41 replies to this topic

[Matt]

First of all let me say that these antibiotics have an important role for fighting infections, and that millions have benefited from taking them. However many suffer side effects, of which are more dangerous that most antibiotics out there. Quinolone antibiotics should be one of the last resort antibiotics in my opinion.

My experience. I had a very rare reaction to metronidazole in 2006 for a dental infection. Symptoms passed pretty quickly but they affected my p.nerves. In October 2007 I took 3 pills of ciprofloxacin and two hours after the first dose I developed tingling in the left side of my body. This gradually wore off but I was concerned. Then the same night I could not sleep at all, and was awake for almost 40 hours before sleeping. I then phoned my doctor and they said it was anxiety related. I then resumed taking the pills and after two hours of a 500mg dose I developed tingling again. With research I found that the peak dose of this quinolone was around two hours after administration. So whatever, I took the last dose that night and could not sleep for another 48 hours. From that point I threw them in the bin, unfortunately I was then left with many side effects. I had to take months off work, 800 pounds in debt and almost lost my job.

Insomnia - lasted 2 months ... I slept about 3 times in two weeks at first! - around 80-90% better (never had insomnia in my life prior to cipro)
Poor sleep quality - waking up every 2 hours - 80% better
Insane Nightmares - I kept waking up crying some times... totally unreal!
Tendonitis both ankles and wrists - 3 months and counting - mostly healed.
Muscle pains - mostly gone
Joint Pains - went away after a week (first came about in sites of previous injury)
peripheral Neuropathy (tingling in arms and feet on the left side) - Now mild or not there
Chronic fatigue for 2 months - Gone
Constant nausea for 1 month - On and Off
Increase T and new tinnitus noises - Almost back to normal
Anxiety - Gone
Panic attacks - Gone
Crying spells - Gone (mostly in the first 3 days while the antibiotic was in my system)
Depersonalization - Gone
Unable to tolerate caffeine - Used to be able to drink tea with caffeine, now it has very bad effects. Probably continued inhibition of P450 enzymes.
Dry eyes - Lasted about 5 days but now gone
Heart palpitations - Gone

All these side effects are listed on the package insert.

I'm probably forgetting some of them. Since I'm quite young and took only 3 doses I am recovering very well, and much more quickly than others I have spoken to about this apparently rare side effect. The problem is, many had delayed reactions where the tendon problems came on weeks or months later (showed in studies to happen aswell). So most people might not associate some symptoms with antibiotics they took weeks ago. I'm writing this now because I've mostly recovered and want to share my experience. The whole thing started one day before my 23rd birthday... oh and guess what... the UTI results came back negative! The doctors were also helpless, but agreed I had a bad reaction to the antibiotics and will never have a quinolone again.

However I'd like you to take a look at the stories from other people like me. There is a yahoo group who had almost IDENTICAL experience as me, but most much more worse. I wasn't in constant pain, most of them were... THere is a yahoo group with over 50,000 msg's and thousands of people who had reaction to quinolones. Many were fit athletes, lived healthy lives but had minor infections and treated with a strong antibiotic.

Please also take a few minutes of your time to view the videos of some like me, but experienced same side effects but much worse


JOHNS STORY (SHORT VERSION) -
John was a pharm rep before he took the antibiotic

JOHN (LONGER STORY) - How Levaquin destroyed my life. Part 1

Part 2 - http://www.youtube.c...feature=related
Part 3 -
Part 4 - http://www.youtube.c...feature=related
Part 5 - http://www.youtube.c...feature=related
Part 6 - http://www.youtube.c...feature=related
Final - http://www.youtube.c...feature=related

BOBS STORY - http://www.youtube.com/watch?v=B2w5Sg03xVw (this is really sad and horrible to watch)

JAMES STORY - http://www.youtube.c...ile?user=caretv (not seen this one yet)

Also see

http://www.askapatie...p;name=LEVAQUIN
http://www.askapatie...?...&name=CIPRO

Compared to other antibiotics, the number of persons reporting here is much larger.

I know this sounds insane, and thought these guys were mad until I started to experience some crazy side effects. Only take antibiotics when you REALLY have to. I have gone through over 350 references which show quinolone toxicities, how they affect GABA receptors, how they prevent collagen formation in tendons, how they cause joint damage and other things. Most symptoms tend to cycle.... the same is true for a related drug for malaria called Larium.

I think that because I was very healthy, and eating very well prior and after having these reactions is why I have recovered quickly. Plus the help from CR in lowering inflammation. Though it makes me wonder, did I eat anything, or has CR increased my likelihood of drug reactions? Since CR I seem to get rare reactions much more now.


