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Cipro joins the 'black box' club

July 8, 2008 |  4:11 pm

Cipro The club may not be as elite as it once was -- or perhaps, in an ideal world, should be -- but the Food and Drug Administration has decided Cipro and its ilk deserve to be members.

As such, the class of antibiotics known as fluoroquinolones will now bear a boxed warning, also known as a "black box," because of reports that the drugs increase the risk of tendinitis and tendon rupture. The FDA has told the manufacturers that the label, the agency's most serious warning, is necessary to ensure that the drugs' benefits outweigh the risks. Always a good thing. It's also told them, while they're at it, to throw in a medication guide to inform patients of potential side effects.

Most people may remember the drugs from their heady days as simply-must-have protection against a potential anthrax attack. But we've all grown older and wiser and less panicked and are now more worried about simply being able to move about the house without hurting something. Says the FDA's release: "The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is further increased in people older than 60, in those taking corticosteroid drugs, and in kidney, heart and lung transplant recipients."

The prescribing information already includes warnings about the potential problem, but sifting through that material isn't easy even for professionals. They're busy, you understand. And besides, there's just something about that black box label that tends to give prescribers -- and prescribees -- pause.

If you've had problems with the drugs (or any drugs), you can offer your two cents at MedWatch, a more user-friendly way of referring to the FDA Safety Information and Adverse Event Reporting Program.  Otherwise, how will anyone know?

For an easy-to-read list of other drugs with black box warnings, go to FormWeb. The information is easier to find than on the government site.

-- Tami Dennis

Photo: When anthrax was discovered at a New York mail processing facility in 2001, workers there were given Cipro as a precautionary measure. Other Americans soon wanted it too.

Credit: Gary Friedman / Los Angeles Times

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Comments (97)

In December of 2007, I became ill with pneumonia. My doctor prescribed Levaquin 500 mg once a day for ten days. The only reaction he said I might notice is nightmares. Well, that was an understatement! After I took the first pill, I reacted very negatively. I went to bed that night with severe heart palpitations and I had the most terrifying panic attacks of my life. I really believed that I might die that night. I could not fall asleep. I kept “hearing” someone screaming in my ear every time I was almost ready to go to sleep, and I was having double vision. I was tossing and turning and freaking out. I finally went downstairs and laid on the couch so my husband could get some sleep. I got terrible sleep for only about 2 hours that night. I also had a terrible “headache” which was more like a sharp pain in the back of my head that lasted the entire time I was on the Levaquin. In the morning, I called my doctor to tell him that I had a reaction. His response to me (through the nurse) was that I had anxiety. He said I should keep taking the Levaquin and also take the ativan he was going to prescribe for me. At the time, I figured he knew best and that this reaction would be temporary. I had to somehow get through this course of Levaquin.

Within two weeks of stopping the Levaquin, I began having a burning pain in my left arm on the inside of my elbow. I wondered if I had a blood clot. That lasted a few days before it started to spread throughout my whole arm. I was experiencing agonizing, throbbing pain. Within another couple of days, my other arm was affected. I couldn't bend or straighten my arms. In addition, I was still experiencing heart palpitations and insomnia. Soon the pain spread to my legs. My knees hurt so bad, I couldn’t bend them to go up or down the stairs. All I could do was to sit and cry. Within the next few days and weeks I had the following adrs: blurry vision, dry eyes, dry mouth, ear pain, neck pain, shoulder tendonitis, popping, cracking joints, dizziness, nausea, diarrhea (I lost 6 pounds in two weeks), headaches, muscle twitching, muscle cramping, muscle jerking (myoclonic jerks), joint pain, EXTREME muscle weakness and soreness. My legs could barely hold me up and I was walking very slowly and stiffly. I couldn’t stand for more than a few minutes. I had pulsating, tingly neuropathy in my legs and feet that was very uncomfortable. My ankles were aching, my fingers were stiff, I had burning pain in my knees, I was even having spasms in my eyes. I had terrible pain and achiness in my lower back, I became very sensitive to noises (if things were quiet and I heard a noise, the right side of my face would spasm).

