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Repeated Use Doesn’t Make Fluoroquinolones Safe

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fluoroquinolone antibiotics

“I’ve prescribed fluoroquinolone antibiotics to hundreds of patients and I’ve never seen problems like yours. It’s a good drug with an excellent safety record.” 

Some version of that statement is said to many patients who approach doctors with the many symptoms of fluoroquinolone toxicity syndrome. Fluoroquinolones (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) have been shown to damage connective tissue (tendons, ligaments, cartilage, fascia, etc.) throughout the body, damage the nervous systems (central, peripheral and autonomic), and lead to multi-symptom, often chronic, illness. Most of the symptoms of fluoroquinolone toxicity are listed on the 43 page warning label for cipro/ciprofloxacin.  However, disregard of patients with fluoroquinolone toxicity syndrome is, unfortunately, common. Statements like the one above are wrong-headed and foolish – here’s why:

  1. The statement of, “I’ve prescribed fluoroquinolone antibiotics to hundreds of patients and I’ve never seen problems like yours” and implying that therefore fluoroquinolones are safe, is an illogical argument based in ego, not fact.  Prescribing a drug hundreds of times does not make it a good, or safe, drug. The fact that something has been done millions times before does not mean that it’s the right way to do things. As an example, millions of people were given Vioxx before it was taken off the market because it causes heart attacks and strokes. If a physician never saw a heart attack result from Vioxx use, that doesn’t mean that they didn’t happen. They did. Thousands of people had heart attacks and died because of Vioxx. A history of doing something wrong does not make it right.  Implied in the statement that a physician has never seen fluoroquinolone damage is the assumption that what a physician sees is factual and without bias.  If a doctor regularly prescribes a drug, he or she is going to believe in its safety and efficacy based on a desire to see him or herself as one who helps patients, regardless of its actual safety and efficacy. Doctors have bias and ego just like the rest of us.  Anecdotal evidence, even anecdotal evidence from a doctor, is not able to trump experimental evidence.  Drugs need to hold up in scientific experiments and controlled trials – not in the opinion court of doctors.  In multiple experiments, fluoroquinolones have been shown to damage cells (by depleting mitochondrial DNA, magnesium, lipids, enzymes, etc.).  Science wins every time, and the scientific evidence comes down on the side of fluoroquinolones being dangerous drugs.
  2. It shows an unwillingness/inability to connect pharmaceutical drugs to multi-symptom diseases. Fluoroquinolones deplete mitochondrial DNA and lead to mitochondrial dysfunction. When mitochondria aren’t functioning properly, cells aren’t functioning properly. Mitochondria are the energy centers of eukaryotic cells – the engines. If cellular engines are malfunctioning, many systems shut down. This shut-down can lead to a cascade of damage – much of it self-perpetuating and difficult to repair. The details of the biochemistry behind this are incredibly complex and difficult, but the basic concept of drugs that cause mitochondrial damage lead to multi-symptom, chronic illness, isn’t so difficult that someone who went through med school shouldn’t be able to grasp it. But many doctors are loathe to admit that the drugs that they prescribe cause mitochondrial damage.  Many studies have shown that fluoroquinolones damage mitochondria (HERE and HERE). Even the FDA acknowledges that the mechanism through which fluoroquinolones do damage is through mitochondrial toxicity. Mitochondrial toxicity = multi-symptom, often chronic, illness. It’s not that hard. But if doctors admitted that fluoroquinolones cause multi-symptom, chronic illness, they may have to look at the relationship between all mitochondria damaging drugs (statins, SSRIs and even acetaminophen are on the list along with fluoroquinolones) and the rise in mysterious multi-symptom illnesses. If they did that, they may have to admit that the drugs they prescribed, ‘hundreds of times’ are hurting people – and who wants to do that?  It’s much easier to repeat the lie of, “these drugs have an excellent record of safety and efficacy,” than it is to admit to inflicting harm (even inadvertently) on patients.
