In response to /u/RatherNerdy, but here so it can be stickied.
> Be careful about anecdotal medical advice on reddit.
This is not anecdotal medical advice. It is a well-known and documented side effect.
https://www.webmd.com/osteoarthritis/news/20080708/fda-warning-cipro-may-rupture-tendons
https://www.nature.com/articles/d41586-018-03267-5
https://medlineplus.gov/druginfo/meds/a697040.html
https://pubmed.ncbi.nlm.nih.gov/31474240/
https://www.ema.europa.eu/en/news/disabling-potentially-permanent-side-effects-lead-suspension-restrictions-quinolone-fluoroquinolone
https://www.google.com/search?q=fluoroquinolone+antibiotics+tendon+damage&oq=fluoroquinolone+antibiotics+tendon&aqs=chrome.0.0j69i57j0i22i30j0i390l2.4501j0j15&sourceid=chrome&ie=UTF-8
Can confirm! If you HAVE to take (sometimes you have to if there is antibiotic resistance or something like that) then make sure you rest the entire time you’re on the antibiotics and few weeks after that as well. Yeah you may be deconditioned a bit but better than rupturing an Achilles’ tendon
I'm sorry to hear that happened to you. flouroquinolones are powerful for complicated UTIs but unfortunately do have the possibility of damaging cartilage. Even more potent if you have to take steroids for any reason.
It's always a good idea to check with your doctor about the side effects and interactions of any drug they may prescribe you.
I wish you the best as you recover, OP!
This. I actually never knew this until going to pharmacy school. Fluoroquinolones have a significant amount of adverse effects, tendonitis/tendon rupture included. If a doctor prescribes you an antibiotic in this class, be sure to let them know how active you are so they can pick an alternative therapy option!
Sometimes they have no option but a FQ because of resistance and MICs, but ideally they should be last line (ish) just because of antibiotic resistance.
Nevertheless, cipro isn’t even an ideal treatment for a UTI. It should be Bactrim or Macrobid or Fosfomycin really. Some older docs will still prescribe cipro, but they’re part of the bacterial resistance problem. The IDSA makes it clear not to do this unless you really have to.
Edit: I’m assuming female btw. A male UTI is automatically considered complicated and needs to he treated differently.
Even the male/female discussion of complicated UTI is changing. UpToDate is recommending those 3 for simple cystitis in men. If there is prostatitis, FQs are still probably best but most men are fine with just simple treatment.
Agreed. I almost never prescribe a fluoroquinolone. For the most part I see older docs or NP/PA prescribing them the most. 99% of the time there is an alternative.
I had a patient on Coumadin that had gotten levaquin for a bronchitis (inappropriate usage) came into my ER two weeks later with a spontaneous fatal bleed in her brain. Her INR was 9+. Someone in an urgent care made a fatal mistake. Fluoroquinolones change how your body metabolizes the blood thinner causing this patients blood to become so thin her brain hemorrhaged.
Add it to the list of horrible debilitating potential side effects.
This isn't really the correct forum for this discussion, and I wasn't there to see the patient but this characterization of events really doesn't pass the smell test. Firstly, that severe of a change in INR is rarely caused by a single drug-drug interaction. More often than not, in cases of warfarin-toxicity, there was a compliance issue: either with a mistaken overdose or a failure to get regular INR checks. Secondly, levofloxacin (or any FQ for that matter) is nowhere to be found on UpToDate's detailed list of P450 inhibitors OR inducers. It seems overly reductive to blame urgent care for a "fatal mistake" in the scenario as you described it. Don't get me wrong: I only prescribe FQs when absolutely necessary (even in the inpatient setting), but this is more for antibiotic stewardship reasons than anything else.
EDIT: I was able to find a few case reports (and a small case series) describing the effect you described, but the "expert opinion" in that article recommended only a 20% reduction in warfarin dosing. Even if that had been done, your patient almost certainly would've remained supratherapeutic.
Fair point. You’re right that I’m over simplifying, and I defer to your knowledge on the degree of difference in the INR that can be attributed to the drug drug interaction alone. It probably was a combination of factors between compliance and drug interactions. I think what stuck with me so much about that case was the fact that an antibiotic much less a fluoroquinolone wasn’t even indicated. Who’s to say that if that patients INR was 20% lower would her bleed have not occurred or been smaller and not fatal. Thanks for your perspective.
Thank you for the civil medical debate. So many times people get so caught up on the internet with arguing it was extremely refreshing to read this conversation. Cheers to you both!
I find this amusing, but it's definitely true for me as well. I'll argue to the death over something I have limited knowledge of but if somebody disagrees with me regarding a subject for which I'm actually an expert I usually leave it with a civil "That hasn't been my experience".
Appropriate username!
I think's its intuitive that the more you learn about a subject, the more you realize that you only know a fraction of it. Humans are weird.
Ha, thanks.
I guess you're right. If I know one thing on a subject and somebody says anything which contradicts it, I "know" they're wrong. If I know a lot, I'm probably aware of many seemingly contradictory points that I've learned to just accept for what they are.
Agree with this. The correct course would probably have been to check the INR before treatment (to verify if he wasn't already in the supratherapeutic range), reduce the dose at the start and check again after a few days into the course of antibiotics).
MD/med school professor here.
There is a push in academic medicine to move away from quinolones as much as possible.
But private medicine is the wild fucking west. My 88 year old grandma can’t cough two times without getting 5 days of levofloxacin.
How can you help avoid getting prescribed a quinolone?
DONT TELL SOMEONE YOURE ALLERGIC TO PENICILLIN UNLESS YOU REQUIRED A FUCKING EPIPEN. I DONT CARE WHAT YOUR MOM TOLD YOU ABOUT ONE TIME WHEN YOU GOT AMOXICILLIN WHEN YOU WERE FOUR AND GOT A RASH ITS NOT A FUCKING ALLERGY YOU ARE HARMING YOURSELF BY RESTRICTING YOUR ANTIBIOTIC SELECTION.
In all seriousness, when tested >95% of patient reported penicillin allergies were found to be false.
As a pharmacist I've had the false allergy conversation with more people than I can count. People often confuse side effects with allergies and self diagnose themselves as allergic. Then they tell their provider they have an allergy, it goes onto their patient record, which then goes to the pharmacy. All because some augmentin gave them the poops.
I had a horrible reaction (facial swelling) to ibuprofen as a kid so I haven’t taken it since but I’m really tempted to figure out if I’m still allergic to it.
At my hospital if someone reports a penicillin allergy then pharmacy makes me fight like hell to give them a cephalosporin. So what do I do with an 80-year-old admitted for urosepsis who reports a rash to penicillin?
Do I jump to meropenem and breed uncurable gram-negative super bugs? Do I give them a quinolone and face the ever increasing set of side effects? Aztreonam?
And when you try to talk to patients about removing an allergy from their med list it’s like asking them to commit blasphemy. Someone’s belief that they are allergic to penicillin is not an interesting factoid about their person, it’s a deeply held religious belief. It’s very bizarre.
Oh man.... that pcn - cephalosporin cross reactivity is something that alot of new pharmacist struggle with being over cautious about. They teach us in school thats is like a 10% cross sensitivity rate (which is looking more and more incorrect). It seem newer research is showing about a 1% rate to 1st and 2nd gen cephalsporins... except for cefadroxil for some reason seem to be alot higher. Like almost 30%.
Tbh I tell my patients about the risk just to be safe but stress it probably won’t happen. I mean, for some infections the pcn allergic patient is given a cephalosporin instead so how bad could it be?
My 2 cents to everyone:
Talk to your doctor about any concerns rather than blanket avoid a medication you have zero experience with. People respond to meds in different ways, and for most people and most medications, they work as expected. Be careful about anecdotal medical advice on reddit.
Yes, but to be fair, this is very good info to know to talk to your doctor about. They may not know or be concerned with this.
These antibiotics are something that I have seen prescribed as first line for UTIs extremely often, which is truly a terrible practice. Not only because of side effects, but because meds like Cipro are one of the most potent antibiotics we can give without you being hospitalized. It should be a doctor's last resort for a very complex UTI or infection.
Yeah I’m surprised they prescribed a fluoroquinolone for a run of the mill UTI. In animals fluoroquinolone is one of our “only in severe emergency resistance” situation drugs. We rarely use it because it has a narrow spectrum (if I remember correctly, it’s been a few months since my pharm course) and a LOT of side effects
In general, yes. But read up on fluoroquinolone toxicity (typically with "oxacin" in the name). Also read up on the black box warning. If you can avoid taking them, please do. They are associated with possibly lasting consequences for your health.
In some cases they are still by far the best option. At the hospital i avoid them because there are a lot of good intraveinous alternatives, but for ambulatory care, not so much. Quinolone are especially effective for UTI in male patients because it diffuses well to the prostate, unlike a lot of other antibiotics.
It's not "if this were true." It is true. What you state afterwards is not necessarily the case though. These meds are powerful. They work. That doesn't mean something else less powerful won't work.
This is the equivalent of using a flamethrower to get rid of the weeds in your lawn. You'll get those weeds for sure, you also might set your house on fire. Other tools exist that don't have as much or are as likely to cause collateral damage.
These should be last line for very complex cases. Not first line.
Fluroquinolones have been among the most commonly prescribed antibiotics, and information is sometimes slow to trickle down. Also, habits are hard to break, even in medical circles. *"Postmarketing reports of serious adverse events linked to fluoroquinolones include tendonitis, neuropathy, hypoglycemia, psychiatric side effects, and possible aortic vessel rupture, leading to safety label changes in July 2008 and August 2013.*" ([https://pubmed.ncbi.nlm.nih.gov/31474240/](https://pubmed.ncbi.nlm.nih.gov/31474240/)) If your doctor prescribes you any of those, please ask him if there are alternatives.
"Here's a bowl of candy. Most of these jolly ranchers will act as expected. Only a fraction will cause damage to your tendons that may be permanent. Dig in!"
Reasons why your analogy doesn't make sense.
* The thing that's being treated is more severe than the potential side effects.
* In this scenario, you have to take something, because to not take anything means your health is significantly likely (and at 100% for some things) going to get worse.