I am now almost seven months out from the initial reaction, and things have not gotten much better. I am still experiencing many of my original ADRS, just not as intensely as I was experiencing them. My worst problems are still pain in my left leg, stiffness in my feet, lower back pain, nervousness and internal tremors, blurry vision in my right eye, gastro-intestinal problems, intermittent tinnitus, and tachycardia.

I believe that reactions to FQs are grossly underreported because many people do not make the connection between their symptoms and the drugs. I am actually one of the lucky ones to have made the connection to prevent a repeat in the future. Also, I tell everyone I know about what happened to me and I believe I am saving people from suffering the same fate.

This class of antibiotics I feel is more harmful than good. Unfortunately I was on of those who had a terrible reaction last summer--my first and last time on the stuff.

Not enough education is done by the doctor and pharmacist to inform patients about the potential harm. I was nearly a week into a dose of flouroquinolones before it came to light I was poisoning myself: tendon pain, joint pain spreading from fingers to wrist to upper arms, fast heartbeat, conjuntivitis, tingling fingers, psychotic and irritable.

Bad stuff in my case. Worse though is that it took a while for a doctor to take me off the stuff. I want to know when I have a reaction, it's being reported back to the FDA and manufacturer.

My body has never been the same since. -h

Yesterday, July 16, 2008, I took my 10th and final Levaquin. 4 days ago, I noticed sleeping was uncomfortable as I sleep on my side and my shoulders became "worn out" quickly and had to sleep on my back. Then next day and since have knuckle pain in the 4 fingers, not the thumbs.
Worst though is foot pain, as if I can feel every bone in my feet. It makes me walk gingerly for a few minutes, but they "warm up" fairly quickly.

This is not now a debilitating pain, but Levaquin side effects occured to me just a couple of days ago. I just looked it up 30 min ago and am alarmed at the volume of materials and complaints describing joint pain and the longevity of the pain.

Does this resolve in any number of patients, and where is that data coming from?


Search "Fluoroquinolone Toxicity"

The full horrendous safety profile of this class can be found on the fqresearch site

Those in need of help and support are encouraged to log into any of the numerous adverse drug reaction forums dealing with the fluoroquinolones. The top two being the quinolone forum hosted by Yahoo since 1999 and the fqresearch forum also hosted by yahoo. Just do a google search for their internet addresses.

James you have to stop taking the drug now, go and get something that isn't a quinolone. The symptoms you describe are classic symptoms of the start of something bad... I hope you made the right decision.

Unfortunately it can take anywhere from 3 months to 5 + years to get better from being 'floxed'.

I was a healthy 42 year old male who took Levaquin for a sinus infection. The same day as the Black Box Warning was issued; I was having my third tendon reattachment surgery. I have to wait at least 6 weeks before I can undergo yet a fourth tendon rupture reattachment. At least it takes my mind of the Achilles Tendinopathy, joint pains, headaches, uncontrolled muscle twitching etc. I consider myself one of the lucky ones since so far it has not affected my kidneys, liver, heart, eyes and other side effects that many are dealing with from this class of drugs. I would urge a real journalist to take the time and look at the real number of cases. The Fda numbers are misleading. The clinical data coming from other counties are showing much higher rates of tendon ruptures and other life threatening side effects.

Fluoroquinolone antibiotics have damaged many people. I know of this severe damage on a personal level since I suffered such and adverse reaction to the fluoroquinolone antibiotic Levaquin myself 22 months ago. Since then I have had daily pain and disability of my nervous and musculoskeletal systems and for several months had endocrine and gastrointestinal problems as well. The disability and damage caused by fluoroquinolones is long term and may gradually escalate in that more severe problems such as worsened neuropathy, neuromuscular disorders, musculoskeletal disorders and endocrine disorders once initiated by the fluoroquinolones may develop with a delayed and insidious progress.

This progression of the fluoroquinolone toxicity syndrome is well know by its sufferers and not recognized by health care givers. There has been no investigation in to the reactions. This lack of attention stems from of an antiquated FDA reporting system and the under-representation of the seriousness and frequency of the adverse reactions. The makers of fluoroquinolones have no interest in investigating adverse reactions when doing so will hurt them financially. It is only recently with the weight of litigation pressing down that the FDA has published its incomplete and grossly inadequate boxed warning about the potential for fluoroquinolone toxicity.