Bottom line ; Don't take antibiotics like these unless you REALLY have to. I felt extremely good prior to taking them, only now 3 months later am I feeling normal again.

Edited by Matt, 23 January 2008 - 11:29 PM.

[Matt]

Yeah I know it sounded crazy I don't expect sympathy, was hoping for a little support and advice though. Maybe an explanation why I'm so damn sensitive to medications now... but never mind.

*hides away. LOL

Edited by Matt, 27 January 2008 - 04:50 PM.

[FunkOdyssey]

Yeah I know it sounded crazy I don't expect sympathy, was hoping for a little support and advice though. Maybe an explanation why I'm so damn sensitive to medications now... but never mind.

*hides away. LOL

I don't have an explanation, but this is gospel truth:

Bottom line ; Don't take antibiotics like these unless you REALLY have to. I felt extremely good prior to taking them, only now 3 months later am I feeling normal again.

Even if you tolerate the initial side effects perfectly well, or don't experience any, you are still dropping a nuclear bomb on your established friendly gut flora. And as you might expect in a real-life nuclear war, after you wipe out the established government and infrastructure of a region, rebels take over. And now the stage is set for chronic disease of the digestive / allergy / auto-immune / etc variety.

[thughes]

Hey,

Yea I had problems with Cipro too, after a UTI =) One pill and wham, major anxiety reaction that lasted at least 12 hours, on top of severe nausea.

The anxiety didn't really go away either, kept coming back every day for no reason. I ended up with a longer term anxiety condition. Can't tell how much was the Cipro as the reaction itself was quite scary and may have traumatized me. It included horrible icky feeling muscles that I just couldn't stand to leave still. That was fun! Plus, I also had problems with the beta blocker they gave me for the rapid heartbeat (which made me feel like fainting all the time and drove my heartbeat down way below normal for me), and with the Paxil CR they gave me for the anxiety, which made me twitch horribly. I love drugs... Cipro certainly started it all though.

I never associated the rapid heartbeat or my continuing problem with caffeine with the Cipro, except that I figured both were secondary effects to the anxiety. Interesting. I had none of the more physical tendon symptoms, and the weird muscle stuff may also have been a side effect of the anxiety.

I agree that antibiotics that cross the blood-brain barrier should be a last resort. I was moved to it as my previous antibiotic wasn't working well. The brain is a wonderful, plastic thing though, as is obvious by your recovery. Sometimes drugs can be good as well, I credit some with saving my sanity here. Yay for regular (non CR) Paxil, though I still twitch (ok yes, its more likely it just took me that long to adjust to the Paxil and there's nothing wrong with Paxil CR). And benzodiazepines are miracle drugs if you aren't addictive. Also, with their aid, I only lost about 3 weeks of work (2 full off, 2 working 1/2 days from home). Fortunately my office loves me.

From what I've read, tingling with Cipro presages a serious side effect. I *think* (but can't check as I threw it out) its now a warning to call your doctor immediately.

I know one person who is allergic to everything except cipro. Biochemistry is funny.

I've done some research on preventing UTIs since this incident. I now take D-MANNOSE and cranberry 2x daily (I used to take cranberry 1x daily). I usually get 2-3 a year, so we'll see if this helps.

- Mey

Edited by meyusa, 08 February 2008 - 08:02 PM.

[Matt]

I have recently found that a few people I personally know that have had reactions to the quinolone class of antibiotics too! Some of them family members even.

Here are quite a few stories from people who were affected by these antibiotics http://fqvictims.org...ctims/index.htm There are more on the website as well.

[Matt]

Here is a more full list of my symptoms that I got from cipro as of today. A little more detail on these that my previous post. It seems symptoms keep cycling all the time. A common experience of people who have been 'floxed'
http://matts-cr.blog...ever-again.html

Edited by Matt, 10 February 2008 - 08:53 PM.

[Matt]

Does anyone understand how it would be possible for symptoms, some inflammatory related that show up weeks to months later? New symptoms are popping up all the time, and all symptoms seem to cycle. Is this likely to be some sort of autoimmune reaction that cipro could have caused? Like tendon pains will just completely go away, then suddenly appear again every 3 weeks or so, then taper off. Dry mouth and eyes keeps coming and going in cycles. The insomnia does the same. This is an almost universal effect from persons that have been 'floxed'.

Obviously there is not going to be any antibiotic left in the body to cause symptoms, but it seems to cause a cascade of symptoms after.