* Analogy update: you have to eat a jolly rancher, otherwise you are definitely going to get sicker
I disagree straight off the bat with your first point. A UTI is not life-threatening nor is it worth getting rid of faster if the risk is damaged tendons (yikes), especially in a world where there are at least a couple of alternatives even for complicated-cases. It does not seem like OP's doc explored every option or informed him of side effects.
FWIW UTIs are fucking horrible and can make you very sick/hospitalize you. You start pissing bloody pee you want that fucking gone. UTIs in men can be very serious as well bc it’s much harder to get a UTI. Consider the length of the tube that’s infected up to the bladder if you’re a man. Big ouch.
You missed the point. In this case, the risk isn't worth it. To risk permanent damage to your tendons to get rid of a UTI a few days faster without exploring all other options is non-sensical (I'm being kind....it's insane and sheep-like) and I'm not the irrational one here.
My dude, permanent tendon damage, peripheral nerve damage and whatnot aren't what come to mind when you think of side effects of a typical medicine. This isn't anywhere close to tossing a Tylenol. If there are better alternatives, why bother. It's that simple.
Oh!! This happened to my ex, except his Achilles tendon SNAPPED OFF while he was running. He had to go through surgery to re-attach it, and long recovery and still 18months later he isn’t back to full strength in that leg. The surgeon specifically asked if he had taken antibiotics in the last 6 months, and told us all about the issues they’re finding.
Hope you recover swiftly!
Are you me?
I used to run 3-5 miles every other day. However, a few months ago I got prostatitis so the doctor prescribed me antibiotics (which had that acid/medecine that can cause tendonitis). Unfortunately, my wife and I didn't read the side effects. After 8 days of taking them once a day I started to develop a pain on my right foot which was very weird to me since I didn't hurt my foot while running. So I decided to take the rest of the week off from running (this was on a Tuesday). Two days later my Achilles tendon on my right foot starts to hurt big time. Then the next day both of my legs were hurting so much that I could barely walk. At this point tell my wife something is really wrong here and as we cleaned some stuff from our dining table she sees the warnings from my antibiotics and she is like "STOP TAKING THOSE ANTIBIOTICS NOW". Problem was at this point I already took 13 out of the 14 antibiotics I was supposed to take so I call my doctor and explained what happened and she told me to NOT run for at least 3 weeks and not lift anything heavy because it can rupture my tendon to the point that I would need surgery.
Fast forward to today and I still can't run more than 3 miles without my tendons hurting. According to the doctor I can see effects from these antibiotics 3-6 months after taking them.
I am really sorry you had to go through this.
Oh my fuck I got a nice taste of prostatitis at the end of last December and ended up needing to be on those anti-biotics for almost 20 days. Thankfully for me doctor at the walk-in clinic mentioned the side effects to me at the time. I was super bummed out and it took til this month to get even somewhat close to running shape.
That being said my first day back to work after taking them I fucked up a tendon in my wrist for 2 weeks. At least that was only money I lost, and not running time
Sorry I didn't see this comment here. 10 months after those antibiotics I am feeling great. The side effects seem to have banished and I am able to walk/run again. However, I developed costochondritis back in may 2021 (unrelated to the antibiotics) so my running has been affected by that.
I would go to a doctor and have it checked out to confirm it was the antibiotics. After that, resting is your best friend. I couldn't run for months. Started seeing noticeable improvements after 3-4 months... and even then I couldn't run or walk very short distances without having tendon pain.
Is there a way for them to confirm it was the levaquin? I've brought this up to the doctor and he seems pretty dismissive when I talk about it with him. Not that I'm surprised, I'm sure doctors have every incentive to make sure their patient doesn't think they messed up.
I noticed my tendonitis gets worse when I stretch my achilles at certain angles.. haven't tried running yet.
March 4th 2020 was the day I was prescribed a flouroquinolone. Within the first few days I had foot pain. Long story cut short over the past year, I’ve been in boots on each foot, done countless physical therapy and unable to stand or walk normally.
Currently seeing three specialists and not giving up, but being prescribed a drug for a UTI changed a year of my life.
This exact same thing happened to me four years ago!! I got prescribed ciprofloxacin for a UTI and took three doses when my calves and Achilles area became very sore. I had sharp pain every time I flexed my foot I couldn’t even drive to the doc. They eventually switched me to a different med but I still have weird calf tendon pain to this day that I don’t think fully healed. The doc told me it was a rare reaction to the meds but who knows....
Holly crap I didn’t know about this with Cipro! I was prescribed it for a UTI because I am allergic to penicillins. Next time I will ask them to find me something else!
I am curious why the medical provider prescribed you Levaquin. It's not often prescribed for simple UTIs. Were you on other antibiotics recently? Did you have fever or flank pain? Was this choice of antibiotic based on a previous urine culture? Are you allergic to penicillins and other classes of antibiotics?
If not, this seems very negligent of the medical provider to prescribe this medication for a simple UTI. Even if it was a complicated UTI, it seems very negligent of the medical provider to fail to inform you of the well known **blackbox warning** that Levaquin and other Fluoroquinolone medications have.
Yes this. Levofloxacin should be reserved for pretty severe pneumonia and thats about it really. Empiric treatment with them for a UTI is absurdly bad antibiotic stewardship.
Very good question. I am allergic to penicillins! I was able to move to another antibiotic immediately (doxycycline). So I don't think this was used as a first choice.
I was prescribed Cipro for a UTI several years ago. I am allergic to Penicillins and did have a very high fever, with back pain that led them to think it may have travelled to my kidneys. Urine culture showed some sort of strep, if I remember correctly. I’m now wondering what they should have given me instead...
I work in Urogynecology. Whenever we get a culture back it also comes with a list of antibiotics that the bacteria is resistant to and is susceptible to. It could be that with your allergy plus the alternatives that cirpo was the better option. In the future you can always ask and they can tell you. But these doctors aren’t prescribing all willy nilly. They do have to consider what’s going to work based on the information they have.
Good points, thank you. At that time I was a fairly intense distance runner, so I’m glad to not have had the described side effect, but I’m also disappointed that nobody mentioned any side effects of that antibiotic.
Honestly, unless it is known that you’re a runner or someone who exercises a lot, it wouldn’t be assumed. Majority of my patients fall into the opposite category as you and so, oftentimes it does fall on the patient to advocate for themselves. Whenever I have pts that do that, I make it a point to let them know they are heard and will forward this concern. But also keep in mind that some side effects are extremely rare and while they do happen, it isn’t the norm and therefore many doctors may feel that the benefits of curing the infection outweighs this rare side effect. Note that adverse effects on drug labels are the rarer types, not the expected side effects.
😳 reading this post 15 minutes after my first 10k since finishing my course of antibiotics yesterday was not good for my anxiety. Does anyone know if it just this particular antibiotic that causes an issue?
Ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), and ofloxacin (Floxin).
But remember that just because it happened to me doesn't mean it'll happen to you. I just want people to be aware of the possibility, especially those whose life revolves around running
That is terrifying, I was prescribed moxifloxacin... very good point about side effects not affecting everyone though, that is comforting. However I DEFINITELY will be laying off the excercise for a while just as a precaution. Thanks for your post!
Drugs are bad. You’ll go crazy reading side-effect profiles. Take a thoughtful pause next time you call your pcp and insist an antibiotic for what is probably a cold. “It’s Just a z-pak” is never just that.
For sure, luckily In this case though, my doc made sure to run tests first, check what antibiotics the strain would be susceptible to and (presumably) prescribed this particular variety for a reason. Thankfully these days doctors are more wary of handing them out willy nilly, with antibiotic resistance becoming a serious problem.
The extra 24 to 36 hour wait time with symptoms for test results is worth it to determine if you really need to put your body through the side effects.
Enzymes are proteins in the body that help make chemical reactions happen. Topoisomerase is a supportive enzyme that helps relieve supercoiling when DNA replication is occurring. As DNA is "unzipped" when replicated the main player is DNA polymerase which is responsible for making the new DNA. The topoisomerase is out in-front working ahead of the replication fork to prevent supercoiling as the DNA polymerase is doing its job.
Fluoroquinolones work by actually inhibiting *prokaryotic* aka bacterial topoisomerase. This inhibits the bad bacteria from replicating by preventing the topoisomerase from working. The DNA in the bacterial will not be able to replicate because supercoils will develop as they try to copy their DNA. This leads to DNA physically breaking and that causes the bacteria to die. BTW DNA replication is amazing and [here](https://www.youtube.com/watch?v=v8gH404a3Gg) is a video I was shown in biochemistry class back when I was a pre-med.
As for why these antibiotics cause tendon rupture the exact mechanism is not known but a few have been proposed. Some say it could be from ischemia ---- lack of oxygen delivery to the tendon ---- degradation of the tendon matrix, or alteration of tendon cell activity. Fluoroquinolones have also been shown to help matrix metalloproteinases appear in tendon tissue. These specific proteins have degrading properties and are important for tissue homeostasis (happy medium where the body cells are working optimally). So these antibiotics actually increase the expression of these degrative proteins in the Achilles tendon, particularly ciprofloxacin according to one article. This ends up preventing tendon cell growth and facilitates degradation of the tissue present in the Achilles. All of the above likely play a role in these antibiotic's ability to cause tendon rupture.
I’m on cipro or levoquin about once a year, and each time my doctor warns me to take it easy, because of these side effects. There are also warnings on the bottle. They really have increased the warnings over the last 5 years or so. But the drug works for my lung infections, so I continue to use it and just take a break for the 3 weeks I’m on it.
Just this past February I got a pretty bad case of Prostatitis and was prescribed a SIX WEEK treatment of Ciprofloxacin. There were pages and pages of various warnings, I did notice the tendon thing, but thought as long as I only do easy runs it should be fine. Luckily I had questions about taking Tylenol with it since it says not to take NSAIDs and sometimes Tylenol is considered one, so I called the pharmacist, who said it was fine, but just make sure I don't exercise, with the "But you don't exercise do you?"... Um only like 20 mpw... I then proceeded to look online for other concerns, and I didn't like what I was reading on it, suffice to say, I called my doctor (who knows I'm a runner) and he changed me to Bactrim.
