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Fluoroquinolone Antibiotics and Life-Threatening Aortic Aneurysm

Fluoroquinolone antibiotics (FQs or quinolones) have been prescribed for common infections, but they have some serious side effects, including aortic aneurysm.

For decades, doctors have prescribed fluoroquinolone antibiotics with abandon. They were perceived as highly effective and safe medications against a wide variety of bacterial infections. Tens of millions of prescriptions have been written for ciprofloxacin (Cipro), levofloxacin (Levaquin) moxifloxacin (Avelox) and norfloxacin (Noroxin), to name just a few FQs or quinolones for short. They are used for sinus, lung and urinary tract infections.

Fluoroquinolone Antibiotics & Side Effects:

It took a long time for the FDA to discover some of the serious complications associated with flouroquinolone antibiotics. They include:

tendon problems, tendinitis, tendon rupture (potentially disabling); arthritis, muscle pain, weakness; headache, dizziness, anxiety, irritability, agitation, restlessness, confusion, insomnia; hallucinations, psychosis, seizures; retinal detachment; depression, suicidal thoughts or actions; irregular heart rhythms, QT prolongation; kidney or liver damage; blood disorders; digestive distress, nausea, diarrhea, constipation, stomach pain, heartburn, vomiting; super-infections, including C. diff diarrhea; allergic reactions, skin rash and anaphylaxis (life-threatening reaction requiring immediate medical attention!).

Add Aortic Aneurysm:

OK, we know your eyes glazed over after the first few side effects. It is impossible to contemplate so many serious drug complications. But we have a relatively new one you need to know about. We suspect most health professionals are unaware of this potentially fatal adverse reaction linked to flouroquinolone antibiotics. Here is a report from a reader:

Q. My dad died five years ago from a ruptured aortic aneurysm. It was just six weeks after being given IV Levaquin for pneumonia–which was misdiagnosed.

At the time, we didn’t connect Levaquin with any problems other than hallucinations. However, four years after his death, researchers reported that fluoroquinolones cause aortic aneurysms and dissections.

There must be others who died from this, and their families will never know that it was from a drug they were given. It saddens me that these drugs are still so commonly used, even after the FDA warned about serious side effects of these antibiotics.

A. A recent Swedish study found that fluoroquinolone (FQ) antibiotics like ciprofloxacin (Cipro) or levofloxacin (Levaquin) are associated with an increased risk of aortic aneurysm (BMJ, March 8, 2018).  In this condition the large artery leaving the heart (aorta) develops a weak area that bulges and may burst. This can be fatal.

Researchers have previously linked FQ use with aortic aneurysm (JAMA Internal Medicine, Nov. 2015).  Despite this, the FDA determined in 2017 that the agency did not see evidence of an association between fluoroquinolones and “bulges or tears in the aorta” (FDA Drug Safety Communication, 7-26-2017).  Perhaps the new study will lead the FDA to reconsider this potentially deadly complication.

The FDA does warn about:

“disabling and potentially permanent side effects of the tendons, muscles, joints, nerves and central nervous system.”

The agency suggests that FQs be reserved for patients who have no other treatment options.

The People’s Pharmacy Perspective:

Antibiotics save lives. There are times when they are absolutely essential. The trouble is that many flouroquinolone antibiotics have been prescribed promiscuously. They should be reserved for last resort situations.

Share your own experience with FQs below in the comment section.

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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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