I have met many other patients suffering from the adverse effects of fluoroquinolones. Many of them reside in my community including 3 physicians and more than twenty patients.

Although these drugs may be life saving in certain infections when less toxic antibiotics may fail, they have been promoted for use as first line treatment for sinusitis, and urinary tract infections, and are often given indiscriminately to unsuspecting patients by uninformed and cavalier physicians for such benign illnesses as the common upper respiratory infection. Unfortunately for many patients they are trading a mild short term medical problem for a serious long term one.


Todd Plumb MD

I was a healthy 42 yr old mother of three with a doctorate that I worked very hard to get. After taking 4.5 days of cipro for a simple UTI, I couldnt work for almost 3 months and I lost my practice. I suffered tendinosis, very painful, head pressure, vasculitis, peripheral neuropathy, tachycardia, and countless other adverse affects.
It is 7 mos later and I am still suffering. There is no cure or treatment, just try to figure out a way to deal with the loss of function and ability to care for my children and to continue my career.
All this is robbed from me. I now have multiple tumors over my body which I did not have before. I dont know what my future is now. I could have had a wonderful life. Now I look through tear filled eyes all the time. Will anyone help us?

I don't feel so alone anymore. I was
begining to think I was loosing my mind.Because no one had an explanation for
my pain. I had a kidney transplant 16 year's ago and I had been off and on
Cipro for the first 10 year's due to infection and phenominia and other
thing's due to transplant. I have had many episodes of gout through them
year's . And 6 year's ago my husband took me to the hospital because I
could not breathe I was diagnoised with phenominia and was transported to
St.Louis U in St.Louis Mo on May 13th 2002 and I bairley remember getting into
the emergency room and nothing until one day I woke up and seen people walking
by my door of the room I was in .I got out July 4th .
And did not understand why the Dr has not came in and seen me yet or they had
and I just did not remember it because it was daylight and It was night when I
got there. Well I seen my hand's where straped to the bed and I could not
move them. I yelled for a nurse and yelled and no one came. There was a pan at
the end of my bed so I kicked it and then they came running in my room.
I ask them to undo my hand's and they said they couldn't and I ask
why not .They said they did not want me to get out of my bed I said I won't
if they undo me.They wouldn't.Come to find out I had been in a coma for 5
1/2 week's and did not know anything about it.
They undone my hand's and I felt my hair and it was long and my ponytail
was matted feeling. And I had a red ponytail holder whenI went in and I had a
yellow one in then.So I could not figure out why.I had to have my hair cut off
because it was so mangled. and I had to take therpy to learn how to walk again.
I tryed to eat and I couldn't hold a fork I shook so hard I couldn't
even eat. I had lost 25 pound's and I had scars on my chest and I ask why
they said I had tubes all in and out of me. I even was entabated three
times'.I had just gotten married for the second time and I didn't even
know who my husband was....I can not to this day remember a lot of things in my
life and have a hard time remembering things from one minute to the next.
I was in the hospital in 1997/98 I can not remember the year exact. And my
left foot was so swollen and would not go down and the pain was so bad.They was
going to remove my left foot if it did not go down some by the next day.Well
luckly it did and I guess it was gout so bad and from the antibotic I also
almost lost me foot.
Well when I left the hospital from the coma I have been on Cipro 500 mg
everyday for 6 year's.I have been to Dr after Dr to try and find out why I
have so much pain all over my body.It is getting so bad I end up in bed more
than out of bed.I am on Hydrocodone 500 mg and a tylenol does more good I have
been on them for 4 year's due to hip pain so bad.And I guess my hip's
are ok or they would have replaced them by now.I have a headache everyday,I
have loss of appitite,I have had a ringing in my ear's for two year's
now.It never goes away.My eye's are awful my glasses do not last long
enough to get a new apir.I can not sleep over 6 hour's if that at all.I
have had hive's for the last 5 year's I have been to dermatoligist
anfer another and they can not figure what is all over my skin it drive's
me nut's it itche's so much/I scratch until I bleed.
My body hurt's so bad I lay in bed and thinkif I was paralized at least I
wouldn't feel the pain.
I have gout,I bruise so easy and I have become a bleeder. I can not remember
a lot of thing's. So if there are a lot of mistakes it is due to me not
remembering how to spell.Or not knowing what I have done. I can not remember a
lot of thing's I have had seizures so bad in the hospital they said I shook
the bed and still have small ones and ontwo med's for them.The Dr's said
they had my children call the family in when I was in a coma they did not expect
me to make it through one day. But by The Grace of God I did. So is there any
way you can tell me how to deal with this. I hurt so bad sometime's I wish
I was dead. And it is all because of a medication I was just taking to try to
stay alive.Because the Dr's told me the next time I got phenominia will
probally kill me. So please help me somehow. Thank you Brenda