You can see here:
http://mb.rxlist.com...rames;read=1399 - lots of posts

http://health.groups...lone_Survivors/ - the evolution and recovery of quinolone toxicity of some people


Would it be almost impossible to take legal action against Bayer, the company that makes this drug?

Edited by Matt, 11 February 2008 - 05:17 PM.

[dr_chaos]

It's messing around with your gen expression. Maybe the body needs some time to get to homeostasis again.

Would it be almost impossible to take legal action against Bayer, the company that makes this drug?

Yes. You haven taken it on your own risk. The side effects are well documented. But if you have legal protection try it anyway

[christines]

Hi,
Sorry to hear about your bad reaction. Hope you have recovered completely.

Sometimes antibiotics may cause totally unexpected side effects. This page has links to other discussions of ciprofloxacin: http://www.healthyst...ofloxacin.shtml

[Matt]

Thanks for the link. I have not recovered completely, I'm becoming increasingly worse off lately. New scary symptoms... My life feels completely destroyed from taking this. This isn't really fun at all.

Edited by Matt, 13 February 2008 - 07:35 PM.

[Matt]

I won't be living to this longevity revolution... from now on it seems I'll just be surviving.

Muscle pains
Crying spells
internal tremors
Metalic taste
tingling left hand and foot
Increase in Tinnitus
Noise sensitivity
Ear pain
Pulsatilee Tinnitus
Strong Pulsating feelings in both temples, neck
Pounding heart
Feels like im constantly shaking
Blurry vision
Dry eyes
Dry mouth
Insomnia
Nightmares
Tendonitis
Joint pains in my knees
Stiff neck
Tension headaches
Swallowing difficulty
Intense stomach pains
Diarrhea
Fatigue
Chemicle reactions to bath products
Dizziness
Twitching
Palpitations

I know some who had over 50 reactions after taking 1 pill!

I think im dying =/

Edited by Matt, 14 February 2008 - 03:48 PM.

[Matt]

Check out this FLOX REPORT

Contains over 380 references http://www.matthewla.../floxreport.pdf

[eternaltraveler]

all of those symptoms could be caused by anxiety.

The cipro may have precipitated the anxiety, but anxiety also has a way of self perpetuation.

Something to consider.

[Matt]

I wish it was anxiety. Then I could exercise lol. Right now I can't walk more than a mile without my tendons becoming really inflamed, painful, stinging - tearing sensation.

I mean I wasn't anxious when I took the antibiotic but went into total insomnia, something that IVE NEVER had in my life.

My eyes months after taking it got incredibly dry so that I could not even open them properly!

The thing is, I don't feel anxious at all the majority of days.

For example, all these were symptoms from when I took the very first dose. I WAS NOT EXPECTING them at all. I wasn't anxious at the time, they suddenly came on after 2 hours. I got Tingling left hand and foot, Insomnia, Nightmares, Joint pain, Muscle pains, Tendonitis, Fatigue, crying spells, Noise sensitivity, Increase in Tinnitus, Joint pains in my knees, Intense stomach pains, Diarrhea, Acid Reflux, Reactions to bath products.

I have considered anxiety and thats what I thought they were after a little bit. No doubt some of the symptoms are related to that. But the majority are not, honestly, you should read some of the posts over at the yahoo group. Some got given the quinolone twice, after first recovering and the exact same thing happened. They didn't know it was in the quinolone group until all the same symptoms showed up.
http://health.groups...vivors/messages

The problem is that too many people dismiss it as anxiety and thats why the reactions are never correlated with the drug someone took many days or months ago. But until it happens to you, it sounds just crazy, insane.

Edited by Matt, 14 February 2008 - 09:12 PM.

[eternaltraveler]

I think you misunderstood me.

I do indeed think that cipro can cause anxiety itself, no matter if you were expecting it or not, and that portion could self perpetuate.

Cipro can also cause problems with tendons, just don't overdue the exercise and that will repair. Perhaps your CR is slowing this repair?

It's certainly not a gentle antibiotic, but beats dying from infection. Like all antibiotics it is over prescribed.

[Matt]

I think you misunderstood me.

I do indeed think that cipro can cause anxiety itself, no matter if you were expecting it or not, and that portion could self perpetuate.

Cipro can also cause problems with tendons, just don't overdue the exercise and that will repair. Perhaps your CR is slowing this repair?

The animal evidence on whether CR slows down repair is really mixed.

