day I awoke unable to walk. Turns out both my Achilles tendons partially ruptured while I slept. I was bed-ridden for 8 months. Every joint in my body was swollen. It was the most horrific pain imaginable. It never got better, only worse until my feet both started to swell and turn purple every night and felt like an overturned tractor trailer had fell on my legs.

    Screaming into pillows and contemplating suicide was a regular daily occurrence. My pain is finally somewhat under control through the use of 3 types of narcotic meds. I was diagnosed with Cipro-induced tendon rupture & toxic peripheral neuropathy (similar to what they see in chemo-induced neuropathy patients), multiple osteo arthritis, autonomic nervous system damage, chronic multi feet & ankle tendionopathy & tendinosis, & PTSD (from the frightening initial ordeal).

    I use a power wheelchair if I need to go more than 30 feet. My arms occasionally lock up like I have MS (not ms, but this is another side effect of the nervous system damage). I was a healthy 35 year old when this happened to me (other than a sinus infection). Now my life is ruined. Do yourself a favor, unless you’re dying of malaria, don’t take FQ’s.

  2. BEC
    3568
    Reply

    What should I do if I have nerve damage and I’m paralyzed in left leg and don’t know the cause but believe it’s maybe from doxycycline.

  3. Nicole
    Vancouver BC
    Reply

    Fluoroquinolones have ended my life! Two years ago I had a adverse reaction to one Cipro which gave me acute hepatitis in a ER. The doctor acted like I was being a baby and made me that a Avelox on top of it! No one checked my liver enzymes for days. I was left on the Avelox 10 days.
    I had taken Cipro twice before getting c-diff both times but that was my only worry as no other warning was given to me.
    I have had just about every symptom you can from this drug over the last two years. From tendon ruptures, irregular heartbeats, depression, hives and so many others but the worst being the horrible burning of neuropathy that is body wide for me and so painful I cannot stand to even live another day!
    I cannot play with my grandchildren and have to go in a wheelchair if I have to walk more than a block.
    I have spent over 30 thousand dollars with naturopathic medicine to just try anything as there is no antidote for this poison!!!!
    I have made friends on line who suffer so much from taking these antibiotics and have known two young men who took their life over the side affects.
    They lie to you about it being rare as it is not!!! Just so many people thinking they have Lyme and so many other illnesses as doctors cannot believe this and are not educated on these drugs!
    I would never take one even as a last resort if I knew what I know now.
    Will so miss my family and beautiful grandchildren but waiting for death as the pain is just too much!!!

  4. Cliff
    Vancouver, Canada
    Reply

    I was prescribed Clarithromycin 250mg back in October 2017 for a sinus infection and my ongoing symptoms are numbness in the hands and feet and nerve pain that was severe but is now being managed by taking 1600mg of Gabapentin daily. Seeing a neurologist but have had no solution to the cause or a treatment solution. Anybody out there experienced the same side effects from this specific type of antibiotic?

  5. Sherri
    SC
    Reply

    Just finished a course of Levofloxacin, I have pain all over from the base of my skull to my toes. I have taken Quinalones before without having this issue. I have been a very active person. Yesterday, I went with my husband to Sam’s Club and the walk around the store left me exhausted and in great pain. I hope this is not permanent and I will never take a Quinolone again.

  6. ellen
    pacific
    Reply

    I agree with all of the comments above but has anyone found effective treatment for gram negative bugs other than with the quinolones and bacterium? The situation seems like a no win one from where i sit.

  7. Saf
    Reply

    Does Bactrim, a sulfa antibiotic cause some of these same problems? I am allergic to Cipro and Levaquin. Recently given Bactrim for wrongly diagnosed UTI and got very sick for more than 3 months.