I'm a 27 year old male who finished a little over 6 weeks of ciprofloxacin in may of 2008. As I was on the drug I noticed increasing muscle and joint stiffness, dizziness, and neve problems such as eye twitching and icy pains shooting down my leg. I assumed these would abate when I stopped the drug, and continued to take it as the doctor refused to give me another antibiotic and I was desperate to get well. Big mistake.

Within a day of stopping I had shooting pains down my legs, and my joints started hurting and cracking loudly when moved. I had constant muscle spasms, tightness and pain in my arms and legs that left me unable to leave the house for a week. I also developed a constant ringing in my ears for the first time in my life, which has not decreased since. Along with a host of other smaller symptoms.

All of my symptoms are still with me over 2 months since stopping the drug and improvement has been very little. A black box warning should include all the possible debilitating side effects of this class of drug.

I took exactly 2500 mg (10 pills of 250 mg) of ciprofloxacin over a period of 5 days in the summer of 2007 .

Because of Cipro I need a wheelchair now.

I've always been a healthy person. I took part in squash, tennis, football and jogging.

After taking the third pill the first signs started. I had joint and muscles pain in my calves and arms. Because it was on saturday I did not call my doctor. I did read the paper in the box of Cipro and it did not say to stop immediately. If I did stop I would have less problems. Damned why don’t they warn us better.

On monday I went to my doctor and he said it was from Cipro but he thought it would not harm to go further. He did not know what to do.

Joint pains
Calves/Achilles Arms Hamstrings Shoulders
Muscle pains
Increased joint stiffness
Dry ears
Dry eyes
Dry mouth and nose
Numbness feeling right foot
Joint popping all over my body
Dry sinus
Ear pain
Red skin after touching it / pressure on it

It is almost a year after taking Cipro.

I cannot walk because of pain in calves and Achilles.
I need a wheelchair out of my home.

I am a 43-year-old woman. In December of 06, I was prescribed Levaquin and then Avelox. I took them for a total of 17 days. Within 24 hours, I felt like I was in a fog. Within two days, I was awakened from a sound sleep with severe muscle cramps in my thighs. My leg pain was excruciating. I was also experiencing electrical and burning sensations all over. I called my doctor. She didn't tell me to stop taking my antibiotic. I continued to take it, never attributing my pain to an antibiotic. Over the next 6 months, I developed tendonitis in every possible tendon in my body. As a professional pianist and piano teacher, I couldn’t practice the piano for 2 months. I couldn’t teach for a whole month as I could barely hobble around. I couldn't drive a car due to the pain in my calves, thighs and knees for 6 months. I couldn't walk 20 yards without my legs giving out. I couldn't even rest my foot on the floor for more than a minute because of the pressure on my tendons. I had to constantly keep changing my position from sitting, to standing, to lying down. I had muscle twitching all over and severe insomnia for about 5 months. I had terrible night sweats, but could never get warm during the day. I lost 13 pounds within 2 weeks. I spent over $3000.00 on medical tests to rule out everything from Celiac's disease to neuromuscular diseases and Sjogren's syndrome. Of course, you can imagine the anxiety over the thought of having a disease like ALS. Gradually, I began to get better. Nearly 2 years later, I have mostly healed. However, I do continue to get tendonitis if I am not careful. I workout daily, as this seems to help ease the arthritis I now have. However, I have to be very careful to not over do it. I have nerve pain in my shoulder and neck that isn't getting better. My husband, an MD, was ashamed that he didn't recognize the symptoms and stop me from taking the drug. He and I both just want doctors to inform patients and recognize these reactions. If I had only known within the first 24 hours to stop taking the drug, I probably wouldn't have had such a severe reaction. These reactions are anything but rare, just RARELY recognized.