As for the time to repair... I've spoken to hundreds of people who have had tendon damage from quinolones, people generally recover after about 9 months to 2 years. A lot though have chronic tendonitis, some for up to 10 years, I think they have multiple tendon ruptures though.

[Mixter]

Dude, wow... I'm sorry to hear that especially if it happens to an immortalist, and such a young guy.

I guess the quinolones and floxacines can be very evil, varying from person to person, probably depending
on individual detoxification enzymes. I had a Ciprofloxacine treatment for severe strep infection on top of flu
two years ago. For a month after, I looked and felt like a zombie, really severe fatigue, and bad wrist pains.

Dude, you should really fight to overcome your situation and do everything possible[ to allow your
nerves to recover, additionally to (or before) seeking out neurological help, because everything you're
experiencing, IMO, seems like some kind of generalized nerve damage symptoms. While, sure, it
could also be only a masked form of anxiety, triggered and then self-perpetuated, but I wouldn't rule out
either possibility. Also, your CR might help with managing inflammation, but IMO, more than a light CR
(~20% less than normal calories) in this kind of situation will probably over strain your body, I wouldn't risk it.

I am not a doctor. But, if I suspected general nerve damage for myself, personally, what I would do is,
follow a nutritional long-term protocol designed for depression, as well as multiple sclerosis, because
the root cause of multiple sclerosis, as well, is inflammatory nerve/neural damage. The LEF protocol for M.S.,
for example, recommends the following nutrients to help fix inflammatory myelin, nerve and brain damage:

* Vitamin D— 1000 international units (IU) daily
* EPA/DHA—3000 to 4000 milligrams (mg) daily of fish oil concentrate
* GLA— 1000 to 3000 mg daily of high GLA oil
* DHEA— 15 to 75 mg daily (Have blood tested in 3 to 6 weeks to maintain optimal levels.)
* NAC— 600 mg daily with 1800 mg of vitamin C
* Vitamin E— 400 IU daily
* CoQ10— 100 to 300 mg daily
* Lipoic acid (preferably R-dihydro lipoic acid)—300 mg daily
* Vitamin B12— 5 to 40 mg daily in the form of sublingual methylcobalamin tablets

Regarding tendon pains, years ago I had pretty bad RSI wrist pains (occupational, too much coding),
and have a lot of experience with _completely_ fixing it. As immortalist, I know it feels devastating.
Like something age-related that seems to just get worse with age, but if you follow the steps below
(in addition to what your doctor says), I am very sure you can completely resolve any tendon damage.
For example, since I already knew how to, I could fix my ciprofloxacin related wrist pains within two
weeks, almost completely (and with some more time, 100%, completely).

Four-step tendonidits / repetitive stress injury / wrist pain repair program

1. Do Regular wrists tendon stretching:

For the first month, do this at least 20-30 minutes at a time, three times a day
The following months, do this at least 20 minutes, 1-2 times every day
When it gets markedly better, keep up doing it at least 10-15 minutes once every day

This fixes a lot of the underlying causes and relieves/prevents osteo-arthritis
and shortened tendon tissue and muscles. It's the most important step for repair.
Additionally, consider daily general stretching and calisthenics, which should
anyhow be in every exercise program for life-extension/longevity.

2. Cool down affected areas (esp. wrists), using frozen ice packs,
for at least 20 minutes every few hours, as long as pain is severe

In the short and middle term, this is the most important step for pain management.

3. 20-30min/day Infrared or ultrasound irradation of hurting areas greatly increases
metabolism and aids the body to fix the damage to the extracellular matrix

4. To keep inflammation down and rebuild tendon extracellular matrix, take daily for at least one year:
500 mg Glucosamine
1 g Methyl-Sulfonyl-Methane (MSM)
1g Cat's Claw and/or 1g Curcumin with bioperine plus regular supps (Omega3, multivitamin)


Optional, if it's severe enough:

5. Wear stabilized, medical wrist braces while typing and during sleep, for at least 2 months
Wearing them while you sleep prevents squeezing and ensures proper blood flow to tendon tissue

6. I had a one-time cortisone injection right into one severely inflamed tendon by a specialist
who advocates this (uncommon) practice. This may cause some reversible muscle atrophy,
but usually stops the inflammation dead in its tracks and makes a fast recovery possible.


Don't give up, and I really hope it helps.

Edited by mixter, 14 February 2008 - 10:42 PM.

[dr_chaos]

The animal evidence on whether CR slows down repair is really mixed.

My opinion: You don't loose anything by stopping cr until you are well again. I'd play safe in this situation. One month of normal metabolism wont hurt you much.