  3. They’re not looking at delayed reactions or tolerance thresholds. Despite the fact that both delayed adverse reactions and tolerance thresholds for fluoroquinolones are documented (it all goes back to how mitochondria respond to damage – more HERE), reactions that occur after administration of the drug have stopped are not connected to the drug by many physicians. “It should be out of your system by now,” is repeated often.  That may be the case, but the drug set off an intracellular bomb and now the damage is self-perpetuating. Delayed reactions and tolerance thresholds may make recognition of adverse drug reactions difficult, but it doesn’t make them go away. Unfortunately, cells don’t always act as they “should” – they act as they do – with messy things like non-linear reactions, negative feedback loops, etc.
  4. The specialist model keeps many doctors from seeing the damage that fluoroquinolones cause. For example, ER doctors often prescribe fluoroquinolones because they’re powerful broad-spectrum antibiotics. But when people have an adverse reaction a week later that looks and feels a lot like an autoimmune disease, they’re not going to the ER for treatment because autoimmune-disease-like symptoms are for a rheumatologist or general practitioner to treat, not an ER doctor. This disconnect keeps many doctors from seeing the harm done by fluoroquinolones.
  5. Statements like, “I’ve prescribed fluoroquinolone antibiotics to hundreds of patients and I’ve never seen problems like yours. It’s a good drug with an excellent safety record.” communicate to patients that a physician’s anecdotal evidence is more important than a patient’s pain. It communicates that it’s okay for side-effects of a drug to be devastating as long as the doctor perceives the adverse reactions as rare. It’s not okay for a doctor to disobey his or her Hippocratic Oath and hurt patients – even inadvertently. And I would argue that adverse reactions to fluoroquinolones are far less rare than anyone would like to believe (arguments HERE and HERE).
  6. It shows that doctors don’t believe the warning labels on drugs. The warning label for Cipro/ ciprofloxacin is 43 PAGES long and lists many musculoskeletal and nervous system adverse effects of cipro and other fluoroquinolones. Do doctors think that the FDA is just kidding when they put all those adverse effects on the warning label?
  7. The mantra of, “fluoroquinolones have an excellent safety record” has been repeated so many times that it is assumed to be true. It is not true. There are hundreds of studies showing that fluoroquinolones profoundly damage cells and there are zero studies that show that people are immune to the damage caused by fluoroquinolones. The perception of safety is based on an unwillingness to recognize tolerance thresholds for fluoroquinolones, delayed adverse reactions to fluoroquinolones and the connection between fluoroquinolones and multi-symptom diseases.
  8. It shows that they’re afraid. Some of the fear is legitimate.  Antibiotic resistance is on the rise.  If fluoroquinolones are restricted to only being used appropriately – i.e. in life-or-death situations after all other antibiotics have failed – doctors will have fewer tools at their disposal and they may not be able to fight a nasty infection without inflicting cellular damage that results in chronic illness. No one wants to have to choose between an infection and multi-symptom, chronic illness.  It would be better to have neither. But if there aren’t any options of antibiotics that don’t cause the cellular damage that leads to oxidative stress and multi-symptom illness… well, that’s a possibility that is too frightening and daunting to think about.
  9. Too many doctors are attached to lazy medicine – throwing strong, broad-spectrum antibiotics at everyone who comes in the door with an infection (or just a high white blood cell count). If the adverse effects of fluoroquinolones were acknowledged, the pros and cons would have to be careful weighed before administering them.  A long discussion with patients about tendon ruptures, peripheral neuropathy, increased chance of diabetes, central nervous system damage, etc., would have to be had along with every prescription for Cipro, Levaquin or Avelox in order for an obligation of informed consent to be met. If broad-spectrum fluoroquinolones couldn’t be thrown at every infection, bacterial cultures would need to be done to figure out exactly what antibiotics would work best.  That takes time and money and it’s easier to do things as they have been done – even if it involves denying the damage that fluoroquinolones do.  Those pesky tests to make sure that the Hippocratic Oath is upheld may get in the way of business.

Adverse drug reactions don’t stop happening just because they’re inconvenient; or because they’re unrecognized or misdiagnosed. They don’t become rare or insignificant just because they are complicated and difficult to recognize.