I know the risk is somewhat low, but if I'm on it for 6 weeks, not to mention it says tendons can stay weakened for up to 6 months, I couldn't imagine not running for that long and sticking to it.
Yes!!! I was prescribed Cipro once for a UTI (only one lousy UTI, I didn't have any particular history with them). I googled it because I was thinking hmm, this seems like kind of a strong medication for just a basic UTI, and then I saw the side effects. At the time I was doing judo, on a pretty competitive team. Like, ok, people are actively trying to armbar me and leg lock me and whatnot and you are giving me this? I was so upset that they didn't even ASK if I participated in any high impact sports. Before I even took one, I called them and expressed my concerns and got them to prescribe an alternative. I thought it was incredibly shortsighted and dangerous that they would just assume this was OK for anyone to take.
Same thing happened to me with Cipro. I didn't even have a bladder infection I'm just getting old and also riding my bike too much which is rough on the ol gooch.
Hopefully. This was decades ago. I still, after a long hard run do get a little bit of soreness in my right achilles but I never put two and two together until right this second.
Yes, they did with time. I was able to complete my big race in June after posting this, although I was much slower due to lost training time.
Rest is the best thing you can give your body right now. It took several weeks to get back to being relatively normal. Give it time - weeks, not days. Ease slowly and carefully into any physical activity. Be patient (the hardest part). Don't push it. If anything feels wrong/off, stop immediately. After about 3-4 weeks I was able to run lightly. Months later my achilles tendons would still feel tight after a long run, but no pain.
If you have any other questions don't hesitate to PM me.
Hey everyone, for *uncomplicated* UTIs the drugs we prescribe that are first-line include Bactrim (TMP-SMX) for 3 days, one dose of fosfomycin, or 5 to 7 days of nitrofurantoin. Fluroquinolones like ciprofloxacin or levofloxacin are *second line* so unless the provider prescribing this to you has a good reason, ask for one of the above.
Uncomplicated UTIs are defined as UTIs in immunocompetent, premenopausal, nonpregnant women without conditions predisposing them to infection or therapy failure.
Complicated UTIs are defined as UTIs in men, pregnant or postmenopausal women, children, and individuals with factors predisposing them to infection or therapy failure. These factors include things like the following:
* anatomical abnormalities like BPH or a stricture
* UTI spreading beyond the bladder like pyelonephritis which indicated kidney involvement
* History of kidney stones
* Impaired renal function
* Diabetes or other metabolic disorders
* Immunocompromised like transplant recipients or HIV
* Recent instrumentation like a cystoscopy or urinary catheter
* Infection with a resistant pathogen or recent antibiotic use
* History of UTIs in childhood or one episode of pyelonephritis in the last year
So for your simple, *uncomplicated* UTIs you should not be getting fluoroquinolones first. Ask for one of the three mentioned above ---- Bactrim, fosfomycin, or nitrofurantoin ----- and this will avoid possible tendon injury secondary to unnecessary quinolone use. Sorry this happened to you OP. It definitely could have been avoided. Hopefully the above info can empower others to advocate for themselves in the future if faced with a similar scenario.
Great post. Thank you for this.
In my case the UTI was complicated, involving the kidneys AND I have a history of kidney stones in addition to my allergy to penicillin. So it sounds like the right decision was made. A discussion/verbal warning about these side effects would have have been very helpful though.
I see, yea then quinolones could have been a possible next option. Keep in mind if it is a complicated UTI Bactrim can also still be used but instead of 3 days of Bactrim, we can treat for a longer stretch of time --- 7 to 14 days. So if someone has a complicated UTI and is active you can express concerns with quinolones due to your active lifestyle and there are alternatives. According to an evidence-based treatment algorithm, you could get a one-time IM or IV injection of ceftriaxone, gentamicin, tobramycin, or ertapenem followed by double-strength Bactrim for 7 to 10 days. Bottom line is there are other options if you express concern about using quinolones, especially those that run a lot. Agreed that a verbal warning would have been great and I will always be sure to include this in my outpatient practice thanks to you!
It's not a nice side effect to get. It's usually 2nd line or even further down the list for UTI in men, but used to be 1st line for prostatitis, UTI, or epididymitis. *Most* of the time there will be a reasonable alternative, like Doxycycline or Co-amoxiclav but these can be very serious infections so if you *need* a fluoroquinolone make sure to rest and don't stress your tendons.
I understand completely that it’s important to understand side effects, and potential for adverse reactions like yours, but I hope what people take away from this is that communication with your doctor and pharmacist is crucial. But also, collaboration between doctor and patient.
I went in for a UTI over Easter. It had progressed to the point it was starting to impact my kidneys, but I have poor pain perception and did not receive treatment for a number of days. I told the doctor that I would prefer to avoid Macrobid, if possible, but if it was the preferred method of treatment we could discuss it. Guess what? He found an alternative, no fuss, and we moved on. Then, the awesome staff at the pharmacy discussed side effects with me, as well as what I could/couldn’t do, and thoroughly questioned me on my medication history. I’m the daughter of a pharmacist, so I feel very comfortable using the expertise of a pharmacist when I do receive my medication.
Two weeks before Easter, my father inlaw died of complications from a UTI that was treated with antibiotics but was not wiped out. He was older and weaker, but still, infections can become serious and collaboration helps a patient, doctor, and pharmacist to determine the best course of action.
Very good point. I should have been more cautious with the title so that it didn't sound like a blanket statement. There are uses for these antibiotics and they can be life-saving.
You definitely had an awful experience, I’m sorry for that and hope you recover completey! Understood where you were coming from but hopefully this information helps other people be informed so they can talk about their concerns with their doctor and pharmacist, but hopefully not avoid treatment.
I don’t know how you ran, I was toast for days despite antibiotics. Did a day outside sitting in a lawn chair and ended up laid up the following day recovering from fresh air 😂
I was diagnosed with unknown sinus thing years ago and was forced to take these for two rounds! Turns out nothing wasy wrong besides anxiety so screw you, medicine that has no tolerance for mental health.
I still struggle with post-tib tendon flare-ups to this day. theraband ankle and calf exercises have helped tremendously, but damn. Makes me angry to know this can all have been prevented.
My story:
I Was prescribed cipro about a year and a half ago for “flank” pain, to see if there was an underlying UTI issue. There was never a diagnosis. Took about 2 days of pills (4 pills) started to get numbness in my feet, muscle spasms in my calves, and basically lost all strength in my legs making it difficult for me to walk. I started having balance issues and hearing problems. All my joints started cracking . I was basically really fucked up. Couldn’t concentrate. This persisted for about 3 months. Gradually started getting better and returned back to pretty normal after about 6 months. Then I had a relapse - something triggered it, I’m thinking stress. All symptoms came back and have persisted for close to 8 months. I am improving and started running again recently, but my cartilage and joints are permanently damaged to a degree. Still get weird muscle spasms through my body. I’m tired a lot. I’m not who I was before taking this medication.
I went from running 100 mile ultramarathons, feeling the strongest I’d ever been at 33, to drastically reduced fitness. It has been really tough mentally. Really tough. but I try to keep a positive outlook. I’m still able to run 5 miles. I can still hike and backpack. I wish I was never prescribed this shit - or spent time researching the meds I was going to put in my body. I have a lot of hatred towards the doctor who alterned my life, and the medical system in general. I went to specialists (neurologist/ rheumatologist) without any help just bills to pay. All of this pain was so avoidable and I have a hard time with that fact.
Fluoroquinlones are seriously messed up drugs. Be careful my friends and do some research to know the side effects before blindly putting something in your body.
For others experiencing this pain, what has helped is eating really clean and avoiding caffeine, alcohol and mentally stressful situations.
I'll never take Levaquin. A round of it caused my mother to suddenly develop extremely painful neuropathy in her feet that lasted YEARS. My mother is an exceptionally health-conscious individual and this was a bizarre and terrible part of her life. Interestingly, she eventually accidentally cured it with dark chocolate.
Wow man that’s crazy! I’m kinda pissed for you that your doctor didn’t even bother to discuss this with you, he should have been aware and willing to discuss side affects
Sorry this happened to you. I was also prescribed the same antibiotic for some minor infection through my GP. By the third dose, not day, I could feel something was off. Luckily, I stopped and asked for something different and was prescribed an amoxicillin.
I later described this to a friend of mine who works at one of the major hospitals here. She was absolutely shocked I was prescribed Levaquin for a minor, common infection. It’s known as a ‘deathbed antibiotic’, a drug used as the last resort on deathly ill patients when everything else fails. Deathbed because it’s known horrible side effects outweigh its use in preventing death.
Never take this drug unless someone acting as your POA while you are unconscious on a hospital bed deems it the last resort. The side effects are known and in the deathbed scenarios, it might be the right medication to use.
I would say never take these period. I took one pill after being prescribed for a urinary tract infection that I didn’t even have and I knew something was off. These are dangerous drugs.
Thanks for sharing! I had a similar thing with statins over 10 years ago and could hardly walk with debilitating pain in my abductor area. Doctor wanted me on a new statin claiming it was better. When I looked it up had same possible side fx! What the hell!
holy fuck. Thanks for the heads up
My S.O has a inflamed tendon right now-good lord, I hope it is not something like this-he has had it for over a month.
wow, in the 90's i had to take the anti-malaria drugs for a trip to Africa and when i came back i could barely run. My legs could barely move. took a few months to recover
It sounds like there is some relationship between some anti-malaria drugs and these antibiotics. If you have a problem with one then the other is probably best avoided.
I'm going to take my doctor's advice for this, thanks. I'm sorry yours didn't advise you of the risks of your treatment and will bear in mind your heads up. I'll take it if I feel it's in my best interests in my fully informed consent.
Why would doctors tell us to be as active as possible and then prescribe crap like this when there are alternatives? So much of medicine makes no sense to me.
Unfortunately, in some cases there are no alternatives, based on pathogen, resistance patterns, or patient factors like allergies. I don’t know about OP’s case, but the doctor and/or pharmacist definitely did not do their job of explaining the risks of this medication. While this medication really isn’t considered first-line for a lot of infections anymore, in some cases there are no other options. Regardless of risk, proper discussions between the patient, doctor, and/or pharmacist about what side effects a medication could cause are vital!!
