Open Letter to Pharmacists Prescribing Fluoroquinolones – You Know!

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Dear Pharmacists,

You know about the dangers of fluoroquinolone antibiotics. You know that Cipro, Levaquin, Avelox and the other fluoroquinolones can cause central nervous system damage that can show up as anxiety, depression, memory loss, depersonalization, loss of intellect and social connectedness, suicidal ideation, etc. You know that fluoroquinolones can cause permanent destruction of all the connective tissue in a person’s body, their tendons, ligaments, fascia and cartilage. You know that adverse reactions to fluoroquinolones can be delayed and that stopping the medication will do nothing to stop its path of destruction.  You know that fluoroquinolones are contraindicated with NSAIDs and steroids. You know that they should NEVER be prescribed or administered to anyone under the age of 18.

You are pharmacists. Your expertise is in pharmaceuticals.  You have studied the chemical structure of fluoroquinolones and you know their effects, both good and bad.  You know that they are dangerous drugs that should only be used in life-or-death situations.  You know that they are over-prescribed. You know that they can have DEVASTATING adverse effects.  YOU KNOW.

Yet you continue to hand them out.  You continue to fill prescriptions with no more warning to the patient than a slip of paper in the bag that contains the poison that may shake their world.  You tell them that their infection will go away when they take the Cipro, Levaquin or Avelox.  The infection will go away but you FAIL to warn them that it may be replaced with chronic conditions that mirror autoimmune diseases, that their mental health may never be the same again, that they may never be the athletic, healthy person that they used to be.

You know that fluoroquinolones should NEVER be given to children. Yet you fill prescriptions for eye and ear drops containing fluoroquinolones for children, even BABIES.  You hand poison over to a mother with a crying 11 month-old child with an ear infection, knowing that the Cipro ear drops will get rid of that child’s infection, but that it may fry their little brain. You know. And you don’t protect the children.

You say that it’s the doctor’s job to know what he or she is prescribing, but you know that they have no clue about the dangers of fluoroquinolones. They disregard the warnings of side-effects on the drug labels, thinking that all drugs have side-effects and that they all should be disregarded because the side-effects listed are arbitrary.  There is nothing arbitrary about the litany of side-effects included with prescriptions of Cipro, Levaquin or Avelox.  You know this to be true, but the doctors don’t.  Their crime is one of willful ignorance and arrogance. They refuse to listen to anyone outside of their ranks, including you (and that’s another problem). They are ignorant, possibly through their own fault.  But you are not ignorant. You know about the dangers of fluoroquinolones. You know.

Doctors may not listen to you, but you can still do something about this moral atrocity.  Please, please, please STOP giving out these drugs. You are the gate-keepers. You can keep patients from poisoning themselves, or worse, poisoning their children. You can refuse to fill those prescriptions. You can tell doctors that they MUST follow their Hippocratic Oath and prescribe a safer antibiotic in non-life-threatening situations. You can ensure that all patients who walk away from your counter with a prescription for a fluoroquinolone have real INFORMED CONSENT. The Hippocratic Oath and Informed Consent are indescribably important. They are the moral bedrocks of the medical system, yet they are being disregarded. You can reinstate them in their appropriate place, at the top of the consciousness of every patient who deals with the medical system. You can and you should, yet you don’t.

You, as an individual, have the power to stop filling these prescriptions. You have the power to talk to the doctors that you work with, to inform them that fluoroquinolones are dangerous drugs. You have the power to talk to your patients and ensure that they have the information that they need to make a decision with true informed consent.  You have that power. Please use it to make the world a better place.

You, as a group, have the power to change the way that all drugs are viewed. You can make sure that a protocol of careful examination and active warnings to patients for all drugs that are truly dangerous is followed when prescribing and filling prescriptions of drugs with serious side-effects. You can pressure the FDA into making sure that the side-effects listed on a drug insert are real and not arbitrary so that they are actually paid attention to.

Please be moral. Do the right thing. Please be ethical. Know that your actions have consequences. They matter. Your decision about whether or not to fill a prescription of Cipro, Levaquin or Avelox can make a difference in a person’s life.

I know that the tone of this letter is scolding. Please know that my intention is not to make you feel like a horrible person, my intention is to ask you to be a better, more empowered, more ethical person.  If that is not possible, I ask you, I beg of you, please just STOP filling prescriptions of fluoroquinolones for children. They need your protection. They will thank you by living a full life without the chronic illness that plagues people who have been adversely effected by fluoroquinolones. Please, do what you can. Please do what’s right.