[Matt]

Thank you for the suggestions, I'll get back to some of these later on tonight.

At the moment it feels like I have Parkinson's disease. 70% of my day is spent shaking / internal tremors. It's crazy trying to fall asleep, feels like I'm shaking all around and constantly on a moving bus or something.

Edited by Matt, 16 February 2008 - 12:10 AM.

[niner]

Thank you for the suggestions, I'll get back to some of these later on tonight.

At the moment it feels like I have Parkinson's disease. 70% of my day is spent shaking / internal tremors. It's crazy trying to fall asleep, feels like I'm shaking all around and constantly on a moving bus or something.

Matt, I'm so sorry to hear this. I think that mixter's advice above was pretty reasonable. What's happening on the doctor front now? Are you seeing anyone else about this, like a neurologist or psychiatrist? I don't know if you've had much experience with anxiety; it can masquerade as a lot of things. I don't think this is simple anxiety, but I think there might be an anxiety component to it- I know that I'd be anxious as hell if I was having all these effects. An experiment that I would try is to take 5 mg of Valium, just to observe what changes. If everything suddenly got better, that would be an interesting piece of information. I'm not saying that it would, necessarily, but some parts of it might. Just a thought. I do hope you're feeling better soon.

[thughes]

70% of my day is spent shaking / internal tremors. It's crazy trying to fall asleep, feels like I'm shaking all around and constantly on a moving bus or something.

Yea that was me for at least 3 months afterwards. Hang in there! You will get better. The anxiety that cipro seems to cause, or caused in me, is the symptoms without the mental part. You don't *feel* anxious, your body feels anxious. Pounding heart, tremors, all sorts of fun stuff. It may be worth going to a doctor and trying a treatment for anxiety.

- Mey

[edit] P.S. I was told that it would take 3 months to start to see a difference with the anxiety symptoms, and I started getting better right on schedule. Also, no matter what symptoms you are suffering, one of the best things to do is find something to distract yourself from them.

Edited by meyusa, 16 February 2008 - 01:04 AM.

[Mixter]

To try and abort a suspected state of anxiety, you could also
try a high dose of ashwagandha (1-2 grams spread throughout
the day for 2-3 days). It should be very efficient and also take a
lot of cortisol out of your system. Another idea would be
trying some days of beta-blockers if your doc agrees.

And IF you're still shaking after ashwagandha, you could try
low dose deprenyl, which is originally a parkinson's med.
Perhaps 1 mg a day in young people may not be too much,
together with high dose B vitamins to prevent excitotoxicity.
Above that it's not recommended for a longer time. Low-dose
deprenyl might mitigate dopaminergic/substantia nigra damage
and also mitochondrial neural damage. But this is just an idea
what could be done, please use your own judgment.

[Matt]

Interestingly over the last few days my nervous system has been going mad

Increased burning all over, hurts just to wear clothes!
Tingling sensations have increased
Numbness on and off
Feels like pins are being stuck into me

also my toes have curled up and are overlapping!

Also my nails look like a 80 year olds. they all have ridges on them and are not smooth.

f8@*%%!

Edited by Matt, 19 February 2008 - 05:27 PM.

[Matt]

I spoke to my doctor and he believes my symptoms were caused by the cipro. He also said that this might be an unrecognized problem with this type of antibiotic and it might take years for the syndrome to be recognized.

[Matt]

Discussion on Tendonitis

Although quinolone-induced tendon rupture has been described in the literature,[6,7] case reports of complete or partial tendon rupture specifically attributed to levofloxacin are rare thus far.[4,5] Quinolone-induced tendonopathy was noted as early as 1983; Bailey et al[8] reported a norfloxacin-related tendonitis in a patient with kidney failure. The first case of a tendon rupture associated with ciprofloxacin was reported in 1987.[9] A pefloxacin-related tendon rupture reported in 1991 led to the published recognition of this complication in the VIDAL (French PDR) in 1992.[1] In October 1996, the US Food and Drug Administration first issued a Report of Adverse Events and revised the class labeling for fluoroquinolones to include a warning of possible tendonitis/tendon rupture after more than 200 reports of quinolone-related tendonopathy over a 10-year period.[10] A warning based on postmarketing surveillance reports was added to the PDR in December 2001, indicating that this risk may be increased in patients receiving concomitant corticosteroids, especially in the elderly.[2] An epidemiologic study from the United Kingdom in 2002 calculated the excess risk for quinolone-induced tendonopathy at 3.2 per 1000 patient years.[11] A 2001 worldwide surveillance report estimated levofloxacin-associated tendon ruptures at less than 4 per million prescriptions.[5]