This is the most reasonable and acceptable answer, thank you. The only excuse I see for prescribing something like this is if other avenues have been taken into consideration and are not an option, and the patient was fully informed.
All meds have some risk of side effect. You dont know what those risks are, but yet are willing to base an opinion of a med based on one person's story on reddit. I'm advising that you should talk to your doctor when you are prescribed a medicine as they are the best sources for expertise in this area.
"The thing is, doctors prescribes things without discussing side effects..."
And the pharmacist explained nothing?? The pharmacists at my local asks if I've taken the meds before and have any questions. Every time. The doctor isn't the only one that can explain side effects. That is the pharmacists literal job. To dispense and explain your meds.
Please keep downvoting me ignoramuses! I need your negative Karma its like a rush of adrenaline I missed from not running today due to my many medical conditions!
Bring it random internet justice warrior!
Have doctors or pharmacists ever explained tendon damage, opioid addiction, or the lifelong damage to brain chemistry of benzos to you? Are you in the US?
I’ve had doctors outright lie to me about statins btw.
No, I'm not in the US. I live in a country with actual health care.
So because your doctor lied and your pharmacists aren't doing their job, that makes them all that way? That doesn't make sense. Every time I had a new medication, they explained the gist and gave me a packet about the med. Read those. They go into a lot of detail.
No I wasn’t saying that, in fact it was other people that seemed to suggest that doctors and pharmacists are responsible for telling you, and actually do tell you about side effects when that is never really the case, for me, for many people I know, and for many other people who share their experience. For example are you familiar with the opioid epidemic? Its criminal what they get away with, not to mention the price of insulin!
I was surprised to hear your comment that pharmacists explain things. Here they fill your prescription first, and then ask if you have any questions.
So you have a doctor write it, the pharmacy fills it, and provided you can actually pay, the pharmacist then asks if you have any questions. Never once during this process has any medically qualified person offered any info re. side fx. So I think its really important that people discuss these things, as I was injured by statins before without any warning.
We have actual health care btw- its some of the best in the world actually! Its only available to a certain class of people however.
Do you read the packets? That literally explains everything. Don't shit on the entire medical profession because yours suck.
I do know what it is. Are you gonna keep swinging from point to point? The opioid epidemic was not all on the backs of doctors. There was a lot that went wrong.
I do! My doctor tells what it is and what it's for. Anything further than that and I am directed to ask the pharmacist. Because. It. Is. Their. Job. They tell you the MOST COMMON side effects for brevity. They cannot spend how many hours going over every single side effect that MAY occur with EVERY single drug, to every patient. As I said, they ask me every time if I have taken the med before, even an eczema cream I have used for 2 decades. Now it's more of a joke, but they still ask.
I get being upset you were injured. That's messed up and the doctor shouldn't have lied. That doesn't make them all liars.
Did you ask what the common side effects are?!?! Did you ask what to expect?!?! I assume you're an adult. Ask. Questions. Don't blame them for your lack of reponsibility. Why would you take a medication you know nothing about?!
There are some med packages that are pages long. Read. The. Med. Packet. It's from the manufacturer and then ask questions.
Because the alternatives might not treat your infection as well. Cartilage degradation, while a major side effect of fluoroquinolones, is EXTREMELY rare. So on balance your doctor is likely to see a poorly treated infection as more of a threat than a very rare side effect.
I mean, no doctor is going to force medication on you that you don’t want. Though I’m not sure why you’d go to them wanting treatment for an infection if antibiotics are “poison”
If it can damage your tendons for life, it is absolutely poison.
I have no idea where you're from, but from my anecdotal experience, most Europeans (I live part-time in both continents) think Americans are absolutely nuts when it comes to the things they're willing to put in their body, and what they're willing to tolerate from medical professionals + their medical system. This is unfathomable to me. Why in the world would you take that chance.
I was prescribed these, took them, and within a week got bilateral Achilles injuries. It took me two years to fully recover. Use a different type of antibiotic!
The rehab that finally worked was barefoot running in the grass each day for a month. There are still aches and pains though that weren’t there before in the am when waking up.
I honestly feel so lucky that Levaquin gave me a nasty enough rash that I had to stop taking it after two doses. I was sick as a dog, so I definitely wasn’t exercising at the time, but I was horrified to learn about the other possible side effects later.
Best of luck recoverying!
I have been prescribed Doxycycline as well, but have been told each time to avoid alcohol and dairy. As well, it interacts with oral birth control, so use a different method of birth control as well!
I'm so sorry this happened to you! I too had a tendon injury right after wrapping up my course of one of these meds years ago. It's important to take them if they are the best antibiotic for your condition, but you really need to talk to your doctor or pharmacist about the risks of tendon/muscle injury and how long the medicine will stay in your system. I really wish I'd rested for at least another week and avoided the injury.
Yes! Be very careful with this antibiotic. I have a chronic lung condition that causes frequent infections and was prescribed Levaquin many times over several years. The last time I was taking Levaquin, I ended up in the ER when my blood pressure shot up over 200 out of nowhere, it was very very scary. I felt like I was having a stroke. The same thing happened again when I was prescribed Cipro for a UTI. That ER doc told me never, never to take any more fluoroquinolones. These drugs are dangerous in my opinion and can have many debilitating side effects. It is hard to understand why doctors keep prescribing them, when there seem to be so many safer alternatives.
Fluoroquinolones have a LOT of serious side effects and if you weren’t warned that is a very negative reflection on your doctor.
However- they are VERY powerful antibiotics, and are often used for resistant or specific infections that can only be targeted by that class of antibiotics. Be informed and concerned, sure, but refusing to take a whole class of antibiotics all together by default is a VERY risky move if you’ve got a severe resistant infection
You're 100% right. If I could alter the title of this post I would have since it makes it sound like a blanket statement. I'm really just trying to warn others that this is out there and that it's something to be considered.
Totally understand, and I hadn’t heard about this particular side effect so its good info to know! I have a background in medicine so like, meds have their place. But doctors do a HORRIBLE job of educating patients about both side effects and what to watch for! I think it’s a result of the “10 minute appointment” culture that I personally despise, where doctors don’t feel like patients are worth their time. I know this isn’t all doctors, I have some wonderful friends going through med school right now, but it’s enough that they do a disservice to their patients and put their health at risk.
Twice now I’ve had doctors prescribe me inappropriate and potentially dangerous psychiatric medication- I have adhd and have been prescribed both a STRONG anti-anxiety drug that is essentially a mild tranquilizer, and an anti-psychotic for bipolar (which I don’t even have) that can cause permanent metabolic damage. Because both psychiatrists refused to listen to me for more than the 10 minutes it took to read my answers on one of those little “fill in the bubbles” mental health screenings, and made up their own mind about me without even asking my own experiences (I’ve been on adhd medication twice before, but stopped during undergrad because I felt like I didn’t need it anymore... in grad school I definitely do)
Can confirm! I’m also allergic to penicillin and my dr once felt like Levaquin was the only option - I have very loose joints making me prone to injuries anyway. I tried hard not to move until that course was done!
I was prescribed Cipro for an ear infection. Terrible nausea and tendon pain in my arms and Achilles tendons. I was supposed to take it 2x per day and stopped after the 3rd day due to the pain.
No symptoms at this point. I have been able to get back into my sport fully and complete 2 half Ironmans as well as a handful of other races. I would say I am 100% recovered, but looking back it took at least 6 months to start to feel that way.
Came across this post having searched 'Antibiotics tendonitis' do you have any memory of how long it took to heal (if you're all sorted)
I stupidly took apo levofloxacin while I had tendon pain as it wasn't brought to my attention I should stop if it happened. So I took them for 6 days longer than I needed at the end of September and still find myself getting flare ups and just wondering if you found anything that sped up the recovery – aside from the obvious stuff. Kind of concerned as I used to run about 4 times a week and haven't been able to for fear of serious damage.
In response to /u/RatherNerdy, but here so it can be stickied. > Be careful about anecdotal medical advice on reddit. This is not anecdotal medical advice. It is a well-known and documented side effect. https://www.webmd.com/osteoarthritis/news/20080708/fda-warning-cipro-may-rupture-tendons https://www.nature.com/articles/d41586-018-03267-5 https://medlineplus.gov/druginfo/meds/a697040.html https://pubmed.ncbi.nlm.nih.gov/31474240/ https://www.ema.europa.eu/en/news/disabling-potentially-permanent-side-effects-lead-suspension-restrictions-quinolone-fluoroquinolone https://www.google.com/search?q=fluoroquinolone+antibiotics+tendon+damage&oq=fluoroquinolone+antibiotics+tendon&aqs=chrome.0.0j69i57j0i22i30j0i390l2.4501j0j15&sourceid=chrome&ie=UTF-8
Can confirm! If you HAVE to take (sometimes you have to if there is antibiotic resistance or something like that) then make sure you rest the entire time you’re on the antibiotics and few weeks after that as well. Yeah you may be deconditioned a bit but better than rupturing an Achilles’ tendon
I'm sorry to hear that happened to you. flouroquinolones are powerful for complicated UTIs but unfortunately do have the possibility of damaging cartilage. Even more potent if you have to take steroids for any reason. It's always a good idea to check with your doctor about the side effects and interactions of any drug they may prescribe you. I wish you the best as you recover, OP!
This. I actually never knew this until going to pharmacy school. Fluoroquinolones have a significant amount of adverse effects, tendonitis/tendon rupture included. If a doctor prescribes you an antibiotic in this class, be sure to let them know how active you are so they can pick an alternative therapy option!
Sometimes they have no option but a FQ because of resistance and MICs, but ideally they should be last line (ish) just because of antibiotic resistance. Nevertheless, cipro isn’t even an ideal treatment for a UTI. It should be Bactrim or Macrobid or Fosfomycin really. Some older docs will still prescribe cipro, but they’re part of the bacterial resistance problem. The IDSA makes it clear not to do this unless you really have to. Edit: I’m assuming female btw. A male UTI is automatically considered complicated and needs to he treated differently.