Fluoroquinolones are dangerous drugs that damage cells on multiple levels. This has been shown in laboratories many times. The cellular damage caused by fluoroquinolones (along with the destruction of the microbiome) leads to multi-symptom, often chronic, illness. This has been shown by multiple patient reports.

Many doctors haven’t read the memo about how dangerous fluoroquinolones are though. Shouldn’t they know the dangers of the drugs that they prescribe?  Shouldn’t they have learned about adverse drug reactions in school?  It doesn’t seem like too much to ask for.  There are hundreds of studies showing that fluoroquinolones damage eukaryotic cells. Shouldn’t they have read them, or at least been told about them by the FDA?

You’d think so.  But the mantra of, “Fluoroquinolones have an excellent record of safety and efficacy” has been repeated so many times that it’s thought to be true just because it’s been heard over and over again.  Let’s change the mantra. How about, “fluoroquinolones are dangerous drugs that should only be used in life-or-death situations?” That mantra sounds much better.  It’s more appropriate, and it’s closer to the truth. If we keep on repeating it, maybe doctors will start to listen.

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This post was first published on October 1, 2014.

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.

Photo by karatara: https://www.pexels.com/photo/male-statue-decor-931317/

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Don’t Take Cipro, Levaquin or Avelox If….

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Lisa Bloomquist flouroquinolone antibiotics

There is a huge range in how people react to fluoroquinolone antibiotics (Cipro/Ciprofloxacin, Levaquin/Levofloxacin, Avelox/Moxifloxacin and Floxin/Ofloxacin). Some people take fluoroquinolones repeatedly and never experience an adverse reaction. Some people are left bed-bound after one pill, or one prescription. Some people take a full fluoroquinolone prescription without incident at one time in their life, then, when they take a second (or third, or fourth) prescription, their body goes hay-wire. Some people have a sudden and severe adverse reaction, where they are unable to move or think after previously being fine, and other people have a gradual onset of symptoms where they damage tendons or develop neuropathy slowly, over time.

What determines how a person reacts to fluoroquinolones? The black box warning label on fluoroquinolones states that, “risk (of tendinitis) 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.” But people who fit into those categories aren’t the only people who are hurt by fluoroquinolones. I didn’t fit into any of those categories. I was 32, athletic, strong, not on any medications, etc. when I was sickened by Cipro. I was healthy. But fourteen 500 milligram pills of Cipro (half taken in 2009 without incident and half taken in 2011 with a sudden severe adverse reaction) were enough to cause my body and mind significant harm.

I must have had risk factors that made me susceptible to fluoroquinolone toxicity though, because Cipro made me quite sick. I’m honestly not sure what those factors are (no one knows – or at least they aren’t publishing papers about it if they do). Perhaps those who are hurt by fluoroquinolones have depleted liver enzymes and therefore they aren’t able to metabolize drugs like people who have more robust supplies of drug metabolizing enzymes. Perhaps people who suffer from fluoroquinolone toxicity are depleted of cellular magnesium, as magnesium has been shown to have protective effects on cells that are exposed to fluoroquinolones. Perhaps the microbiome of those who are hurt by fluoroquinolones is depleted of good bacteria and an overwhelming number of bad bacteria in the gut leads to many of the symptoms of fluoroquinolone toxicity. Perhaps there are some people who are genetically predisposed toward having an adverse reaction to fluoroquinolones. As with everything, there is a mix of genetics and environment that goes into how the body reacts when faced with a chemical onslaught. Human bodies are unbelievably complex and multifaceted; once individual differences are considered, the complexity becomes mind-boggling.

Customizing medicine is difficult. The entire human genome, though sequenced, has not yet been mapped out. We are not at a point yet where we can easily and inexpensively test genes and interpret the results of genomic tests.

Genes aren’t the only things that determine how a person reacts to a drug. The microbiome also plays an important role in determining drug metabolism. Per an article entitled, Role of Intestinal Microflora in Xenobiotic-induced Toxicity, “individual differences in the intestinal microflora may result in individualized xenobiotic (a chemical or substance that is foreign to an organism or biological system) toxicities.” The differences in the bacteria in our gut make a difference in how drugs are metabolized. As the microbiome is changed, through drugs – especially antibiotics, the reaction of the individual patient to formerly well tolerated drugs, can change.