The presentation of quinolone-induced tendonitis is characteristically abrupt in onset, with sharp pain occurring spontaneously with walking and/or palpation.[10] Although most tendon ruptures occur after 2 weeks, they can occur as early as a few hours after the initial dose or up to 6 months after drug therapy. A direct relationship exists between severity and the length of treatment; there is a predilection for the Achilles tendon, but shoulder and hand involvement has been reported as well.[2,6,12] The injury may be bilateral, partial, or complete and is usually located 2 to 3 cm above a poorly vascularized area.[1,13] On examination, substantial swelling is frequently noted, and the presentation may mimic phlebitis. The patient usually presents with a positive Thompson sign (absence of plantar flexion on squeezing the calf muscle in the prone position).[1,10] Pain diminishes after tendon rupture occurs. The clinical diagnosis may be confirmed by ultrasound or more precisely by MRI. An MRI of a new rupture shows evidence of edema, hemorrhage and fiber discontinuity.[1,7,10]

Treatment consists of immediate discontinuation of quinolone therapy at the earliest suspicion of tendonopathy.[7,12] For mild tendonitis, weight-bearing restriction ranges from 2 to 6 weeks. Tendon rupture, whether surgically or conservatively treated, requires casting and prolonged rest. The duration of immobilization varies from 6 weeks to 6 months.[1,10] This can be especially debilitating to the elderly, more so if bilateral injury is involved. Thirty percent of patients proceed to tendon rupture despite adequate intervention. Once a quinolone-induced tendonopathy is suspected, a patient should not be rechallenged with quinolones.[10]

The pathologic mechanisms responsible for quinolone-induced tendonopathy seem to be multifactorial. Studies have implicated ischemic, toxic, and matrix-degrading processes. Jorgensen et al[14] described degenerative tendon lesions with interstitial edema and necrosis. Quinolone-induced tendon rupture more often occurs in less vascularized areas, which further supports an ischemic process.[13] Premarketing studies found quinolone-induced macroscopic cartilaginous erosive lesions in weight-bearing joints of juvenile dogs, leading to the early contraindication for quinolone use during childhood, adolescence, pregnancy, and nursing.[2,10] In an in vitro study, exposure of tendon tissue to ciprofloxacin showed a 60% to 68% decrease in fibroblast proliferation, a 36% to 48% decrease in collagen synthesis, a 14% to 60% decrease in proteoglycans synthesis, and a significant increase in matrix-degrading proteolytic activity after only 72 hours in culture.[15] Reports of tendonopathy occurring hours after a single dose further suggest direct cytotoxicity.[10,16]

Risk factors for tendonitis/tendon rupture are emerging from postmarketing surveillance. The most commonly reported risk factors are concomitant steroid therapy and renal insufficiency.[4,10,11,17] Other conditions that may predispose a patient to a quinolone-related tendon rupture include advanced age, prior tendonopathy, magnesium deficiency, hyperparathyroidism, diuretic use, peripheral vascular disease, rheumatoid arthritis, diabetes mellitus, and strenuous sports activities.[1,11,18] The patient in this case report noted symptoms of tendonitis within days after oral levofloxacin was initiated. MRI confirmed the diagnosis of tendon rupture 3 weeks later. His risk factors included advanced age, steroid therapy, a brief course of diuretics, and prolonged exposure to levofloxacin.

http://www.medscape....rticle/464865_2


Peripheral Neuropathy Associated With Cipro
NEW YORK (MedscapeWire) Nov 2 — Adverse effects associated with the use of ciprofloxacin (Cipro) and other fluoroquinolone antibiotics are not always benign. Not infrequently, they can be severe and permanently disabling, and they may occur following just one or a few doses, according to a study posted on the Annals of Pharmacotherapy Web site. Scheduled for publication in December 2001, this article was released early online because of the threat of anthrax and subsequent heightened interest in Cipro.

Jay S. Cohen, MD, an associate professor of family and preventive medicine at the University of California, San Diego, analyzed 45 cases in which fluoroquinolone antibiotics (including 11 cases involving ciprofloxacin) were associated with adverse effects involving the peripheral nervous system such as tingling, numbness, burning pain, twitching, or spasms. Of those 45 cases, 42 (93%) of these patients also sustained adverse effects involving other systems. Seventy-eight percent experienced central nervous system (CNS) symptoms such as dizziness, agitation, impaired cognitive function, or hallucinations, and 73% reported musculoskeletal symptoms such as joint or muscle pain or tendon rupture. Adverse events also involved the cardiovascular and gastrointestinal systems, skin, and special senses in 18%-42% of cases.