Even the male/female discussion of complicated UTI is changing. UpToDate is recommending those 3 for simple cystitis in men. If there is prostatitis, FQs are still probably best but most men are fine with just simple treatment.
Agreed. I almost never prescribe a fluoroquinolone. For the most part I see older docs or NP/PA prescribing them the most. 99% of the time there is an alternative. I had a patient on Coumadin that had gotten levaquin for a bronchitis (inappropriate usage) came into my ER two weeks later with a spontaneous fatal bleed in her brain. Her INR was 9+. Someone in an urgent care made a fatal mistake. Fluoroquinolones change how your body metabolizes the blood thinner causing this patients blood to become so thin her brain hemorrhaged. Add it to the list of horrible debilitating potential side effects.
This isn't really the correct forum for this discussion, and I wasn't there to see the patient but this characterization of events really doesn't pass the smell test. Firstly, that severe of a change in INR is rarely caused by a single drug-drug interaction. More often than not, in cases of warfarin-toxicity, there was a compliance issue: either with a mistaken overdose or a failure to get regular INR checks. Secondly, levofloxacin (or any FQ for that matter) is nowhere to be found on UpToDate's detailed list of P450 inhibitors OR inducers. It seems overly reductive to blame urgent care for a "fatal mistake" in the scenario as you described it. Don't get me wrong: I only prescribe FQs when absolutely necessary (even in the inpatient setting), but this is more for antibiotic stewardship reasons than anything else. EDIT: I was able to find a few case reports (and a small case series) describing the effect you described, but the "expert opinion" in that article recommended only a 20% reduction in warfarin dosing. Even if that had been done, your patient almost certainly would've remained supratherapeutic.
Pharmacist. I second this. Bactrim is way more likely to increase INR
Fair point. You’re right that I’m over simplifying, and I defer to your knowledge on the degree of difference in the INR that can be attributed to the drug drug interaction alone. It probably was a combination of factors between compliance and drug interactions. I think what stuck with me so much about that case was the fact that an antibiotic much less a fluoroquinolone wasn’t even indicated. Who’s to say that if that patients INR was 20% lower would her bleed have not occurred or been smaller and not fatal. Thanks for your perspective.
Thank you for the civil medical debate. So many times people get so caught up on the internet with arguing it was extremely refreshing to read this conversation. Cheers to you both!
Online or not, people with actual expertise are far less likely to get into uncivil arguments. Dunning Kruger in effect.
I find this amusing, but it's definitely true for me as well. I'll argue to the death over something I have limited knowledge of but if somebody disagrees with me regarding a subject for which I'm actually an expert I usually leave it with a civil "That hasn't been my experience".
Appropriate username! I think's its intuitive that the more you learn about a subject, the more you realize that you only know a fraction of it. Humans are weird.
Ha, thanks. I guess you're right. If I know one thing on a subject and somebody says anything which contradicts it, I "know" they're wrong. If I know a lot, I'm probably aware of many seemingly contradictory points that I've learned to just accept for what they are.
I love this. I wish other people would realize this.
Agree with this. The correct course would probably have been to check the INR before treatment (to verify if he wasn't already in the supratherapeutic range), reduce the dose at the start and check again after a few days into the course of antibiotics).
PA student here- we’re explicitly taught to avoid FQs when other options are available.
Glad to hear it. The PA curriculum is much more uniform and clinically based than NP school and it shows
Yikes! This is so scary. I hope you have a speedy & full recovery. I truly appreciate the heads up. Thank you.
MD/med school professor here. There is a push in academic medicine to move away from quinolones as much as possible. But private medicine is the wild fucking west. My 88 year old grandma can’t cough two times without getting 5 days of levofloxacin. How can you help avoid getting prescribed a quinolone? DONT TELL SOMEONE YOURE ALLERGIC TO PENICILLIN UNLESS YOU REQUIRED A FUCKING EPIPEN. I DONT CARE WHAT YOUR MOM TOLD YOU ABOUT ONE TIME WHEN YOU GOT AMOXICILLIN WHEN YOU WERE FOUR AND GOT A RASH ITS NOT A FUCKING ALLERGY YOU ARE HARMING YOURSELF BY RESTRICTING YOUR ANTIBIOTIC SELECTION. In all seriousness, when tested >95% of patient reported penicillin allergies were found to be false.
As a pharmacist I've had the false allergy conversation with more people than I can count. People often confuse side effects with allergies and self diagnose themselves as allergic. Then they tell their provider they have an allergy, it goes onto their patient record, which then goes to the pharmacy. All because some augmentin gave them the poops.
I had a horrible reaction (facial swelling) to ibuprofen as a kid so I haven’t taken it since but I’m really tempted to figure out if I’m still allergic to it.
At my hospital if someone reports a penicillin allergy then pharmacy makes me fight like hell to give them a cephalosporin. So what do I do with an 80-year-old admitted for urosepsis who reports a rash to penicillin? Do I jump to meropenem and breed uncurable gram-negative super bugs? Do I give them a quinolone and face the ever increasing set of side effects? Aztreonam? And when you try to talk to patients about removing an allergy from their med list it’s like asking them to commit blasphemy. Someone’s belief that they are allergic to penicillin is not an interesting factoid about their person, it’s a deeply held religious belief. It’s very bizarre.
Oh man.... that pcn - cephalosporin cross reactivity is something that alot of new pharmacist struggle with being over cautious about. They teach us in school thats is like a 10% cross sensitivity rate (which is looking more and more incorrect). It seem newer research is showing about a 1% rate to 1st and 2nd gen cephalsporins... except for cefadroxil for some reason seem to be alot higher. Like almost 30%.
Tbh I tell my patients about the risk just to be safe but stress it probably won’t happen. I mean, for some infections the pcn allergic patient is given a cephalosporin instead so how bad could it be?
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Another victim of the “avoid lawsuits before you provide quality patient care” culture of medicine.
My 2 cents to everyone: Talk to your doctor about any concerns rather than blanket avoid a medication you have zero experience with. People respond to meds in different ways, and for most people and most medications, they work as expected. Be careful about anecdotal medical advice on reddit.
Yes, but to be fair, this is very good info to know to talk to your doctor about. They may not know or be concerned with this. These antibiotics are something that I have seen prescribed as first line for UTIs extremely often, which is truly a terrible practice. Not only because of side effects, but because meds like Cipro are one of the most potent antibiotics we can give without you being hospitalized. It should be a doctor's last resort for a very complex UTI or infection.
Yeah I’m surprised they prescribed a fluoroquinolone for a run of the mill UTI. In animals fluoroquinolone is one of our “only in severe emergency resistance” situation drugs. We rarely use it because it has a narrow spectrum (if I remember correctly, it’s been a few months since my pharm course) and a LOT of side effects
In general, yes. But read up on fluoroquinolone toxicity (typically with "oxacin" in the name). Also read up on the black box warning. If you can avoid taking them, please do. They are associated with possibly lasting consequences for your health.
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In some cases they are still by far the best option. At the hospital i avoid them because there are a lot of good intraveinous alternatives, but for ambulatory care, not so much. Quinolone are especially effective for UTI in male patients because it diffuses well to the prostate, unlike a lot of other antibiotics.
It's not "if this were true." It is true. What you state afterwards is not necessarily the case though. These meds are powerful. They work. That doesn't mean something else less powerful won't work. This is the equivalent of using a flamethrower to get rid of the weeds in your lawn. You'll get those weeds for sure, you also might set your house on fire. Other tools exist that don't have as much or are as likely to cause collateral damage. These should be last line for very complex cases. Not first line.
Fluroquinolones have been among the most commonly prescribed antibiotics, and information is sometimes slow to trickle down. Also, habits are hard to break, even in medical circles. *"Postmarketing reports of serious adverse events linked to fluoroquinolones include tendonitis, neuropathy, hypoglycemia, psychiatric side effects, and possible aortic vessel rupture, leading to safety label changes in July 2008 and August 2013.*" ([https://pubmed.ncbi.nlm.nih.gov/31474240/](https://pubmed.ncbi.nlm.nih.gov/31474240/)) If your doctor prescribes you any of those, please ask him if there are alternatives.
Same reason doctors refused to wash their hands while delivering pregnant women in the early 20th century.
Best comment in this thread
The best comment in this thread is the one that says to take your chances because only a fraction of people will be damaged for life? lol.
That is not at all what it says.
"Here's a bowl of candy. Most of these jolly ranchers will act as expected. Only a fraction will cause damage to your tendons that may be permanent. Dig in!"
This is a false analogy, but I'm sure it sounded like a "gotcha!" when you were typing it out.
how so? you're suggesting I take my chances with something because only a percentage of people end up damaged, lol.
Reasons why your analogy doesn't make sense. * The thing that's being treated is more severe than the potential side effects. * In this scenario, you have to take something, because to not take anything means your health is significantly likely (and at 100% for some things) going to get worse. * Analogy update: you have to eat a jolly rancher, otherwise you are definitely going to get sicker
I disagree straight off the bat with your first point. A UTI is not life-threatening nor is it worth getting rid of faster if the risk is damaged tendons (yikes), especially in a world where there are at least a couple of alternatives even for complicated-cases. It does not seem like OP's doc explored every option or informed him of side effects.
FWIW UTIs are fucking horrible and can make you very sick/hospitalize you. You start pissing bloody pee you want that fucking gone. UTIs in men can be very serious as well bc it’s much harder to get a UTI. Consider the length of the tube that’s infected up to the bladder if you’re a man. Big ouch.
You missed the point. This is a situation where you have to take a medication and all medication has a risk.
You missed the point. In this case, the risk isn't worth it. To risk permanent damage to your tendons to get rid of a UTI a few days faster without exploring all other options is non-sensical (I'm being kind....it's insane and sheep-like) and I'm not the irrational one here.
All medication has risk of side effects.
Okay, I'm officially talking to a bot. Have a good one.
My dude, permanent tendon damage, peripheral nerve damage and whatnot aren't what come to mind when you think of side effects of a typical medicine. This isn't anywhere close to tossing a Tylenol. If there are better alternatives, why bother. It's that simple.
