A couple of weeks ago, I got sick and self-medicated myself for two days with a course of ciprofloxacin (or Cipro) until I got a chance to talk to my primary physician. She agreed with my tentative diagnosis and prescribed a full course of Cipro. In fact, whenever the family travels on vacation, we pack it in case we get a case of “turista.” I viewed it as necessary and commonplace as packing some ibuprofen for pain. So I was surprised when my doctor cautioned me against strenuous exercise because a major side effect has been recently identified: tendinitis, and worse: tendon rupture. Having gone through the agony of Achilles tendon rupture during a marathon race, and surgery for a ruptured biceps tendon, her warning put the fear of God in me. They are one of the most commonly prescribed classes of antibiotics. Indeed, when I got the Cipro bottle, the first thing that tumbled out of the package was a warning about tendon problems. The reason for their popularity with physicians and patients alike is their broad-spectrum anti-bacterial activity and their high tissue distribution. These drugs are generally well-tolerated, and adverse reactions are relatively uncommon; nonetheless, if they occur, they are pretty unpleasant. Fluoroquinolones were reported to cause dysglycemias (hyper and hypo-glycymia), cardiac arrhythmias, neuropsychiatric events, corneal perforation (topical application only, and by another fluor ofloxacin, not cipro), most important to exercise fanatics: tendinitis and tendon rupture. Over the last several years, more people of all ages have been playing sports, which has led to an increasing number of sports injuries, including tendinopathies. Achilles tendinopathies have been problematic, especially in athletes participating in all type of sports. However, these injuries are not related to athletes alone as one-third of all Achilles tendon issues occur in non-athletes. The Achilles tendon is one of the more frequently injured tendons due to its “whipping action" during use. Many factors appear to be involved with this problem, including changes in training patterns, shoe gear, training surfaces and any type of speed work. These problems can lead to an overloading of the tendon, resulting in breakdown, inflammation and even rupture. There are many other factors that can lead to breakdown of the tendon as well.
[Posted 12/20/2018]AUDIENCE: Health Professional, Infectious Disease, Cardiology, Patient ISSUE: FDA review found that fluoroquinolone antibiotics can increase the occurrence of rare but serious events of 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. They can occur with fluoroquinolones for systemic use given by mouth or through an injection. BACKGROUND: Fluoroquinolone antibiotics are approved to treat certain bacterial infections and have been used for more than 30 years. They work by killing or stopping the growth of bacteria that can cause illness. Without treatment, some infections can spread and lead to serious health problems (see List of Currently Available FDA-Approved Systemic Fluoroquinolones, available at RECOMMENDATION: Healthcare professionals should: Taking ciprofloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. This content has not been reviewed within the past year and may not represent Web MD's most up-to-date information. To find the most current information, please enter your topic of interest into our search box. The new warnings apply to fluoroquinolones, a class of antibiotics that includes the popular drug Cipro. The FDA has told companies that the drugs must now carry "black box" warnings alerting doctors and patients that the drugs can increase risk of tendinitis and tendon rupture in some patients. Fluoroquinolones have carried similar warnings for years, but officials say they continue to receive reports of safety problems. A "black box" warning is the FDA's sternest warning. "We have seen continuing reports of tendon rupture so we are trying to increase awareness," says Edward Cox, MD, director of the FDA's Office of Antimicrobial Products. The warning applies to drugs of the fluoroquinolone class, including Cipro, Cipro XR, Proquin XR, Levaquin, Floxin, Noroxin, Avelox, Factive, and marketed generics.
Antibiotics are prescribed to treat infections from head to toe—from bronchitis to urinary tract infections (UTIs). But doctors and patients are increasingly learning more about the alarming side effects of one particular class called fluoroquinolones, which include Cipro and Levaquin. Rare cases of severe tendon damage associated with the use of the drug, among other side effects, have been reported in recent years. Now, experts want both doctors and patients to be more aware of these potential dangers. Prescribing fluoroquinolone antibiotics more judiciously can help control the spread of resistant infections while reducing who experiences the side effects. Doctors say tendon issues weren’t apparent in the 1970s, when thousands of people tested fluoroquinolones in trials before the drugs were approved. As these medications became popular for treating many common infections, including pneumonia, sinusitis, bronchitis and UTIs, the side effect started to emerge. Gareth Gillespie and Sarah Baggot highlight the risk of tendon ruptures as a complication of ciprofloxacin The antibiotic ciprofloxacin is widely used in Singapore and Hong Kong – but while its uses are well-known, a rare but well-established complication, tendon rupture, is less so. MPS has recently handled a number of cases in Singapore where a patient has suffered tendon rupture after taking ciprofloxacin, yet the prescribing doctor was unaware of this complication. Our aim is not so much to influence clinical judgment about appropriate antibiotic use but to increase awareness, so that doctors and patients are better informed during the consent process. The complication, although not very common, is more widely known in countries such as the United Kingdom and the United States; this article explores the available literature to highlight the complication’s symptoms and signs, patient risk factors, and the likelihood of it occurring. Ciprofloxacin is part of a group of fluoroquinolone antibiotics and is used to treat respiratory, urinary tract, gastrointestinal and abdominal infections. Fluoroquinolone-associated tendinopathy was first reported in 1983, when a 56-year-old renal transplant patient who was taking norfloxacin for a urinary tract infection with septicemia, developed Achilles tendinopathy. Although norfloxacin, ofloxacin, pfloxacin and levofloxacin have been linked to tendon injuries, a study published in 2000 concluded that ciprofloxacin was the most common fluoroquinolone in such cases, appearing in 90% of them.
Jan 7, 2016. Fluoroquinolones and risk of Achilles tendon disorders case-control study. If you have experienced problems with Cipro and tendonitis or. Jul 25, 2018. Findings suggest that ciprofloxacin and other antibiotics of the same class should. of the normal functions of connective tissue, including tendon rupture. association between fluoroquinolones and cardiovascular problems.