Assessments of severity revealed 2 cases that were mild (4%), 7 moderate (16%), and 36 severe (80%) with chronic pain and/or significantly limited normal function. Symptoms were typically long-term, with 91% exceeding 1 month in duration, 71% exceeding 3 months, and 58% exceeding 1 year. Twelve cases (27%) lasted longer than 2 years. These severe, long-term reactions occurred in a generally young and healthy population. The average patient age was 42 years (range, 11-68 years). Sixty-two percent had no other medical disorder except the infection (mainly sinusitis, prostatitis, urinary infections) that prompted fluoroquinolone therapy.

Because of the current anthrax threat and the hoarding of ciprofloxacin by thousands of people, it is imperative that physicians and the public understand the benefits and potential risks of using ciprofloxacin or other fluoroquinolone antibiotics indiscriminately. The media have, generally, presented only a few fluoroquinolone adverse effects, which are usually described as mild and brief. There are anecdotal reports of people already taking ciprofloxacin prophylactically.

The cases presented in this article, as well as previously published articles about the adverse effects of fluoroquinolones, should give physicians pause before using fluoroquinolones unnecessarily, especially because other, safer antibiotics (eg, penicillin, doxycycline) can often be used instead. Moreover, not all serious reactions associated with fluoroquinolones are listed in package inserts or the Physicians' Desk Reference.

Patients must be informed that with the development of any musculoskeletal, or peripheral or central nervous system symptoms, fluoroquinolone treatment should be discontinued immediately unless medical circumstances (eg, severe infection and no alternative treatment) warrant otherwise. Patients sustaining these reactions should not receive fluoroquinolone antibiotics in the future.

Edited by Matt, 20 February 2008 - 04:42 PM.

[Matt]

Full list of side effects by quinolones at the moment.

"Post-marketing surveillance reports indicate that this risk may be increased in patients receiving concomitant corticosteroids, especially in the elderly...Ruptures of the shoulder, hand, and Achilles tendons that required surgical repair or resulted in prolonged disability have been reported in patients receiving quinolones. Tendon rupture can occur during or after therapy with quinolones. "

There are other serious adverse reactions associated with this class including Irreversible Peripheral Neuropathy, (permanent nerve damage), increased QT prolongation, Torsades de Pointes, central nervous system (CNS) events including severe nervousness, agitation, chronic insomnia, anxiety attacks, nightmares, and paranoia. Toxic Psychosis has also been reported.

Life threatening disturbances of blood glucose, including symptomatic hyper- and hypoglycemia, are also associated with the use of the fluoroquinolones.

Fluoroquinolones caused fetal harm in animal studies, including decreased body weights and malformed bones as well as an increased risk of death. Because of the potential for serious adverse effects to the fetus, these drugs should not be used by pregnant women.

Fluoroquinolones are excreted in human milk. Because of the potential for serious adverse effects in nursing infants, you should not take these drugs while nursing.

Other adverse events found within the package inserts for Ciprofloxacin include the following:

Cardiovascular: Palpitation, atrial flutter, ventricular ectopy, syncope, hypertension, angina pectoris, myocardial infarction, cardiopulmonary arrest, cerebral thromobosis. Cardiovascular collapse, cardiopulmonary arrest, myocardial infarction, arrhythmia, tachycardia, palpitation, cerebral thrombosis, syncope, cardiac murmur, hypertension, hypotension, angina pectoris. Postural hypotension, vasculitis.

Central Nervous System: Dizziness, lightheadedness, insomnia, nightmares, hallucinations, manic reaction, irritability, tremor, ataxia, convulsive seizures, lethargy, drowsiness, weakness, malaise, anorexia, phobia, depersonalization, depression, paresthesia. Convulsive seizures, paranoia, toxic psychosis, depression, dysphasia, phobia, depersonalization, manic reaction, unresponsiveness, ataxia, confusion, hallucinations, dizziness, lightheadedness, paresthesia, anxiety, tremor, insomnia, nightmares, weakness, drowsiness, irritability, malaise, lethargy Agitation, confusion, delirium, dysphasia, myoclonus, nystagmus, toxic psychosis.