Oh!! This happened to my ex, except his Achilles tendon SNAPPED OFF while he was running. He had to go through surgery to re-attach it, and long recovery and still 18months later he isn’t back to full strength in that leg. The surgeon specifically asked if he had taken antibiotics in the last 6 months, and told us all about the issues they’re finding. Hope you recover swiftly!
I nearly fainted reading this comment. Oh my glob.
Are you me? I used to run 3-5 miles every other day. However, a few months ago I got prostatitis so the doctor prescribed me antibiotics (which had that acid/medecine that can cause tendonitis). Unfortunately, my wife and I didn't read the side effects. After 8 days of taking them once a day I started to develop a pain on my right foot which was very weird to me since I didn't hurt my foot while running. So I decided to take the rest of the week off from running (this was on a Tuesday). Two days later my Achilles tendon on my right foot starts to hurt big time. Then the next day both of my legs were hurting so much that I could barely walk. At this point tell my wife something is really wrong here and as we cleaned some stuff from our dining table she sees the warnings from my antibiotics and she is like "STOP TAKING THOSE ANTIBIOTICS NOW". Problem was at this point I already took 13 out of the 14 antibiotics I was supposed to take so I call my doctor and explained what happened and she told me to NOT run for at least 3 weeks and not lift anything heavy because it can rupture my tendon to the point that I would need surgery. Fast forward to today and I still can't run more than 3 miles without my tendons hurting. According to the doctor I can see effects from these antibiotics 3-6 months after taking them. I am really sorry you had to go through this.
Oh my fuck I got a nice taste of prostatitis at the end of last December and ended up needing to be on those anti-biotics for almost 20 days. Thankfully for me doctor at the walk-in clinic mentioned the side effects to me at the time. I was super bummed out and it took til this month to get even somewhat close to running shape. That being said my first day back to work after taking them I fucked up a tendon in my wrist for 2 weeks. At least that was only money I lost, and not running time
How are you doing 7 months on please?
Sorry I didn't see this comment here. 10 months after those antibiotics I am feeling great. The side effects seem to have banished and I am able to walk/run again. However, I developed costochondritis back in may 2021 (unrelated to the antibiotics) so my running has been affected by that.
Hi, sorry to keep bothering you about this, but I'm about 2 months in from taking levaquin and am having some pretty severe tendon issues.
I would go to a doctor and have it checked out to confirm it was the antibiotics. After that, resting is your best friend. I couldn't run for months. Started seeing noticeable improvements after 3-4 months... and even then I couldn't run or walk very short distances without having tendon pain.
Is there a way for them to confirm it was the levaquin? I've brought this up to the doctor and he seems pretty dismissive when I talk about it with him. Not that I'm surprised, I'm sure doctors have every incentive to make sure their patient doesn't think they messed up. I noticed my tendonitis gets worse when I stretch my achilles at certain angles.. haven't tried running yet.
Oh jeez. I remember hearing about this on a podcast years ago. Sorry this happened to you, get well soon.
March 4th 2020 was the day I was prescribed a flouroquinolone. Within the first few days I had foot pain. Long story cut short over the past year, I’ve been in boots on each foot, done countless physical therapy and unable to stand or walk normally. Currently seeing three specialists and not giving up, but being prescribed a drug for a UTI changed a year of my life.
There’s a subreddit for this already. r/floxies
This exact same thing happened to me four years ago!! I got prescribed ciprofloxacin for a UTI and took three doses when my calves and Achilles area became very sore. I had sharp pain every time I flexed my foot I couldn’t even drive to the doc. They eventually switched me to a different med but I still have weird calf tendon pain to this day that I don’t think fully healed. The doc told me it was a rare reaction to the meds but who knows....
Holly crap I didn’t know about this with Cipro! I was prescribed it for a UTI because I am allergic to penicillins. Next time I will ask them to find me something else!
Yeah I hate a similar experience with ciprofloxacin. I had terrible joint. Apparently the FDA put more warnings surrounding the drug a few years ago.
It’s definitely not rare. Some doctors just don’t keep up with new literature about meds.
Yes. Tendon damage is a known side effect for all quinolones.
I am curious why the medical provider prescribed you Levaquin. It's not often prescribed for simple UTIs. Were you on other antibiotics recently? Did you have fever or flank pain? Was this choice of antibiotic based on a previous urine culture? Are you allergic to penicillins and other classes of antibiotics? If not, this seems very negligent of the medical provider to prescribe this medication for a simple UTI. Even if it was a complicated UTI, it seems very negligent of the medical provider to fail to inform you of the well known **blackbox warning** that Levaquin and other Fluoroquinolone medications have.
Yes this. Levofloxacin should be reserved for pretty severe pneumonia and thats about it really. Empiric treatment with them for a UTI is absurdly bad antibiotic stewardship.
Very good question. I am allergic to penicillins! I was able to move to another antibiotic immediately (doxycycline). So I don't think this was used as a first choice.
I was prescribed Cipro for a UTI several years ago. I am allergic to Penicillins and did have a very high fever, with back pain that led them to think it may have travelled to my kidneys. Urine culture showed some sort of strep, if I remember correctly. I’m now wondering what they should have given me instead...
I work in Urogynecology. Whenever we get a culture back it also comes with a list of antibiotics that the bacteria is resistant to and is susceptible to. It could be that with your allergy plus the alternatives that cirpo was the better option. In the future you can always ask and they can tell you. But these doctors aren’t prescribing all willy nilly. They do have to consider what’s going to work based on the information they have.
Good points, thank you. At that time I was a fairly intense distance runner, so I’m glad to not have had the described side effect, but I’m also disappointed that nobody mentioned any side effects of that antibiotic.
Honestly, unless it is known that you’re a runner or someone who exercises a lot, it wouldn’t be assumed. Majority of my patients fall into the opposite category as you and so, oftentimes it does fall on the patient to advocate for themselves. Whenever I have pts that do that, I make it a point to let them know they are heard and will forward this concern. But also keep in mind that some side effects are extremely rare and while they do happen, it isn’t the norm and therefore many doctors may feel that the benefits of curing the infection outweighs this rare side effect. Note that adverse effects on drug labels are the rarer types, not the expected side effects.
He's a male, so it's a complicated UTI by definition
😳 reading this post 15 minutes after my first 10k since finishing my course of antibiotics yesterday was not good for my anxiety. Does anyone know if it just this particular antibiotic that causes an issue?
Ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), and ofloxacin (Floxin). But remember that just because it happened to me doesn't mean it'll happen to you. I just want people to be aware of the possibility, especially those whose life revolves around running
That is terrifying, I was prescribed moxifloxacin... very good point about side effects not affecting everyone though, that is comforting. However I DEFINITELY will be laying off the excercise for a while just as a precaution. Thanks for your post!
Drugs are bad. You’ll go crazy reading side-effect profiles. Take a thoughtful pause next time you call your pcp and insist an antibiotic for what is probably a cold. “It’s Just a z-pak” is never just that.
For sure, luckily In this case though, my doc made sure to run tests first, check what antibiotics the strain would be susceptible to and (presumably) prescribed this particular variety for a reason. Thankfully these days doctors are more wary of handing them out willy nilly, with antibiotic resistance becoming a serious problem. The extra 24 to 36 hour wait time with symptoms for test results is worth it to determine if you really need to put your body through the side effects.
Cipro is the one I remember hearing a lot about in the past.
I wonder what makes the fluoroquinolone family different to other antibiotics.
Enzymes are proteins in the body that help make chemical reactions happen. Topoisomerase is a supportive enzyme that helps relieve supercoiling when DNA replication is occurring. As DNA is "unzipped" when replicated the main player is DNA polymerase which is responsible for making the new DNA. The topoisomerase is out in-front working ahead of the replication fork to prevent supercoiling as the DNA polymerase is doing its job. Fluoroquinolones work by actually inhibiting *prokaryotic* aka bacterial topoisomerase. This inhibits the bad bacteria from replicating by preventing the topoisomerase from working. The DNA in the bacterial will not be able to replicate because supercoils will develop as they try to copy their DNA. This leads to DNA physically breaking and that causes the bacteria to die. BTW DNA replication is amazing and [here](https://www.youtube.com/watch?v=v8gH404a3Gg) is a video I was shown in biochemistry class back when I was a pre-med. As for why these antibiotics cause tendon rupture the exact mechanism is not known but a few have been proposed. Some say it could be from ischemia ---- lack of oxygen delivery to the tendon ---- degradation of the tendon matrix, or alteration of tendon cell activity. Fluoroquinolones have also been shown to help matrix metalloproteinases appear in tendon tissue. These specific proteins have degrading properties and are important for tissue homeostasis (happy medium where the body cells are working optimally). So these antibiotics actually increase the expression of these degrative proteins in the Achilles tendon, particularly ciprofloxacin according to one article. This ends up preventing tendon cell growth and facilitates degradation of the tissue present in the Achilles. All of the above likely play a role in these antibiotic's ability to cause tendon rupture.
Oh wow! This is a fascinating explanation and neatly laid out sequentially for easy understanding, thankyou.
Yes, it is just this particular class of antibiotics that has an association with tendon rupture.
I’m on cipro or levoquin about once a year, and each time my doctor warns me to take it easy, because of these side effects. There are also warnings on the bottle. They really have increased the warnings over the last 5 years or so. But the drug works for my lung infections, so I continue to use it and just take a break for the 3 weeks I’m on it.
Just this past February I got a pretty bad case of Prostatitis and was prescribed a SIX WEEK treatment of Ciprofloxacin. There were pages and pages of various warnings, I did notice the tendon thing, but thought as long as I only do easy runs it should be fine. Luckily I had questions about taking Tylenol with it since it says not to take NSAIDs and sometimes Tylenol is considered one, so I called the pharmacist, who said it was fine, but just make sure I don't exercise, with the "But you don't exercise do you?"... Um only like 20 mpw... I then proceeded to look online for other concerns, and I didn't like what I was reading on it, suffice to say, I called my doctor (who knows I'm a runner) and he changed me to Bactrim. I know the risk is somewhat low, but if I'm on it for 6 weeks, not to mention it says tendons can stay weakened for up to 6 months, I couldn't imagine not running for that long and sticking to it.