Thank you,

Lisa Bloomquist

Survivor

P.S. – If you’re pleading ignorance, let me ask you this question – Would you give your child a fluoroquinolone?  If your answer is no, YOU KNOW.

Information about Fluoroquinolone Toxicity

Information about the author, and adverse reactions to fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) can be found on Lisa Bloomquist’s site, www.floxiehope.com.

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Lisa Bloomquist was "Floxed" on her 32nd birthday by Cipro, a fluoroquinolone antibiotic. After 2 years of battling the mysterious health ailments that come with an adverse reaction to a fluoroquinolone, she has fought her way back to health. Lisa is now fighting for recognition of the harm that these drugs can cause and hoping to help those who are suffering from them through their fluoroquinolone induced illness to find recovery. Her web site, highlighting stories of hope and recovery, is www.floxiehope.com. After a while of studying how fluoroquinolones damage mitochondria, she noted that mitochondria were being systematically ignored when forming disease models. She started www.mitomadness.com to bring attention to the role that mitochondria play in health and disease.

10 Comments

  1. Every time I here a doctor or person say bad effects from a fluoroquinilone are rare. I can’t help but be sad for the ” rare” people who suffer needlessly from the damage caused by fluoroquinilones and even more sad that there pain is dismissed by there doctors and families and friends. It’s like “rare” is the justification to continue decimating peoples lives when there are other choices for drugs. I am battling my second case of bronchitis since being floxed 23 mos ago. I have stopped working and battle pain and joint destruction every day. Greed is all the drug companies care about. doctors can shut patients up, here’s a script-go, be healed but that’s not the case when 4 pills later and I can’t walk. When I told my pharmacist as I shuffled to the counter what happened he looked like I told him the most horrible news, get to the doctor right away he said. So I rush off to the doctor but there is nothing they can do except prescribe more of their FDA approved drugs for the degenerative changes and yes the drug companies win again, more business. These drugs have a place for LIFE THREATENING infections that no other drug will respond to. Add to this last bronchitis was healed with NO ANTIBIOTIC. This bronchitis even with a fever is healing with NO ANTIBIOTIC.

  2. Every time I here a doctor or person say bad effects from a fluoroquinilone are rare. I can’t help but be sad for the ” rare” people who suffer needlessly from the damage caused by fluoroquinilones and even more sad that there pain is dismissed by there doctors and families and friends. It’s like “rare” is the justification to continue decimating peoples lives when there are other choices for drugs. I am battling my second case of bronchitis since being floxed 23 mos ago. I have stopped working and battle pain and joint destruction every day. Greed is all the drug companies care about. doctors can shut patients up, here’s a script-go, be healed but that’s not the case when 4 pills later and I can’t walk. When I told my pharmacist as I shuffled to the counter what happened he looked like I told him the most horrible news, get to the doctor right away he said. So I rush off to the doctor but there is nothing they can do except prescribe more of their FDA approved drugs for the degenerative changes and yes the drug companies win again, more business. These drugs have a place for LIFE THREATENING infections that no other drug will respond to.

  3. Wow that was a quick response. You shouldn’t feel bad. For someone that doesn’t work in the medical field I think your questions are legitimate and open up to good discussion.

    I’ve asked myself “How in the hell could this have happened to me!?”

    I actually completely understand when “floxies” (I hate that term, it’s too happy sounding) think that there is some sort of consipiracy with FQ antibiotics… as if Dr.’s are paid to pretend that they don’t know about FQ toxicity and they are covering it up.

    They actually don’t know… it’s ignorance. I’m not saying Dr.s are ignorant. Many of them are brilliant people, highly intelligent. I feel that they are legitimately trying to help their patients, not hurt them. They need to have accurate information to go off of….

    Take care Lisa

  4. Final thought…..

    In medicine you always have to weigh the risk vs benefit. I don’t believe the risks of taking FQ’s are accurately described in the package insert.

    For example one of the black box warnings in Cipro:

    WARNING:
    Fluoroquinolones, including CIPRO®, are associated with an increased risk of tendinitis
    and tendon rupture in all ages. This risk is further increased in older patients usually
    over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney,
    heart or lung transplants (See WARNINGS).

    The medical community pays attention to these black box warnings. OK, but where is the part about progressive, irreversible damage to pretty much all joints in your body that no rheumatologist or orthopedist can fix?