At age 46 I was given 750 mg of Levaquin for 21 days to combat epidytimitis in 2007. I had some
mild side effects during the course of treatment, ie... mild insomnia, mild joint aches, and some skin itching. After finishing my course of treatment I have developed more severe muscle and joint aches and pains
along with muscle weakness. Alot of my joints, especially my knees and wrists became very frail and prone to easy damage.
At a year out I have experienced Severe joint pain (especially of the knees and leg muscles), weakness in the
arms and neck, never-ending neck pain (constant muscle strains and pains), insomnia, anxiety, depression, dryness and vision issues with left eye, and various peripheral neuropathies. I have had periods of
no symptoms followed by strong relapses (cycles).Prior to this adverse drug reaction I was very healthy and bicycle 7-10 miles a day. I have never regained the ability to aerobic exercise and have to constantly guard against joint damage.

My reaction to avelox started almost three months after I took the drug for a sinus infection, in March, 2005. I did not have the muscloskeletal problems that many have, but I had the vision problems, extreme fatigue, dehydration, brain fog and short term memory loss, neuropathy, and tinnitis. Some of these ADRs stay with me today.

The medical community simply does not acknowledge the danger of fluoroquinolones. In 6 months of going from specialist to specialist, no one could tell me what was wrong with me because nobody is looking for ADRs to drugs in their diagnostic paradigm. And because they’re not, people are being mis-diagnosed.

I feel this is nothing short of a health crisis in this country. These drugs are causing major damage to people and incur great cost to our health care system. In my case, I had probably 30K worth of useless tests. Chronic Fatigue Syndrome and Fibromylgia are possible results of fluoroquinolone ADRs. I know that FQ ADRs mimic arthritis in older people. FQs have been known to cause diabetes. And the list goes on.

Black box warnings should include the FULL SPECTRUM of the ADRs assocoated with these drugs. The FDA is only cutting their losses with this warning in response to a lawsuit by Public Citizen. The FDA should insist on Dear Doctor letters in the USA like there are in Europe. But the FDA is not protecting the citizens of this country; that much is evident.

Well, the black box warning about tendon ruptures is a start, BUT there is so much more to warn people about. I was misdiagnosed with a kidney infection and began taking Levaquin (500mg once per day) in September 2006. On the 5th day I had to stop taking the medication due to severe shin pain and Achilles tendon pain. I began to have difficulty walking. Over the next several months new symptoms appeared including severe muscle twitching in my legs and feet, painful aching in legs, heart palpitations (for three weeks I had arrythmias for 3-5 hours every day), severe brain fog, paresthesia in feet, toes, fingers, and face, rash on arms, severe shoulder and hip tendonitis, severe insomnia, body vibrations and dysthesias, chills, depression, dizziness, itchy torso, anxiety, panic attacks, tinnitus, eye twitches, GERD, severe neck and shoulder pain, head pressure, tachycardia, burning soles of feet, anorexia with loss of 17 pounds over 5 months, mood changes, crying jags, popping joints, arthritic like pain in fingers, hip sciatica (diagnosed by Rheumatologist), vertical nail ridges, tender scalp and migrating pain (moving from one area of the body to another), horrible headaches, internal tremors, blurry vision. I had not had any of these symptoms prior to taking Levaquin. I began taking Ativan to sleep and ease the anxiety and became addicted to it for 8 months. I was lucky to be on a sabbatical when the symptoms were the worst, otherwise I would have had to take a leave of absence. I spent so much time being tested by different specialists (referred by the primary care physician) for cancer, MS and other neurological disorders. After 22 months I still have many of these symptoms. Levaquin has brutally altered my quality of life.