Until customizing medicine to the individual becomes feasible, what are doctors supposed to do to prevent their patients from having a dangerous adverse reaction to a drug? Drugs with potentially devastating adverse effects could be avoided entirely unless they are necessary to save a life. This is the policy that I would like to see applied to fluoroquinolones. (The cellular damage that fluoroquinolones inflict make their use inappropriate for infections that are not life-threatening.) Unfortunately, prudence in regards to prescribing fluoroquinolones is not the current trend. In 2011, 23.1 million prescriptions for fluoroquinolones were written in the U.S., and despite the 43 page warning label that comes with Cipro/Ciprofloxacin, fluoroquinolone toxicity is denied by many physicians. As much as I would like to cut the number of fluoroquinolone prescriptions by 90%, the entire medical establishment is not yet listening to me and others who are screaming about the pain and suffering caused by fluoroquinolones. To reduce the number of people hurt, either a study or news story must induce a paradigm shift enabling all doctors to see that fluoroquinolones are vastly more dangerous than penicillin, or patients (especially those in the risk categories listed below) must ask their doctors to not prescribe them.

Though the true risk factors for fluoroquinolone toxicity (genetic, enzyme and microbiome markers) are not yet established, there are some groups of people who are at higher risk of an adverse reaction than others. They should never be given fluoroquinolones. Those groups are:

  1. People who have had an adverse reaction to a fluoroquinolone in the past. Despite the fact that all of the warning labels for fluoroquinolones state that they should not be given to people with a history of hypersensitivity to fluoroquinolones, the recommendation that they be avoided is often ignored. This is the case because people often don’t realize that they are having a mild adverse reaction to a fluoroquinolone. Who would think that muscle twitches, insomnia, urgency when urinating or loss of endurance would be related to the administration of an antibiotic? The connection is so bizarre that it is often not recognized. A list of warning signs that your body has reached its threshold for fluoroquinolones can be found here: Warning Signs of Fluoroquinolone Toxicity.
  2. Athletes. It is well documented and known that fluoroquinolones degrade the structure of tendons. They “exert a toxic effect not only on tendons but also on cartilage, bone, and muscle,” per a Mayo Clinic affiliated article entitled Musculoskeletal Complications of Fluoroquinolones: Guidelines and Precautions for Usage in the Athletic Population. Further information about why the Mayo Clinic researchers note that, “Athletes should avoid all use of fluoroquinolone antibiotics unless no alternative is available” can be found here: Deciphering the Pathogenesis of Tendonopathies: A Three Stage Process.
  3. People on steroids. Steroids are contraindicated with fluoroquinolones. As is noted in the Cipro/Ciprofloxacin warning label, people who are on corticosteroids are at an increased risk of tendonitis when administered fluoroquinolones. In addition to the increased risk of tendon damage, the combination of steroids and fluoroquinolones can increase the risk of development of a deadly glabrata fungal infection.
  4. People who need to take NSAIDs regularly. NSAIDs, and other drugs that contain a carboxylic acid molecule, are contraindicated with fluoroquinolone toxicity. Patients suffering from fluoroquinolone toxicity have reported adverse reactions to NSAIDs even weeks or months after they have stopped taking fluoroquinolones. The adverse interaction between fluoroquinolones / fluoroquinolone toxicity and NSAIDs is likely because of the formation of poisonous acyl glucuronides. Articles describing this process can be found on Fluoroquinolone Links and Resources.
  5. Immunocompromised individuals. Fluoroquinolones, and other broad spectrum antibiotics, kill good bacteria along with harmful bacteria. When the good bacteria in the gut are wiped out, they can no longer keep the bad bacteria, or fungal infections, in check. Fungal infections can take over a person’s body and they can be deadly. This can happen with people who have healthy immune systems. For people with already compromised immune systems, vulnerability to fungal infections may be increased. Per an article in Life Extension Magazine, “Anyone can acquire a fungal infection, but the elderly, critically ill, and individuals with weakened immunity, due to diseases such as HIV/AIDS or use of immunosuppressive medications (such as corticosteroids), have a higher risk.”
  6. People with mitochondrial dysfunction. Per an article entitled Mitochondrial Reactive Oxygen Species Control T Cell Activation by Regulating IL-2 and IL-4 Expression: Mechanism of Ciprofloxacin-Mediated Immunosuppression, “ciprofloxacin was also shown to deplete the mitochondrial DNA (mtDNA) content, thus leading to mitochondrial dysfunction and retarded cellular growth.” Ciprofloxacin and other fluoroquinolones damage mitochondria. Those with preexisting mitochondrial dysfunction will suffer more as their mitochondria are further damaged.
  7. Children. Fluoroquinolones have been shown to degrade cartilage in juvenile animals and, for this reason, are generally considered to be contraindicated in the juvenile population. Unfortunately, children are still prescribed fluoroquinolones by pediatricians who are unaware of the severity of adverse reactions to fluoroquinolones.