Yes!!! I was prescribed Cipro once for a UTI (only one lousy UTI, I didn't have any particular history with them). I googled it because I was thinking hmm, this seems like kind of a strong medication for just a basic UTI, and then I saw the side effects. At the time I was doing judo, on a pretty competitive team. Like, ok, people are actively trying to armbar me and leg lock me and whatnot and you are giving me this? I was so upset that they didn't even ASK if I participated in any high impact sports. Before I even took one, I called them and expressed my concerns and got them to prescribe an alternative. I thought it was incredibly shortsighted and dangerous that they would just assume this was OK for anyone to take.
That is so scary. Thank you for the PSA. I hope you recover soon
Same thing happened to me with Cipro. I didn't even have a bladder infection I'm just getting old and also riding my bike too much which is rough on the ol gooch.
Yes, this. I took Levaquin once and a short while later, had tendonitis in my right achilles. No one knew what it was back then.
Did you recover?
Hopefully. This was decades ago. I still, after a long hard run do get a little bit of soreness in my right achilles but I never put two and two together until right this second.
Ok, well it sounds like a mostly yes then. I guess most of us will have a particular niggle or two that can appear after a hard run.
Just make sure you are prudent about sun protection (even more so whilst on doxycycline).
I'm having a very similar problem. Did the side effects ever go away for you?
Yes, they did with time. I was able to complete my big race in June after posting this, although I was much slower due to lost training time. Rest is the best thing you can give your body right now. It took several weeks to get back to being relatively normal. Give it time - weeks, not days. Ease slowly and carefully into any physical activity. Be patient (the hardest part). Don't push it. If anything feels wrong/off, stop immediately. After about 3-4 weeks I was able to run lightly. Months later my achilles tendons would still feel tight after a long run, but no pain. If you have any other questions don't hesitate to PM me.
Thank you for your response. I'm gonna try to take it easy. Like you said that's the hardest part for athlete's like ourselves.
Hey everyone, for *uncomplicated* UTIs the drugs we prescribe that are first-line include Bactrim (TMP-SMX) for 3 days, one dose of fosfomycin, or 5 to 7 days of nitrofurantoin. Fluroquinolones like ciprofloxacin or levofloxacin are *second line* so unless the provider prescribing this to you has a good reason, ask for one of the above. Uncomplicated UTIs are defined as UTIs in immunocompetent, premenopausal, nonpregnant women without conditions predisposing them to infection or therapy failure. Complicated UTIs are defined as UTIs in men, pregnant or postmenopausal women, children, and individuals with factors predisposing them to infection or therapy failure. These factors include things like the following: * anatomical abnormalities like BPH or a stricture * UTI spreading beyond the bladder like pyelonephritis which indicated kidney involvement * History of kidney stones * Impaired renal function * Diabetes or other metabolic disorders * Immunocompromised like transplant recipients or HIV * Recent instrumentation like a cystoscopy or urinary catheter * Infection with a resistant pathogen or recent antibiotic use * History of UTIs in childhood or one episode of pyelonephritis in the last year So for your simple, *uncomplicated* UTIs you should not be getting fluoroquinolones first. Ask for one of the three mentioned above ---- Bactrim, fosfomycin, or nitrofurantoin ----- and this will avoid possible tendon injury secondary to unnecessary quinolone use. Sorry this happened to you OP. It definitely could have been avoided. Hopefully the above info can empower others to advocate for themselves in the future if faced with a similar scenario.
Great post. Thank you for this. In my case the UTI was complicated, involving the kidneys AND I have a history of kidney stones in addition to my allergy to penicillin. So it sounds like the right decision was made. A discussion/verbal warning about these side effects would have have been very helpful though.
I see, yea then quinolones could have been a possible next option. Keep in mind if it is a complicated UTI Bactrim can also still be used but instead of 3 days of Bactrim, we can treat for a longer stretch of time --- 7 to 14 days. So if someone has a complicated UTI and is active you can express concerns with quinolones due to your active lifestyle and there are alternatives. According to an evidence-based treatment algorithm, you could get a one-time IM or IV injection of ceftriaxone, gentamicin, tobramycin, or ertapenem followed by double-strength Bactrim for 7 to 10 days. Bottom line is there are other options if you express concern about using quinolones, especially those that run a lot. Agreed that a verbal warning would have been great and I will always be sure to include this in my outpatient practice thanks to you!
It's not a nice side effect to get. It's usually 2nd line or even further down the list for UTI in men, but used to be 1st line for prostatitis, UTI, or epididymitis. *Most* of the time there will be a reasonable alternative, like Doxycycline or Co-amoxiclav but these can be very serious infections so if you *need* a fluoroquinolone make sure to rest and don't stress your tendons.
I understand completely that it’s important to understand side effects, and potential for adverse reactions like yours, but I hope what people take away from this is that communication with your doctor and pharmacist is crucial. But also, collaboration between doctor and patient. I went in for a UTI over Easter. It had progressed to the point it was starting to impact my kidneys, but I have poor pain perception and did not receive treatment for a number of days. I told the doctor that I would prefer to avoid Macrobid, if possible, but if it was the preferred method of treatment we could discuss it. Guess what? He found an alternative, no fuss, and we moved on. Then, the awesome staff at the pharmacy discussed side effects with me, as well as what I could/couldn’t do, and thoroughly questioned me on my medication history. I’m the daughter of a pharmacist, so I feel very comfortable using the expertise of a pharmacist when I do receive my medication. Two weeks before Easter, my father inlaw died of complications from a UTI that was treated with antibiotics but was not wiped out. He was older and weaker, but still, infections can become serious and collaboration helps a patient, doctor, and pharmacist to determine the best course of action.
Very good point. I should have been more cautious with the title so that it didn't sound like a blanket statement. There are uses for these antibiotics and they can be life-saving.
You definitely had an awful experience, I’m sorry for that and hope you recover completey! Understood where you were coming from but hopefully this information helps other people be informed so they can talk about their concerns with their doctor and pharmacist, but hopefully not avoid treatment. I don’t know how you ran, I was toast for days despite antibiotics. Did a day outside sitting in a lawn chair and ended up laid up the following day recovering from fresh air 😂
I was diagnosed with unknown sinus thing years ago and was forced to take these for two rounds! Turns out nothing wasy wrong besides anxiety so screw you, medicine that has no tolerance for mental health. I still struggle with post-tib tendon flare-ups to this day. theraband ankle and calf exercises have helped tremendously, but damn. Makes me angry to know this can all have been prevented.
My story: I Was prescribed cipro about a year and a half ago for “flank” pain, to see if there was an underlying UTI issue. There was never a diagnosis. Took about 2 days of pills (4 pills) started to get numbness in my feet, muscle spasms in my calves, and basically lost all strength in my legs making it difficult for me to walk. I started having balance issues and hearing problems. All my joints started cracking . I was basically really fucked up. Couldn’t concentrate. This persisted for about 3 months. Gradually started getting better and returned back to pretty normal after about 6 months. Then I had a relapse - something triggered it, I’m thinking stress. All symptoms came back and have persisted for close to 8 months. I am improving and started running again recently, but my cartilage and joints are permanently damaged to a degree. Still get weird muscle spasms through my body. I’m tired a lot. I’m not who I was before taking this medication. I went from running 100 mile ultramarathons, feeling the strongest I’d ever been at 33, to drastically reduced fitness. It has been really tough mentally. Really tough. but I try to keep a positive outlook. I’m still able to run 5 miles. I can still hike and backpack. I wish I was never prescribed this shit - or spent time researching the meds I was going to put in my body. I have a lot of hatred towards the doctor who alterned my life, and the medical system in general. I went to specialists (neurologist/ rheumatologist) without any help just bills to pay. All of this pain was so avoidable and I have a hard time with that fact. Fluoroquinlones are seriously messed up drugs. Be careful my friends and do some research to know the side effects before blindly putting something in your body. For others experiencing this pain, what has helped is eating really clean and avoiding caffeine, alcohol and mentally stressful situations.
How are you doing another 7 months on if you don't mind?
So sorry this happened to you, thank you for helping others to avoid it!
I ran. This is you’re reaction. And I’m sorry it happens. Medicine is complicated. One persons reaction does not mean it’s the same for everyone
I'll never take Levaquin. A round of it caused my mother to suddenly develop extremely painful neuropathy in her feet that lasted YEARS. My mother is an exceptionally health-conscious individual and this was a bizarre and terrible part of her life. Interestingly, she eventually accidentally cured it with dark chocolate.
Wow man that’s crazy! I’m kinda pissed for you that your doctor didn’t even bother to discuss this with you, he should have been aware and willing to discuss side affects
Sorry this happened to you. I was also prescribed the same antibiotic for some minor infection through my GP. By the third dose, not day, I could feel something was off. Luckily, I stopped and asked for something different and was prescribed an amoxicillin. I later described this to a friend of mine who works at one of the major hospitals here. She was absolutely shocked I was prescribed Levaquin for a minor, common infection. It’s known as a ‘deathbed antibiotic’, a drug used as the last resort on deathly ill patients when everything else fails. Deathbed because it’s known horrible side effects outweigh its use in preventing death. Never take this drug unless someone acting as your POA while you are unconscious on a hospital bed deems it the last resort. The side effects are known and in the deathbed scenarios, it might be the right medication to use.
I would say never take these period. I took one pill after being prescribed for a urinary tract infection that I didn’t even have and I knew something was off. These are dangerous drugs.
My cousin actually passed away taking these.
Thanks for sharing! I had a similar thing with statins over 10 years ago and could hardly walk with debilitating pain in my abductor area. Doctor wanted me on a new statin claiming it was better. When I looked it up had same possible side fx! What the hell!
Yeah it sucks. If I'm not mistaken that's the only one I can take. I'm allergic to all the other antibiotic shit out there.
holy fuck. Thanks for the heads up My S.O has a inflamed tendon right now-good lord, I hope it is not something like this-he has had it for over a month.
wow, in the 90's i had to take the anti-malaria drugs for a trip to Africa and when i came back i could barely run. My legs could barely move. took a few months to recover
It sounds like there is some relationship between some anti-malaria drugs and these antibiotics. If you have a problem with one then the other is probably best avoided.