I've had severe arm and shoulder pain for over 1-1/2 years, since a bout of Bronchitis treated with Levaquin in 2007. MRI, orthopedic surgeon and neurology consults, chest X-ray, two nerve conduction tests, electrical stimulation 24x7 for months, physical therapy, more drugs - more antibiotics, steroids, and Nsaids in high doses, and even accupuncture (I hate needles and have a low tolerance for pain, so that was a huge leap for me) and rest whenever possible gave little relief but time seemed to help. Then the second bout of Bronchitis a year later and a huge relapse. I asked the doctor if the drugs could be the problem since the arm pain was so much worse following Bronchitis both times. The answer - NO, probably the coughing aggravated my neck and affected the nerves. That was in February 2008. I could tell stress made the symptoms worse. I quit my job in April to rest and get better. Early June, I had a UTI, took Cipro, and had an arm spasm so bad my hand distorted after my 6th pill. I reread the warnings and saw the tendon rupture in small print. My doctor and I decided to stop the drug and I hit the web. I now realize that I've had other cases of severe tendonitis, one for which I used a cane for months in my 30s, that were associated with this drug family but nobody made the connection. Even my doctor said she knew it could cause tendon ruptures but not the kind of pain I was experiencing. This family of drugs has it's purpose in life threatening situations, but everyone should be allowed to make an informed choice.

In January 2008, I was 37 years old, married with 3 kids under six and in reasonable good shape considering I had had a partial elbow replacement in September 2006 from a fall. That took a real downward turn once I went to my doctor for what I thought was a sinus infection. At the visit the doctor without doing any test wrote me a prescription for ciprofloxin, which I had never heard of and definitely never used before. Of course I filled said prescription only to be somewhat surprised when I read in the warning that this was a drug used for anthrax infections. Like a good patient, I started the medication even though its strength concerned me only to have burning pain in my surgically repaired elbow and my achilles tendons at which time I called my doctor per the instructions on the medication warnings. The doctor totally ignored my complaints, saying they had nothing to do with the meds and told me to keep taking the cipro. Once again, I did what my doc suggested only to have increased tendon/muscle pain over the next two days and finally found myself having an anxiety attack after 8 cipro tablets. I stopped the medicine and made an appointment with my doctor. For the two days I had to wait to see my doctor, I was in bed with terrible anxiety, severe muscle/tendon pain/weakness and all sorts of neurological issues like brain fog, neuropathy,and spatial proximity distortion that I had no knowledge of before taking this drug. When I did go to the doctor he acknowledged that cipro could have rare side effects but didnt think my issues were caused by the medication and told me to give it a month to see if everything went away and if not come back and we would start running tests to discover my real problem. I left feeling both betrayed and scared , because my doctor of the last fifteen years had basically disregarded all my issues. So I have struggled for six months by myself trying to fix these side effects. At present I still cannot say I am 100% back to normal again. Each day has been a day to discover what side effect I will have today. One day I will have severe tendon pain/tightness then that will resolve and brain fog will creep up then that resolves only to have burning neuropathy plague me for a few hours or days. The side effects from these drugs are exactly that nothing short of a modern day plague. No one acknowledges they exist and no doctor that I have seen has any idea what to do for them except to ignore them or to blame them on another disease, yet every day I have to deal with them as best I can.

I was a healthy, vibrant and active 27 year-old wife and mother when I was prescribed Cipro on September 25, 2007. I stopped after the third 500 MG pill when a "guardian angel" friend helped me connect the insomnia and severe headache I was experiencing to the Cipro....within 24 hours of discontinuing the Cipro symptoms intensified and multiplied. I experienced severe neuropathy all over my body, tachycardia, insomnia (not one minute of sleep for over two weeks), profuse sweating, inability to stop pacing, psychosis, loss of appetite, metallic taste in my mouth, mouth sores, dizziness, tendon pain, joint pain, extreme weakness in every muscle of my body especially my jaw, high blood sugar readings, inability to focus my vision on objects, eye floaters, and many more. After this acute stage subsided I have since gone on to develop vertigo (bad enough at times that turning over in bed induced vomiting), severe jaw pain, treatment-resistant hypothyroidism, inability to digest food and extreme stomach pain, atonic colon, skin that will not heal, multiple food and chemical sensitivities broken capillaries all over my body/face, weight loss, extreme fatigue, and a disabling skin reaction to any amount of UV light, and I look like a deflated balloon...there are more but my memory has been affected as well. If I had been given adequate risk/benefit warnings regarding taking this drug I would have absolutely opted to take another antibiotic instead. This drug has ruined my life, and robbed my children of their mother and my husband of his wife. There is not one aspect of my life that hasn't been affected by those three Cipro pills taken almost 10 months ago. My brief experience with conventional medicine is officially done....if there is one thing that I am grateful for from going through this experience it has taught me that without exception no pharmaceuticals can be trusted, and I will never put my life and health in the hands of conventional medicine again