Until medicine is more individualized and every factor that makes a person more or less susceptible to experiencing an adverse reaction to a drug can be tested before that drug is administered, everyone who takes a fluoroquinolone is at risk of experiencing an adverse reaction. The best way to protect oneself from fluoroquinolone toxicity is to not take a fluoroquinolone. Though there are some risk factors that make some groups of people more susceptible to experiencing a severe adverse reaction to fluoroquinolones than others, there is no guarantee that not fitting into one of those groups will ensure your safety. With that noted, the people who fit into any of the seven categories listed above should avoid fluoroquinolones whenever possible.

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.

Participate in Research

Hormones MatterTM is conducting research on the side effects and adverse events associated with the fluoroquinolone antibiotics, Cipro, Levaquin, Avelox and others: The Fluoroquinolone Antibiotics Side Effects Study. The study is anonymous, takes 20-30 minutes to complete and is open to anyone who has used a fluoroquinolone antibiotic. Please complete the study and help us understand the scope of fluoroquinolone reactions.

Hormones MatterTM conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

To sign up for our newsletter and receive weekly updates on the latest research news, click here.

What Else Can I Do To Help?

Hormones MatterTM is completely unfunded at this juncture and we rely entirely on crowdsourcing and volunteers to conduct the research and produce quality health education materials for the public. If you’d like help us improve healthcare with better data, get involved. Become an advocate, spread the word about our site, our research and our mission. Suggest a study. Share a study. Join our team. Write for us. Partner with us. Help us grow. For more information contact us at: info@hormonesmatter.com.

To support Hormones Matter and our research projects – Crowdfund Us.

This post was published previously on Hormones Matter in January 2014.

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Fluoroquinolone Antibiotic Dangers: Why Didn’t They Tell Me?

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Lisa Bloomquist

Hundreds of articles about the harmful effects of fluoroquinolone antibiotics (Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin and Floxin/ofloxacin) have been published in medical and scientific journals, yet most of the articles have been ignored by the medical community and downplayed by the FDA. I can only surmise that the ignorance around the dangers of fluoroquinolones is because they are used as antibiotics and antibiotics are “supposed” to be safe and only damage bacteria, while leaving human cells unscathed. Or maybe it is because of the constant repetition of the baseless statement that fluoroquinolones have an “excellent record of safety and tolerance;” a statement that is only true if delayed reactions, tolerance thresholds and epigenetic effects are not taken into consideration.

Regardless of the motivations of those who are ignoring how destructive fluoroquinolones are, valuable information about the safety (or rather, the dangers) of fluoroquinolones as a class of drugs, have been ignored. Warnings about the toxicity of fluoroquinolones have been noted in journal article after journal article, yet they are still some of the most popular antibiotics prescribed.