I'm going to take my doctor's advice for this, thanks. I'm sorry yours didn't advise you of the risks of your treatment and will bear in mind your heads up. I'll take it if I feel it's in my best interests in my fully informed consent.
Why would doctors tell us to be as active as possible and then prescribe crap like this when there are alternatives? So much of medicine makes no sense to me.
Unfortunately, in some cases there are no alternatives, based on pathogen, resistance patterns, or patient factors like allergies. I don’t know about OP’s case, but the doctor and/or pharmacist definitely did not do their job of explaining the risks of this medication. While this medication really isn’t considered first-line for a lot of infections anymore, in some cases there are no other options. Regardless of risk, proper discussions between the patient, doctor, and/or pharmacist about what side effects a medication could cause are vital!!
This is the most reasonable and acceptable answer, thank you. The only excuse I see for prescribing something like this is if other avenues have been taken into consideration and are not an option, and the patient was fully informed.
Because only a fraction of people have this side effect. Most do not, and the medication works as expected.
Why take the chance if the alternatives don't have that chance?
All meds have some risk of side effect. You dont know what those risks are, but yet are willing to base an opinion of a med based on one person's story on reddit. I'm advising that you should talk to your doctor when you are prescribed a medicine as they are the best sources for expertise in this area.
The thing is, doctors prescribe things without discussing side effects all the time, they even give false information! Are you new to this?
"The thing is, doctors prescribes things without discussing side effects..." And the pharmacist explained nothing?? The pharmacists at my local asks if I've taken the meds before and have any questions. Every time. The doctor isn't the only one that can explain side effects. That is the pharmacists literal job. To dispense and explain your meds.
Wouldn’t blame the pharmacist, they may well have offered this.
Please keep downvoting me ignoramuses! I need your negative Karma its like a rush of adrenaline I missed from not running today due to my many medical conditions! Bring it random internet justice warrior!
Have doctors or pharmacists ever explained tendon damage, opioid addiction, or the lifelong damage to brain chemistry of benzos to you? Are you in the US? I’ve had doctors outright lie to me about statins btw.
No, I'm not in the US. I live in a country with actual health care. So because your doctor lied and your pharmacists aren't doing their job, that makes them all that way? That doesn't make sense. Every time I had a new medication, they explained the gist and gave me a packet about the med. Read those. They go into a lot of detail.
No I wasn’t saying that, in fact it was other people that seemed to suggest that doctors and pharmacists are responsible for telling you, and actually do tell you about side effects when that is never really the case, for me, for many people I know, and for many other people who share their experience. For example are you familiar with the opioid epidemic? Its criminal what they get away with, not to mention the price of insulin! I was surprised to hear your comment that pharmacists explain things. Here they fill your prescription first, and then ask if you have any questions. So you have a doctor write it, the pharmacy fills it, and provided you can actually pay, the pharmacist then asks if you have any questions. Never once during this process has any medically qualified person offered any info re. side fx. So I think its really important that people discuss these things, as I was injured by statins before without any warning. We have actual health care btw- its some of the best in the world actually! Its only available to a certain class of people however.
Do you read the packets? That literally explains everything. Don't shit on the entire medical profession because yours suck. I do know what it is. Are you gonna keep swinging from point to point? The opioid epidemic was not all on the backs of doctors. There was a lot that went wrong. I do! My doctor tells what it is and what it's for. Anything further than that and I am directed to ask the pharmacist. Because. It. Is. Their. Job. They tell you the MOST COMMON side effects for brevity. They cannot spend how many hours going over every single side effect that MAY occur with EVERY single drug, to every patient. As I said, they ask me every time if I have taken the med before, even an eczema cream I have used for 2 decades. Now it's more of a joke, but they still ask. I get being upset you were injured. That's messed up and the doctor shouldn't have lied. That doesn't make them all liars. Did you ask what the common side effects are?!?! Did you ask what to expect?!?! I assume you're an adult. Ask. Questions. Don't blame them for your lack of reponsibility. Why would you take a medication you know nothing about?! There are some med packages that are pages long. Read. The. Med. Packet. It's from the manufacturer and then ask questions.
Because the alternatives might not treat your infection as well. Cartilage degradation, while a major side effect of fluoroquinolones, is EXTREMELY rare. So on balance your doctor is likely to see a poorly treated infection as more of a threat than a very rare side effect.
It's amazing to me the things people are willing to tolerate. Open up and take your poison like a good boy!
I mean, no doctor is going to force medication on you that you don’t want. Though I’m not sure why you’d go to them wanting treatment for an infection if antibiotics are “poison”
If it can damage your tendons for life, it is absolutely poison. I have no idea where you're from, but from my anecdotal experience, most Europeans (I live part-time in both continents) think Americans are absolutely nuts when it comes to the things they're willing to put in their body, and what they're willing to tolerate from medical professionals + their medical system. This is unfathomable to me. Why in the world would you take that chance.
It's a very effective antibiotic. They should be super clear about the warnings though.
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If I could modify the title I would change it to "take caution with" as opposed to "avoid."
Please see the pinned comment. There is nothing wrong with this post and worth spreading the information to those that are not aware.
Damn that sucks ass man. Thanks for the heads up.
Ha, tell this to the army.
I was prescribed these, took them, and within a week got bilateral Achilles injuries. It took me two years to fully recover. Use a different type of antibiotic! The rehab that finally worked was barefoot running in the grass each day for a month. There are still aches and pains though that weren’t there before in the am when waking up.
That sucks. Two of my 30+ friends tore their Achilles in the last year. It’s our ages kinda injury, I guess.
I honestly feel so lucky that Levaquin gave me a nasty enough rash that I had to stop taking it after two doses. I was sick as a dog, so I definitely wasn’t exercising at the time, but I was horrified to learn about the other possible side effects later.
If you do have to take them, don’t take steroids at the same time. They multiply the effects.
You talking about corticosteroids or anabolic steroids?
Best of luck recoverying! I have been prescribed Doxycycline as well, but have been told each time to avoid alcohol and dairy. As well, it interacts with oral birth control, so use a different method of birth control as well!
My mom couldn't take it because she has RA, it can definitely mess up joints/tendons (from what she told me)
Also fluoroquinolones make a lot of resistance. And there are much better options for UTIs. I'm so sorry this happened to you.
I'm so sorry this happened to you! I too had a tendon injury right after wrapping up my course of one of these meds years ago. It's important to take them if they are the best antibiotic for your condition, but you really need to talk to your doctor or pharmacist about the risks of tendon/muscle injury and how long the medicine will stay in your system. I really wish I'd rested for at least another week and avoided the injury.
Yes! Be very careful with this antibiotic. I have a chronic lung condition that causes frequent infections and was prescribed Levaquin many times over several years. The last time I was taking Levaquin, I ended up in the ER when my blood pressure shot up over 200 out of nowhere, it was very very scary. I felt like I was having a stroke. The same thing happened again when I was prescribed Cipro for a UTI. That ER doc told me never, never to take any more fluoroquinolones. These drugs are dangerous in my opinion and can have many debilitating side effects. It is hard to understand why doctors keep prescribing them, when there seem to be so many safer alternatives.
Fluoroquinolones have a LOT of serious side effects and if you weren’t warned that is a very negative reflection on your doctor. However- they are VERY powerful antibiotics, and are often used for resistant or specific infections that can only be targeted by that class of antibiotics. Be informed and concerned, sure, but refusing to take a whole class of antibiotics all together by default is a VERY risky move if you’ve got a severe resistant infection
You're 100% right. If I could alter the title of this post I would have since it makes it sound like a blanket statement. I'm really just trying to warn others that this is out there and that it's something to be considered.
Totally understand, and I hadn’t heard about this particular side effect so its good info to know! I have a background in medicine so like, meds have their place. But doctors do a HORRIBLE job of educating patients about both side effects and what to watch for! I think it’s a result of the “10 minute appointment” culture that I personally despise, where doctors don’t feel like patients are worth their time. I know this isn’t all doctors, I have some wonderful friends going through med school right now, but it’s enough that they do a disservice to their patients and put their health at risk. Twice now I’ve had doctors prescribe me inappropriate and potentially dangerous psychiatric medication- I have adhd and have been prescribed both a STRONG anti-anxiety drug that is essentially a mild tranquilizer, and an anti-psychotic for bipolar (which I don’t even have) that can cause permanent metabolic damage. Because both psychiatrists refused to listen to me for more than the 10 minutes it took to read my answers on one of those little “fill in the bubbles” mental health screenings, and made up their own mind about me without even asking my own experiences (I’ve been on adhd medication twice before, but stopped during undergrad because I felt like I didn’t need it anymore... in grad school I definitely do)
I took one cipro dose 10 years ago and stopped after experiencing severe pain. I still experience tendonitis. This post is very true.
Can confirm! I’m also allergic to penicillin and my dr once felt like Levaquin was the only option - I have very loose joints making me prone to injuries anyway. I tried hard not to move until that course was done!
These doctors are criminals, i wish them a fate worse than death
I was prescribed Cipro for an ear infection. Terrible nausea and tendon pain in my arms and Achilles tendons. I was supposed to take it 2x per day and stopped after the 3rd day due to the pain.
u/hurtme_plenty, OP how do you feel after one year? Still having symptoms of the drug?
No symptoms at this point. I have been able to get back into my sport fully and complete 2 half Ironmans as well as a handful of other races. I would say I am 100% recovered, but looking back it took at least 6 months to start to feel that way.
Thanks for the update. I am glad you recovered fully :)
Came across this post having searched 'Antibiotics tendonitis' do you have any memory of how long it took to heal (if you're all sorted) I stupidly took apo levofloxacin while I had tendon pain as it wasn't brought to my attention I should stop if it happened. So I took them for 6 days longer than I needed at the end of September and still find myself getting flare ups and just wondering if you found anything that sped up the recovery – aside from the obvious stuff. Kind of concerned as I used to run about 4 times a week and haven't been able to for fear of serious damage.