I must have a pretty rare doctor. He's a standard board certified doc and all that, his MD is from Harvard though he never mentions or advertises that. He promotes diet and excercise first, meds as a last resort. Right now I have a mild toenail fungus, so I figured some sort of med would cover that. His 2c is that between a powerful systemic antibiotic (I guess there's nothing local to be applied) and letting it be the latter is the better choice. Antibiotics are fine when you have an infection which spreads or is dangerous, but otherwise they're dangerous in themselves. Same thing with statins - he has me on a low dose to control cholesterol, but says this will be unneeded after we find the right combo of diet and excercise.

Laurie - you're not the only one. The risks of common drugs, especially new drugs seem to be understated, not understood by docs who prescribe them or in some cases ignored when the industry just doesn't want to know. Powerful modern drugs have saved people from various severe illnesses, but the severe illness the drugs can cause isn't discussed or even revealed. Best wishes for your recovery -- it's possible, just the means is unknown.

The black box warning about tendon ruptures is a good start, but many more symptoms have to be included like damage to the liver, CNS system, heart… There is no part in the body, which can not be damaged by this drug. It must be underlined that the symptoms do not only last during the treatment but that they can stay for a long time or even forever – in my case since 20 years and there is no end in sight. I only took 1 pill Floxin.

What shocks me is that the doctors, who describe these drugs, are not properly informed by the manufactures about the real toxicity and ADRs of the fluoroquinolones. In addition to this the medical class ignores, if a patient shows up with ADRs and is able to connect it directly with the treatment with this drug.

For me it was a battle every day, because it damaged the blood-brain-barrier, which protects the brain. Now substances can enter and cause big damage similar to stroke or brain tumor. I have the feeling that a mouse is eating up my brain bite by bite and it takes away slowly but steadily many of the normal skills and my personality. In order to protect my brain I have to isolate myself and I have to avoid all exposures.

Flouroquinolones antibiotics (Levaquin, Cipro, Avelox) can be very dangerous. It’s imperative to understand the potentially insidious side effects and that research be spent on finding a cure.

I was a healthy 43 year old male. 12 days of Levaquin has changed my life. I had never had a side effect from a medication. This dangerous drug is in a different league.

My side effects from Levaquin include a deep ache in thigh, disabling tendon issues across achilles, groin, elbow, etc. I have tingling, numbness sensations, and muscle twitching. I need crutches now to walk, and some days cannot walk at all. This is my life now because of Levaquin.

While the black box warning issued by the FDA is a start, it doesn’t go nearly far enough in describing the seriousness nor the scope of the side effects.

It’s time to recognize the facts and not rationalize them away. Let’s not have more tragedies.

I had surgery in 2000 to remove a urinary bladder stone caused by a previous unnecessary and unsuccessful surgery for minor stress incontinence. I was given Cipro for weeks prior to the surgery and after. I was told that the inside of my bladder looked like raw hamburger meat. I continued to get UTIs while the bladder surface was healing. I was given Cipro many times over the next 5 years by 3 different physicians. I was 60 or over at the time. I was told by 2 physicians that I needed to be on Cipro for a year. After 5 months in 2005, I stopped taking the drug since I developed severe ear pain. I experienced about 20 side effects, tendon rupture, neuropathy, sensitivity to noises, balance problems, rashes and itching, sun sensitivity, fatigue, vision problems, to name just a few. I'm still disabled and suffering. What in the world will a black box do? This drug needs to be withdrawn from the market.

