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Do Fluoroquinolone Antibiotics Damage Heart Valves?

The trail of tears from antibiotics like ciprofloxacin (Cipro) and levofloxacin (Levaquin) continues. The latest chapter in this saga: damaged heart valves!
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We have been tracking a tale of woe and intrigue with fluoroquinolone (FQ) antibiotics for more than 25 years. One reader reported hallucinations and a terrible skin rash after taking ofloxacin (Floxin) for a sinus infection. Another complained that levofloxacin (Levaquin) left her with ringing in her ears, difficulty walking, terrible insomnia and shortness of breath. Many people have reported that FQ antibiotics changed their lives permanently. Now, add damaged heart valves to the long list of complications from fluoroquinolones.

A Horrible History of Deny and Delay:

Fluoroquinolone antibiotics like Cipro or Levaquin have been prescribed for sinus, lung and urinary tract infections. For decades, such drugs were perceived as safe and effective treatment options. When patients complained about nerve pain, dizziness, difficulty sleeping, depression, muscle pain or arthritis, many health professionals doubted such symptoms could be caused by antibiotics.

Gradually, the FDA recognized that there were some serious adverse reactions associated with FQs.

Although this class of antibiotics has been on the market for more than three decades, it took until May, 2016, for the agency to issue this warning:

“An FDA safety review has shown that fluoroquinolones when used systemically (i.e. tablets, capsules, and injectable) are associated with disabling and potentially permanent serious side effects that can occur together. These side effects can involve the tendons, muscles, joints, nerves, and central nervous system.”

One reader took Cipro for a urinary tract infection. Just one pill left her with progressive muscle pain and weakness. Another received Levaquin for a mild chest cold. It left her with horrific nerve pain. She couldn’t walk and ended up in a wheel chair.

She says that she trusted her doctor to help her heal and instead he ruined her life:

“I cry daily, I am full of dread for the loss of my real self and all I worked for. All my dreams are gone.”

Fluoroquinolones and the Heart:

We started asking in May of 2014 about a really serious complication of fluoroquinolone antibiotics called aortic aneurysm. By November, 2015, we were warning that this life-threatening reaction was being reported by our readers. If the main artery that carries blood from the heart develops a weak spot or ruptures, a patient can bleed to death. Here’s just one story:

Did Levaquin Antibiotic (Levofloxacin) Cause Lethal Aortic Rupture?

We urged the FDA to take action.

Finally, on December 20, 2018, the FDA announced that FQ antibiotics were indeed linked to:

“ruptures or tears in the main artery of the body, called the aorta. These tears, called aortic dissections, or ruptures of an aortic aneurysm can lead to dangerous bleeding or even death.”

Read more about this scary FQ side effect at this link:

FDA Warns About Fluoroquinolone Antibiotics and Aortic Aneurysm!

The Latest Chapter–Damage to Heart Valves:

A study published in the Journal of the American College of Cardiology (Sept. 2019) reports that people taking fluoroquinolone antibiotics are almost two and a half times more likely to have leaky heart valves while they are on this medicine compared to people taking amoxicillin. Visitors to this website alerted us to this potential adverse drug reaction before the JACC article.

Dorothy took Cipro for diverticulitis:

“On the tenth and final day of treatment I had a sinus tachycardia event (heart rhythm irregularity) for the first time. It’s over a month since the last dose and I had another event yesterday. I had a heart ultrasound and discovered I have a slight leakage from my aortic valve. I’ve always had a strong heart and been very active. This has changed my life, and I hope it is temporary. I can’t help but think the Cipro is the cause.”

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Linda had a similar story:

“I went to the doctor because I was short of breath and tired. My X-rays were clear, but she decided to treat for pneumonia and prescribed levofloxacin.

“That night my heart rate went up to 160 along with my blood pressure. By the next day I was in the hospital in critical condition. During my stay at the hospital I was told that the aortic valve in my heart was failing. I have always had a very healthy heart, and in previous caths was told that my heart was in very good condition and my arteries were clear. I feel that the levofloxacin damaged the valve. Is this possible or probable?”

The study published in the Journal of the American College of Cardiology concludes:

“The results of this study found an association between oral fluoroquinolones and an increased risk of mitral and aortic regurgitation.”

How Do FQs Lead to Damaged Heart Valves?

The JACC study points out that FQ antibiotics are toxic to connective tissue. By weakening collagen in tendons, the aorta and heart valves, all sorts of complications can occur.