    This med needs many more black box warnings and they need to be more descriptive of the nature of the adverse effects.

    THEN Dr.’s can effectively weigh risk vs benefit.

    Maybe a more regulated approach should be taken for this class. (For example the Clozapine registry)

    It is not the responsiblity of the pharmacist to fix this mess. A Dr. will listen to a pharmacist when there is a drug allergy, or if the patient has renal dysfunction and the dose needs to be reduced, and in certain other circumstances but when you start trying to tell Dr.s how to prescribe or try to convince them that the risk vs benefit for FQ’s isn’t there.. you are asking for a lot of trouble. These meds are widely used. Dr.s prescribe these meds ALL of the time with no problems… at least that is how most of them see it. Most pharmacist I’m sure feel the same way. I did prior to being floxed. If the information isn’t there it is going to take every Dr. being floxed before his or her eyes are opened to the horrors of this class.

    It is the responsibility of the drug company and the FDA to research this and make the information known.

  5. Hi Mike,

    I feel bad. I know several floxed pharmacists and, you’re right, they didn’t have a clue before it hit them. I’ve written a couple of posts in anger. This is one. In some ways, I wish that my anger were more justified – that pharmacists did know how dangerous these drugs are. I wish that it was just known generally, by people other than victims of these drugs, that they are dangerous and that they are destroying lives. It is up to the FDA to convey that information. They are failing. They deserve an angry post more than pharmacists.

    Thank you for your comment! You are right in everything that you said and your perspective is appreciated!

    Regards,
    Lisa

  6. Hey Lisa,

    I just came across this article today. I am a pharmacist…. I’ve emailed you before.

    We as pharmacists don’t know the full extent of the devastation that the fluoroquinolone class of antibiotics can cause. (I am an unlucky exception I suppose.)

    Before I was floxed I thought FQ’s were a great class of antibiotics because I looked at how effective they were at fighting infection. They are well absorbed if taken orally and they reach sites in the body that a lot of meds don’t get to.

    I knew about the most notable warnings and adverse reactions. I knew about torsades (heart arrythmia) that it could cause. I knew about potential achilles and rotator tendonitis and rupture. I knew that it had a long list of ADR’s but hey so does just about every other drug out on the market….

    We as pharmacists DON’T KNOW that these meds can cause irreversable damage. We DON’T know the incredible myriad of ADR’s that can hit you at one time. Most drugs can cause some ADR’s while you are on the med and if you stop taking the med the ADR’s go away. Most drugs you might get one ADR like dry mouth or whatever… but not 25 at one time that never go away!!!

    We DON’T KNOW these things because they are not in the package insert AND the FDA needs to make the severity of these irreversible and incurable reactions known in more black box warnings etc…

    These meds don’t just cause a few problems while you are on the med and go away after you stop…. they ruin lives! They can pretty much cause a new disease state that cannot be treated, hence the term “floxed”. We as pharmacists don’t see this type or reaction and if we do it is usually in the chemo family and the FDA treats that class completely different from other regular meds… you should see all of the precautionary protective gear we have to put on before we go into the special “chemo room” when we make IV admixtures!

    I’ve only seen one class of medications that has a “life time” amount that you can give a patient before he or she can hit certain toxicity that cannot be reversed. CHEMO! (for example doxorubicin)

    We have safeguards for meds like this but I believe the safeguards aren’t there for the FQ’s. This is a strange class of meds with strange ADR’s. Why can so many take them while others are devastated? Why are the adverse effects delayed by YEARS in some cases? There are questions that need answers so we CAN KNOW!!

    Why aren’t more people coming forward with issues? Is it because their Dr.s tell them “no it isn’t the FQ that caused that” Is it because it is not documented correctly in the package insert for the Dr.s and pharmacists to know? Is it because most of the people that are affected are elderly… or is it because the info isn’t out there like it should be?? Is it all of the above????? Sites like floxie hope shed light on FQ toxicity where light definitely needs to be shined. HOW MANY people have been affected by this class of med and don’t know! I was floxed before but never knew it and I’m a freaking pharmacist!

    This class needs to be researched!!!!!! We need to get to the bottom of this! The drug company and the FDA SHOULD be the ones doing this. As far as Iknow there is only one group actually looking into this and it is the Dr. out of California. What she is doing is what it is going to take to make things change.

    IMHO…. Mike

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