The ADR from a derivative of fluoroquinolones changed my life for ever. From being very healthy to suffering from day one with, cardiac, neurological, liver, kidneys, muscles, tendons, muscles, life threatening hypoglycaemia, visual and auditory damage, debilitating weakness leading to being bedridden for many months and usage of a wheelchair, neuropathic pains, indescribable pains, and more. For those who want info strictly concerning the ADR, visit and a forum to exchange info, tips, and is diverse, and has a chatroom, where we meet every Thursday nights, visit:

My name is Leslea and I am a Clinical Laboratory Manager, have been a Medical Technologist for almost 30 years. I am very well respected by the medical staff at my facility because if I bring up a subject, perhaps a laboratory protocol that I want to put into place or changed, I have done my homework on the subject.
With that in mind, I want to urge physicians to take heed to the fact that fluoroquinolones are not safe for a very large segment of the population. There are literally thousands and thousands of people whose lives are forever changed because of the quinolones.
I know that most, if not all, facilities with microbiology departments put out an antibiogram, at least annually, for the medical staff to reference. Please use your antibiograms to pick the least toxic and most effective antibiotic for your patient.
Use the quinolone class only as a last resort, after other antibiotics have failed or the patient will expire if they aren’t used. Using the quinolones routinely just doesn’t make sense when other antibiotics will work. Keep in mind if this class of antibiotics continues to be used so nonchalantly they will become ineffective due to bacteria developing resistance to them.
I have personally experienced multiple system adr’s to the quinolones, and know a multitude of people like me. That is why I am writing this, I want to prevent the number of people that are damaged by quinolones from growing exponentially.
The adr’s to the quinolones are grossly under reported due to the fact that a lot of reactions aren’t recognized, but are diagnosed as an unrelated problem. If the number of adr’s to quinolones were accurately reported to the medical community, no physician would ever routinely prescribe quinolones again, unless he was some sort of sadist.
My motivation for writing this is honorable, our term would be risk management in the medical community, for the layperson it would be a passionate desire to prevent others from suffering like I am.
Just in case you are wondering, my first reaction to a quinolone caused damage to my tendons particularly my left knee. The tendons were so weak that my knee dislocated 6 times over a 7 month period, I probably should have been in a wheel chair, but I needed to work. I have a permanent baker’s cyst in that knee. The tendonitis was so painful that walking was more like hobbling.
My second reaction made my first reaction seem like a walk in the park. When I mentioned multiple systems earlier, I meant CNS, muscular, skeletal, soft tissues and connective tissue damage. Four and a half years post two doses of Avelox, I still have a multitude of symptoms, some that are not going to resolve. Although I am in severe unrelenting pain, I consider the worst part of my reaction to be the CNS or brain damage.
I have debilitating depression, which I never had prior to this. But the thing that takes the cake is the following: I am sure you can imagine that I am or actually was above average in intelligence, Avelox has destroyed my short term memory and has made me struggle to find simple everyday words when carrying on a conversation. My nickname used to be “The Steel Trap” because I never forgot anything and could recall verbatim conversations no matter how long or short the amount of time that had elapsed. My memory was what is called photographic in nature. You might be tempted to say, well you are getting older, well I don’t believe that CNS changes due to aging happen overnight unless there is a stroke involved. That, and the fact that I am not alone with this reaction, speaks very loudly to the truth of the matter.
I will quickly list the other damage I am dealing with; peripheral neuropathy, myofascial damage in my right hip that has lead to permanent gluteus median adhesions after tearing. I have chronic muscle spasms and knots in my right hip and shoulder, this is the cause of the severe unrelenting pain, the shoulder knots and spasms lead to horrible tension headaches. I also have to take Valtrex to keep shingles at bay, another wonderful symptom of the nerve damage. My tendons and ligaments in my right knee are tender to the touch and painful, my vision is altered due to floaters and blurring, luckily laboratories are notoriously noisy so I don’t notice the tinnitus too much. I could go on and on, but you get the picture. By the way, I was a healthy active person prior to this reaction, I was 47 at the time and most people would guess my age at 35 because of my personality, strength and agility, they were always shocked to find out how old I was.
Please help me in preventing any other healthy individuals from experiencing this nightmare.
I also challenge you to do your own research into the real picture of this class of antibiotics, quit taking the word of the FDA or pharmaceutical companies, they have an agenda, but it is less than honorable. You can start by going to .
Thank you for your time.



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