That is why some people experience tendonitis or tendon ruptures, aortic dissections and damage to heart valves. This can happen quickly.

The authors note:

“The acute onset of collagen damage with FQs has also been shown to lead to rupture of large tendons within hours and aortic dissection within days.

The People’s Pharmacy Perspective:

As far as we can tell, the FDA has not issued any warnings about FQ-related damage to heart valves. Judging from past experience, we suspect that it will take the agency a long time to alert physicians and patients to this “new” danger. Remember, it took decades for the FDA to alert people to tendon and nerve problems brought on by drugs like ciprofloxacin and levofloxacin.

Some people have called for banning FQ antibiotics. We’re not there yet, though we believe these drugs should be used very, very cautiously.

The Last Resort:

The FDA advises health professionals to reserve fluoroquinolones for situations when no alternative treatment options exist. If you or someone you love is prescribed an FQ antibiotic, make sure to ask whether it is absolutely essential and whether there are any other antibiotics that might work for your condition.

Share your own FQ antibiotic story in the comment section below. Have you or someone you know ever experience damage to heart valves after taking a fluoroquinolone? 

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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When I was 64 I took 2 doses of Cipro prescribed for a UTI, and I believe that it nearly killed me. I couldn’t sleep at night due to the extreme pain from random muscle cramps in my legs, became paranoid and anxious to the point that I couldn’t work or drive. I lost 15 pounds and was down to 100 lbs. I lost thousands of dollars because I couldn’t work or drive for months, had to hire a driver, and finally went to an alternative physician who helped, but was expensive. I still have muscle cramps 11 years later. These fluoroquinolones should be taken off the market!

I will never take those medications again. I have had a broken foot, and I could actually feel the rupture before I fell down when my foot broke. And I now have a moderately leaky mitral valve and aortic valve. I will not put my trust in doctors handing out prescriptions without researching them. I guess any med can cause problems but this one is ridiculous and has messed up too many lives.

I never had a heart murmur from heart valve damage until after being treated with Levaquin a couple of years ago. And doctors are still going to cipro, prescribing them like candy, and I always have to ask for an alternative — I have asked for an alternative at least two or three times this year. I also never used to have UTIs — maybe next we’ll learn that they may short-term end an infection, but make you more prone to them long-term. I’m so tired of having to do so much of my own medical research!

Can you please provide the specific reference for medical providers for the statement:”The FDA advises health professionals to reserve fluoroquinolones for situations when no alternative treatment options exist.”
Thank you!

Garry, here is the black box warning:

“Because fluoroquinolones, including CIPRO, have been associated with serious adverse reactions [see Warnings and Precautions ( 5.1-5.16 )], reserve CIPRO for use in patients who have no alternative treatment options for the following indications:
• Acute exacerbation of chronic bronchitis [see Indications and Usage (1.10)].
• Acute uncomplicated cystitis [see Indications and Usage (1.11)].
• Acute sinusitis [see Indications and Usage (1.12)].’

Then there is this from the FDA:

“In 2016, the FDA enhanced warnings about the association of fluoroquinolones with disabling and potentially permanent side effects involving tendons, muscles, joints, nerves and the central nervous system. Because the risk of these serious side effects generally outweighs the benefits for patients with acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis and uncomplicated urinary tract infections, the FDA determined that fluoroquinolones should be reserved for use in patients with these conditions who have no alternative treatment options.”

I have been disabled for more than 7 years from cirpro. Not leaky heart valve yet. I know a woman who has suffered more than 20 years and could not even hold her head up. I had a stroke in my sleep after 1 pill. I had electric shocks, fatigue, numbness and cartilage breaks. The vet gave it to my pet cat with pneumnia and Fluffy died and like my friend lost ability to hold his head up. No one should take this.

I’ve not had my heart checked. But I do suffer from dizziness, shortness of breath and nerve pain. My doctor put me on lyrica and said I have fibromyalgia.

Does People’s Pharmony have a recommendation for a safer antibiotic than the fluoroquinolones?

I developed a leaky heart valve and weakened leg muscles after taking Levaquin. Even though I exercise daily the leg strength has not returned and stairs are a problem. Now I wonder when will my aorta shred?

Thanks for this valuable information but, you didn’t talk about alternatives that are safe and effective.