Gastrointestinal: Painful oral mucosa, oral candidiasis, dysphagia, intestinal perforation, gastrointestinal bleeding. Cholestatic jaundice has been reported. Ileus, jaundice, gastrointestinal bleeding, C. difficle associated diarrhea, pseudomembranous colitis, pancreatitis, hepatic necrosis, intestinal perforation, dyspepsia, epigastric or abdominal pain, vomiting, constipation, oral ulceration, oral candidiasis, mouth dryness, anorexia, dysphagia, flatulence Constipation, dyspepsia, flatulence, hepatic necrosis, jaundice, pancreatitis, pseudomembranous colitis. (The onset of pseudomembranous colitis symptoms may occur during or after antimicrobial treatment.)

Hemic/Lymphatic: Agranulocytosis, hemolytic anemia, methemaglobinemia, prolongation of prothrombin time

Metabolic/Nutritional: Elevation of serum triglycerides, cholesterol, blood glucose, serum potassium.

Musculoskeletal: Arthralgia or back pain, joint stiffness, achiness, neck or chest pain, flare up of gout. Arthralgia, jaw, arm or back pain, joint stiffness, neck and chest pain, achiness, flare up of gout Myalgia, possible exacerbation of myasthenia gravis, tendinitis/tendon rupture.

Renal/Urogenital: Interstitial nephritis, nephritis, renal failure, polyuria, urinary retention, urethral bleeding, vaginitis, acidosis. Renal failure, intarstitial nephritis, hemorrhagic cystitis, renal calcuti, frequent urination, acidosis, urethral bleeding, polyuria, urinary retention, gynecomastia, candiduria, vaginitis. Crystalluria, cylindruria, hematuria, and albuminutia have also been reported. Albuminuria, candiduria, renal calculi, vaginal candidiasis.

Respiratory: Dyspnea, epistaxis, laryngeal or pulmonary edema, hiccough, hemophysis, bronchospasm, pulmonary embolism. Respiratory arrest, pulmonary embolism, dyspnea, pulmonary edema, respiratory distress, pleural effusion, hemoptysis, epistaxis, hiccough

Skin/Hypersensitivity: Pruritus, urticaria, photosensitivity, flushing, fever, chills, angioedema, edema of the face, neck, lips, conjunctivae or hands, cutaneous candidiasis, hyperpigmentation, erytherna nodosum. Allergic reactions ranging from urticaria to anaphylactic reactions have been reported. Anaphylactic reactions, erythema multiforme/Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, vasculitis, angioedema, edema of the lips, face, neck, conjunctivae, hands or lower extremities, purpura, fever, chills, flushing, pruritus, urtigaria, cutaneous candidiasis, vesicles, increased perspiration, hyperpigmentation, erythema nodosum, photosensitivity. Allergic reactions ranging from urticaria to anaphylactic reactions have been reported. Anaphylactic reactions, erythema multiforme/Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis.

Special Senses: Blurred vision, disturbed vision (change in color perception, overbrightness of lights), decreased visual acuity, diplopia, eye pain, tinnitus, hearing loss, bad taste. Decreased visual acuity, blurred vision, disturbed vision (flashing lights, change in color perception, overbrightness of lights, diplopia), eye pain, anosmia, hearing loss, tinnitus, nystagmus, a bad taste Also reported were agranulocytosis, prolongation of prothrombin time, and possible exacerbation of myasthenia gravis. Anosmia, taste loss.

[Matt]

Over 1900 stories of long term disabilities from levaquin http://www.medications.com/se/levaquin

The problem with these drugs is that the effects are long term, which is NOT stated on the package insert for the drug. I was stunned when I read some of these stories...

[thughes]

Hey wow, 'floxed' people get intermittant numbness due to ulnar neuritis. Thats cool to know, I had wondered why I was always having problems with this part of my hands falling asleep since the Cipro. At least its neither severe nor painful, just annoying.

- Mey

[Matt]

I must say that I'm feeling really good at the moment, maybe an indication that things are improving. My sleeping is still not 'perfect' but its getting there. I Just have some minor tingling on and off, very minor tendonitis, and minor sleep issues.

I feel 90% back to normal now. Though this thing can come back and cycle so just enjoying feeling good at the moment!

Edited by Matt, 23 February 2008 - 11:58 PM.

[Matt]

Still doing OK, I guess. Though I have some more intense symptoms

My throat is just completely dry, my eyes are dry, my tongue is burning, my mouth is dry. My finger nails look old, my finger tips are all wrinkled like a 80 year olds (you know when you get out of the bath and your fingers go wrinkly for a few minutes?). My skin is all dry.....

Dry dry dry dry dry