Caution, prudence and thoughtfulness should be exercised when prescribing drugs that are as dangerous and destructive as fluoroquinolones. Fluoroquinolones are chemo drugs that are being mis-prescribed as antibiotics. Before filling a prescription for a fluoroquinolone to treat a sinus infection, or to use prophylactically for traveler’s diarrhea, or putting in your child’s ear to treat an ear infection, I encourage you to note the cellular destruction done by fluoroquinolones. Neither the FDA nor the average doctor is properly warning patients about the dangers of fluoroquinolones. Unfortunately, it is up to patients to inform themselves and gain proper warnings about the consequences of these dangerous drugs.

Fluoroquinolones Damage DNA

Back in 1992, when fluoroquinolones were first gaining popularity, Scientists raised concerns about their safety in an article published by the Proceedings of the National Academy of Sciences of the United States:

“the interaction (of fluoroquinolones) with DNA is still of great concern because of the possible long-term genotoxicity of quinolone compounds, which are increasingly adopted as first-choice antibiotics for the treatment of many infections, and because it addresses the real mechanism of action of this class of molecules.”

Fluoroquinolones are topoisomerase interrupters, meaning that their mechanism of action is described as, “The bactericidal action of ciprofloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV (both Type II topoisomerases), which are required for bacterial DNA replication, transcription, repair, and recombination.” (Cipro warning label).

Very little, if any, concern over the possible genotoxic effects of fluoroquinolones were expressed to the public as they gained popularity and uses were expanded in the early 1990s. The warnings and concerns expressed by the scientists quoted were ignored.

It is noted in Molecular Pharmacology, “Delayed Cytotocicity and Cleavage of Mitochondrial DNA in Ciprofloxacin Treated Mammalian Cells” that fluoroquinolones “cause a selective loss of mitochondrial DNA (mtDNA)” and “The loss in mtDNA was associated with a delayed loss in mitochondrial function.” Additionally, it is stated that “ciprofloxacin induces reversible double-stranded breaks in nuclear DNA.” Studies have shown that both mitochondrial and nuclear DNA is adversely affected by fluoroquinolones, yet those studies have not gained traction in the medical community and have effectively been ignored.

The intergenerational effects of depleting DNA with fluoroquinolones is unknown at this time (I surmise that this is because these studies have been ignored, intergenerational studies are difficult to do, and funding for them is hard to come by). However, it is known that, “a number of human mitochondrial genetic diseases that are clinically discreet are being diagnosed at unexpected rates” (source). Additionally, in an article published in Nature in 2013 entitled, “Topoisomerases facilitate transcription of long genes linked to autism” it was noted that, “Our data suggest that chemicals or genetic mutations that impair topoisomerases, and possibly other components of the transcription elongation machinery that interface with topoisomerases, have the potential to profoundly affect the expression of long ASD (autism spectrum disorder) candidate genes.” Fluoroquinolones are topoisomerase interrupting chemicals.

Thus far, neither the increase in mitochondrial genetic diseases nor the link between topoisomerase interrupting drugs and autism have been acknowledged by the medical community, the FDA or the general public.

Fluoroquinolones Damage Mitochondria

The deleterious effects of fluoroquinolones on mitochondria have been noted repeatedly in journal articles, and even by the FDA.

In Science Translational Medicine, “Bactericidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells,” it is noted that bactericidal antibiotics, including ciprofloxacin, a fluoroquinolone, “damage mammalian tissues by triggering mitochondrial release of reactive oxygen species (ROS).” Even the FDA acknowledges that fluoroquinolones cause mitochondrial damage. In their April 27, 2013 Pharmacovigilance Review, “Disabling Peripheral Neuropathy Associated with Systemic Fluoroquinolone Exposure,” the FDA notes that the mechanism for action through which fluoroquinolones induce peripheral neuropathy is mitochondrial toxicity. The report says:

“Ciprofloxacin has been found to affect mammalian topoisomerase II, especially in mitochondria. In vitro studies in drug-treated mammalian cells found that nalidixic acid and ciprofloxacin cause a loss of mitochondrial DNA (mtDNA), resulting in a decrease of mitochondrial respiration and an arrest in cell growth. Further analysis found protein-linked double-stranded DNA breaks in the mtDNA from ciprofloxacin-treated cells, suggesting that ciprofloxacin was targeting topoisomerase II activity in the mitochondria.”