    • WM
      southwest Ohio
      Reply

      Last year at this time (fall) I had emergency surgery (intestinal blockage) but ended up being hospitalized on and off for three months. The worst of it was a reaction to Bactrim (after bad effects with Cipro). I had a high fever when I was readmitted , but had left the Bactrim at home and so could not finish the course of the antibiotic. Almost immediately my fever subsided but after a couple days I went into some sort of withdrawal. My skin became hypersensitive, to the point at which I couldn’t touch anything. For me to even attempt to eat the nurses had to wrap utensils in large foam collars and even still I could barely touch them. My skin literally fell off, and lost all its elasticity. I was bright red. My hair turned white, and I became very weak.

      A full year later, I am still so weak I can hardly get up stairs or lift myself out of the bath. My feet and hands are numb and sometimes painful. I must be careful about resting a limb on anything, even another limb, or greater numbness results. Once my entire lower leg became painfully paralyzed as though petrified, like a stone. None of this was happening to me before the episode with the bactrim (and perhaps the cirpo is involved); I was a pretty normal person, running, bicycling, etc.. Now I’m suddenly an old man, virtually over night. I can also confirm the hallucinations some have mentioned; for several days they were so confusing I preferred dying to continuing. I’ve been to a neurologist for tests and he confirms nerve damage. The previous surgery closing has failed and I am scheduled for another to repair a grapefruit-sized incisional hernia and don’t know what to do re. antibiotics. WM

  8. Squirrely
    Canton,MI
    Reply

    I took Cipro in June 2017. Starting in Beginning September, I began feeling Severe tingling, numbness, and pain in both hands. I am in Physical therapy and have been since beginning October. Since then I have had an EMG which turned out to be normal. I was left with the question “why am I experiencing these symptoms if the EMG is normal?”

    I went to my Primary care doctor a few days ago (for symptoms of sinus infection). She asked what antibiotics work for me. I mentioned Cipro. She then preceded to tell me that there are neurological side effects linked to taking cipro. I did some research and it sounds like what I am experiencing. Could I be experiencing side effects from cipro?

    I am nervous to take cipro again. I am to have urologic surgery next week. When seeing my urology doctor he saw that I am positive for Bacteria in my urine and wants to treat me with cipro especially before the surgery. I am not having any symptoms of UTI. Should I take the cipro again or not? What can I take instead of cipro to get rid of bacteria in my urine? So frustrated and confused. My Lord is with me through it all. Thank god.

    • Terry Graedon
      Reply

      Explain to the urologist the symptoms you have had and that you believe they are linked to Cipro. Ask him to select a different antibiotic.

    • Janet
      Broward County Florida
      Reply

      I am highly allergic to Cipro, which I discovered when it was given to me in the hospital. I broke out in a rash and had a central nervous system reaction, which was that my legs felt like lead, especially from the knees down. Within a week I felt better. Six months later fast forward to June 2017: I had an uncomplicated UTI, and the doctor prescribed Levaquin for three weeks by pill. The last day of the dosage, I became very weak and started to black out on the tennis court. I felt so weak each day after that. I was using a walker within a week, and from that point on I have had severe nerve pain although my EMG was negative. Currently I take gabapentin 1800 mg per day for the nerve pain. I was playing tennis 3 to 4 times a week, worked full-time and cared for my family. Now I can’t exercise because the pain is unbearable after walking a half mile, burning and pain in legs feet and toes, hands and side of face. Work is limited as I have to get in and out of the car to show property.
      It seems that we are all feeling similar symptoms, and my doctors at the Cleveland Clinic in Weston have not heard of this although it is on their website as a possible side effect of the drug. Two doctors in Broward County did bring it up with me. I was thankful. Am now eating cleaner,taking my medication, and trying to stay hopeful that at some point this pain will subside.

  9. John I.
    Pleasanton, CA
    Reply

    I was just put on Cipro and took 5 pills ( Tuesday, Wedesday and Thursday) I started to feel pins and needles and a burning on my skin. I stopped the next morning and called my doctor. Of course out of the office til 11/13. HIs department suggested stop taking right away…still feeling kinda light headed and have some pin/needles feeling.

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