Levaquin/Cipro and tendon injuries???

Parent Cafe
1

<p>Has anyone on this board taken the antibiotics Levaquin and/or Cipro and had a subsequent injury to any of their tendons, particularly the achilles tendon?</p>

<p>In late April, my then 14-year-old daughter had a bad sinus infection, and for convenience sake, I took her to our local walk-in, prompt care clinic. (I won’t say the name here, but it is located in a CVS store.) She was seen by a nurse practitioner and diagnosed with a bad sinus infection. The NP asked if my D was allergic to amoxicillin, and I said no. I assumed that the prescription that the NP gave me was for amoxicillin and (my mistake) didn’t look at it carefully. Turns out she wrote for 500mg Levaquin. </p>

<p>As an aside, I also mentioned, several times, that my D is a serious ballet dancer who dances betwen 15 and 30 hours a week. I mentioned it because I wanted to know if she could continue to dance while taking the meds. I was told she could.</p>

<p>Long story made longer :), the Levaquin made my D feel horrible; so horrible and dizzy that she had a bad fall (face down from en pointe) one day. I took her off after three doses. Her regular pediatrician was concerned when I talked to him: he said that Levaquin is for older people who have “been on everything else and it didn’t work” and he pondered aloud why a NP would give such a strong dose of a strong medication to a 95-pound 14 year old.</p>

<p>Topping this off is the fact that one of the side effects of Levaquin is tendon ruptures!! I mention this because yesterday, my D came home form her ballet intensive with a very painful right achilles tendon. It just came on suddenly, during contemporary dance, and though she can walk OK, it hurts.</p>

<p>I am so worried that this is related to the use of Levaquin back in April. I did some Googling and it scared me even more: lots of lawsuits related to Levaquin use, though most of them are in older adults who were also taking steroids.</p>

<p>We have an appt with a foot and ankle specialist next week (soonest you can see anyone, unfortunately, except through the ER) and she is resting and icing it. </p>

<p>But this kid is supposed to begin in August at a very rigorous arts magnet school, where she will dance about four hours a day. The school has a serious ballet program that prepares dancers for work in companies, as well as college. Chances are, this is just a routine ballerina injury, but I worry …</p>

<p>Anyone have any experience with this drug and injuries? I can’t stop kicking myself for not checking the medication side effects and trusting that when the NP said “Is she allergic to amoxicillin?” she meant she was giving my kid amoxicillin.</p>

2

<p>It is true that Levaquin can cause tendon injuries (it’s part of the quinolone antibioitcs, like cipro) and for that reason is usually not given to children. However, usually the tendon injuries occur while taking the drug and not after dosing has ended. </p>

<p>It’s good that you have an appointment set up with a specialist; obviously, he/she can give you better advice than we anonymous on-line “experts”! Hopefully your daughter feels better already.</p>

3

<p>I had major and ongoing sinus infections for years (under care of an infectious disease specialisat) and I did take Cipro several times longterm. I think that feeling horrible and dizzy and the fall may have been from the severe sinus infection more than the drug. I have been so dizzy with an infection that I could barely walk down the hall. You get dehydrated from a serious sinus infection and it affects your thinking and your balance. I think that three doses of the drug are unlikely to have caused the injury this much later.</p>

<p>Amoxicillin is useless for a sinus infection–too weak and then the “smart bugs” just keep replicating and the infection gets worse and you have to go on a stronger drug anyway after the course of amoxicillin. One current theory is that antibiotics are not that useful in fighting a sinus infection because the sinuses have a poor blood supply and not that much of the antibiotic gets in there. Meanwhile the patient is taking a strong antibiotic killing off all sorts of bacteria both good and bad and messing up the digestive tract. I believe now some dr.s are using an antibiotic nasal spray plus nasal rinsing plus extra rest (plus other precriptions to help with drainage) to try to resolve sinus infections. </p>

<p>You should know that once you have had a severe sinus infection, you are more susceptible to them in future (damage to nasal cells or something).</p>

4

<p>Thanks to those who posted. She actually finished out a course of Zithromax after being taken off the Levaquin and it wiped out the infection. Good to know that most tendon stuff happens while taking the Levaquin, though according to numerous posts on the Internet, they can happen months afterward.</p>

5

<p>Tendonitis/tendon rupture is a rare side effect of the fluoroquinolone class of antibiotics (Cipro, Levaquin, etc). Dizziness is a common side effect.
Except in the case of anthrax, it is not recommended to give those drugs to children.
Levaquin clears from your body within a day of stopping it. Once it is out of you, it cannot cause any problems.
500mg is the normal dose for Levaquin. There is also a 250mg and a 750 mg tablet available.</p>

6

<p>While the Levaquin might lead to dizziness, the dizziness and the fall was more likely related to the combination of the sinus infection and a small 14 yo continuing to push herself, dancing 15-30 hours a week. The Levaquin was more likely secondary in the dizziness. </p>

<p>I am not aware of tendon problems 6-8 weeks or more after the use of a quinalone. Injuries are more likely to occur in people who are over 60 years of age, taking steroids (corticosteroids), or who have undergone a kidney, heart, or lung transplant. It is not a common side effect.</p>