Horrible side effects after high doses given “prophylactically” that have lasted years, extreme fatigue, disorientation, tinnitus, joints popping, tendons tearing, explosive diarrhea, black spots in vision as well as eyesight deterioration, palpitations, insomnia and a strange anxiety that occurs over things that would normally be inconsequential, heightened effects after other medications and even without any discernable cause…. And yes, my heart has been affected.

I had a very painful tendon problem in both shoulders that lasted for six months. It was so painful I needed help to dress or perform an task.
Luckily, I slowly recovered. My doctor tried to tell me I must have injured myself but I knew it had to be the Levaquin that his RNP had prescribed for a recurring sinus and respiratory infection.
Two years later my husband was prescribed the same drug for an illness and after two doses sat down at the dinner table and appeared to not know where he was and behaved as though he may have been having a stroke. My son was there, so he and I got my husband into the car and took my him to the ER. He was admitted to the hospital that night and put through a bunch of tests. He had not had a stroke, thank goodness, but I’m sure it was a reaction to Levaquin. The paperwork given at the pharmacy mentioned that it shouldn’t be prescribed for persons over 60, which we bot are and I’ve heard of younger people having similar tendon issues after taking Cipro.
I’m wondering what toxic substances are in these medications since I’m sure they must be from China or India. Our FDA is supposed to protect us not allow other countries to harm us.

i took Cipro 250 mgs, 2x/day for 3 days for a UTI. During this time I experienced a pronounced metallic taste in my mouth and malaise, I just didn’t feel “right.”

I have permanent nerve and tendon damage from several doses of ciprofloxacin and Levaquin given to me for travel diarrhea, and for ear, sinus and urinary tract infections over the years. The damage was accumulative and I didn’t connect the dots until it was too late.

At first doctors didn’t believe that antibiotics could cause this. Now they know. Recently I was diagnosed with Mitral Valve Prolapse and I wouldn’t be surprised if it were also caused by fluoroquinolones. My weight, diet, exercise and life style are and always have been very healthy. Mine is definitely a case of living with rather than healing from fluoroquinolone damage.

Thank you for the excellent coverage of the dangers of these drugs. Facebook is filled with multiple support groups now with thousands of suffering daily from horrific adverse effects.

In a comment quoted in the article, the person states they had always had a healthy heart and references previous caths. Why was a person with a healthy heart having multiple heart catheterizations. Since there is risk of damage involved why subject yourself if you’ve always had a healthy heart? That may be what caused the damage.

I was given many rounds of Levaquin for repeated sinus infections many years ago and have regurgitated mitral and tricuspid valves. We thought I was allergic to penicillin and I finally got tested and found out I’m not allergic to it. As recent as a couple of years ago, my internist was still trying to give me Levaquin and I refused. She acted like it was my only option at the time.

As an RN, after reading your articles on FQ, seeing the over prescribing by doctors, and seeing reactions in my clients, I started listing them in my allergies. I was recently bit by a dog at work, so had to obtain care from a different doctor. When I told him I was allergic to Cipro, he got this deer in the headlights look like I’d taken away his only hammer. So many docs still haven’t gotten the message about all the previous issues, not to mention the newest problem.

Thank you once again for continuing to report the perils of this poisonous group of antibiotics. I have been contributing my own experiences with you for many years and you have published my comments several times. In fact I am the daughter of the man who was 93 and hallucinated badly for 6 weeks before dying when his aortic aneurysm ruptured after taking Levaquin.

I myself have been ill since the 90s and I am now 68. Most doctors still refuse to even be educated on these drugs from patients who have connected the dots. I have been to many heart specialists after my husband had a heart attack last year and mentioned to them about the “newest” findings and they just shrug their shoulders.

The FDA is very slow to put out warning labels. Eventually retinal detachments will be added because fluoroquinolones absolutely play a role in this issue and I am also hoping in my lifetime that the FDA will recognize that the ear and eye drops are also as harmful as the pill and IV form because as of now they do not have enough Medwatch reports from patients to put out yet another warning.

When people tell me that every drug has side effects, this is very true, but this group of antibiotics are especially more dangerous than any other and has had more warnings added since 2008 than any other drug. The FDA knew about many of them way before 2008 as the tendon issues started to become an issue in 1996 when Dr. Sidney Wolfe reported them, but as I said, the FDA is way too slow and that blackbox warning took 12 years to appear.

Please keep on reporting because you are our only lifeline to these dangers!

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