7

<p>Levaquin and cipro are powerful wide-spectrum antibiotics with lots of side effects - but there are many doctors who do not think twice about that. </p>

<p>I was prescribed levaquin once for sinus infection and I refused to take more than 2 doses because of side effects. I went back and got zithromax, which worked wonderfully.</p>

8

<p>I know Levaquin from its use as an anti-malarial (Lariam). Popular in the U.S. Banned in most of Europe (or at least it used to be) because of documented psychotic effects.</p>

<p>There are some folks in the medical community who believe that the use of Lariam/Levaquin by soldiers in Iraq/Afghanistan is associated with their higher rates of suicide and suicidal ideation. (you google it, and you’ll find tons of stuff.)</p>

9

<p>I’ve used a related medication, Avelox a lot because of respiratory infections. One of its side effects can also be tendon repture, but for all these meds it is said to be quite rare. My kids’ docs were very cautious about giving such strong antibiotics to our kids, who as also light (by weight-- < 100 pounds & over 5 feet). They would only resort to it after other meds failed because it IS strong for a kid.</p>

<p>On another note, I’ve spoken with many in the medical profession and they caution that training and experience of NPs varies GREATLY. To date, we’ve never used any but I’ve heard some horror stories from folks who have worked with some who very scary ones (of course there are scary folks in all professions).</p>

10

<p>I have reported bruce27’s inappropriate post to the moderators.</p>

11

<p>I have posted this before on a similar thread here. My DH did not have a rupture but the pain became so severe that he was not able to walk. He was on Cipro for a few days when the symptoms got so bad that he was honestly not able to walk by himself.</p>

<p>[?Black</a> Box? Warning Issued for Levaquin and Cipro | InjuryBoard Houston](<a href=“http://houston.injuryboard.com/fda-and-prescription-drugs/black-box-warning-issued-for-levaquin-and-cipro.aspx?googleid=243704]?Black”>http://houston.injuryboard.com/fda-and-prescription-drugs/black-box-warning-issued-for-levaquin-and-cipro.aspx?googleid=243704)</p>

12

<p>My daughter also had achilles’ tendon problems after being on Cipro, but it was immediately after.</p>

13

<p>Hunt, what kind of problems did she have, and how did they resolve? I finally had my D seen by a very reputable orthopedic person dealing win feet and ankles and he assured me that there is no reasonable connection between her being on Levaquin for three days and an achilles strain more than six weeks later.</p>

14

<p>NotMamaRose, so did I, an hour or so ago. Sigh. Spammers!!</p>

<p>Glad that your D was seen by a specialist. I hope she is doing better.</p>

15

<p>My daughter’s problems (mainly pain in the Achilles tendon) started (she just told me) a couple of months after the Cipro, and it was serious enough that she wore a boot, and later a brace. It gradually resolved, although she still feels discomfort in certain kinds of shoes. It was never definitively tied to the Cipro, but she had no apparent source of injury. I have to say that for it to happen to a ballet dancer, and six months later, it is highly unlikely that you would ever be able to clearly link it to the drug.</p>

16

<p>More than six WEEKS later. She started on Levaquin on April 24 and injured herself June 24. However, she was only on 500mg Levaquin for three days before I had her stop the meds.</p>

17

<p>It’s probably going to be one of those things that you’ll always be suspicious about (as were we), but there probably isn’t anything to be done. It would be too hard to show causation to sue anybody, for example.
Although of course six weeks is a lot closer than six months (pardon my misreading).</p>

18

<p>The part that really irks me is that if I said it once, I said it five times that my D (the one who was prescribed Levaquin) is a ballet dancer. I mentioned it because I asked the prescriber if it was OK if my D went to ballet rehearsal that afternoon. The prescriber then asked how much my D danced, and my D answered “between 15 and 30 hours a week.” The prescriber then asked me if my D was allergic to amoxicillin and I said she was not, so I stupidly (I am kicking myself still!) figured that the script in my hand was for amoxicillin by another name. Had I really looked at it, I would have asked questions and never ever allowed my 14 year old now (now 15) to take a medication with a black box warning about tendon injuries. My D has danced since she was 6 with NO tendon problems and then – two months after taking this – she has strained achilles tendons (she has been seen by a very reputable orthopedic surgeon specializing in ankles and feet) and posterior tibial tendonitis in her right ankle/foot. She had to forgo dance this summer and is about to start PT and personal training.
I will never ever ever go to Minute Clinic again.</p>

19

<p>NMR - I’m so sorry to read about this - I hope she will have a full recovery. I can just imagine how upsetting it is. Since we are in the same area, I can recommend the Patient First at Greenspring Station for emergencies. They have a listing of the doctors on staff and their schedules on the website so you can check out their credentials too. </p>

<p>As an aside about the sinus issues - does she use a sinus rinse product? If not, try the Neil Med kit - she may see great improvement with the sinus problem.</p>

20

<p>My husband’s symptoms resolved immeditely after he stopped taking Cipro but a patient of mine had a reaction with symptoms lasting many months after stopping the abx.
In the hospital that I work Levaquin (an IV of Cipro) is given for majority of cases requiring an antibiotic.
Mind you, DH was given Cipro after a very, very bad case of a food poisoning (most likely Salmonella) in a Middle East country.</p>