Fluoroquinolones are very, very bad for mitochondria. As the engines of our cells, healthy mitochondria are very necessary for healthy cells. Mitochondrial dysfunction is connected with many chronic diseases, including autism, CFS/ME, fibromyalgia, Alzheimer’s Disease, Parkinson’s Disease,multiple sclerosis, etc.

Fluoroquinolones Alter Neurons

Fluoroquinolones downgrade GABA-A receptors and can lead to a variety of CNS related symptoms of fluoroquinolone toxicity such as “dizziness, confusion, tremors, hallucinations, depression, and, rarely, psychotic reactions have progressed to suicidal ideations/thoughts and self-injurious behavior such as attempted or completed suicide,” as well as “nervousness, agitation, insomnia, anxiety, nightmares or paranoia” (Cipro warning label).

It was concluded in an article in The Journal of Neurophysiology in 1991 that, “in the presence of an anti-inflammatory agent, the quinolone antibiotics decrease the affinity of GABAA receptors, the result being induction of epileptogenic neurotoxicities.”

GABA receptors
Copyright 2009 Pharmacy Weekly, Inc. Printed with permission.

An article in Pharmacology Weekly that was published in 2009 notes that fluoroquinolones “modulate the activity of the gamma-aminobutyric acid (GABA)-A receptor” leading to the CNS side-effects of fluoroquinolones that include “tremors, restlessness, anxiety, confusion, paranoia, insomnia, etc.” and that “the presence of an NSAID or NSAID metabolite can significantly augment this effect and result in an even greater inhibition of GABA-A receptor activity” and lead to seizures, in addition to the other CNS effects listed. But, in 2015, people still are not systematically warned about the possibility of fluoroquinolone induced “nervousness, agitation, insomnia, anxiety, nightmares or paranoia” and NSAIDs are still prescribed concurrently with fluoroquinolones, despite documentation that the combination of fluoroquinolones and NSAIDs downgrade important neurotransmitters.

Though the symptoms that arise when GABA-A receptors are downgraded are noted on the warning labels for fluoroquinolones, nowhere on the warning label does it say that these effects can be long-lasting, or even permanent.

Generally, the effects of fluoroquinolones on neurotransmitters are ignored, and ensuing anxiety, insomnia and psychiatric illnesses are assumed to have nothing to do with the antibiotics that were prescribed for a sinus or urinary tract infection. The research and the warnings, have been ignored.

Fluoroquinolones Damage Cells

In The Journal of Medical Microbiology it was noted that:

“Dougherty & Saukkonen (1985) showed that inhibition of DNA synthesis by nalidixic acid, a DNA gyrase inhibitor, results in morphological changes consistent with a loss of membrane integrity and leakage of intracellular components. Similar results were presented by Wickens et al. (2000), who noticed a decrease of both membrane integrity and membrane potential after exposure of E. coli to CIP. One of the proposed explanations of this finding is that, as a result of processes induced by inhibition of DNA replication, cells lose their capacity to synthesize necessary components and to maintain the proper membrane structure (Dougherty & Saukkonen, 1985).”

Naladixic acid is the root component of all fluoroquinolones.

In case it needs to be said, cellular membrane integrity and keeping intracellular components inside cells, are important. It is important for cells as a whole, and for organelles within cells such as mitochondria. As the importance of the microbiome is being uncovered, the importance of the bacteria in our guts maintaining cellular integrity is slowly being realized as well.

Fluoroquinolones are Dangerous Drugs

The FDA warning label for Cipro/ciprofloxacin is 43 pages long. The serious and severe adverse effects listed on the warning label are due to the cellular destruction done by Cipro. Other fluoroquinolones (Levaquin and Avelox are popular) have similar safety/danger profiles.

Though no antibiotics are without consequence, the cellular destruction done by fluoroquinolones makes them far more dangerous than other antibiotics. Fluoroquinolones should be categorized as chemo drugs along with all other topoisomerase interrupters. Please be wary and cautious with fluoroquinolones, and don’t use them unless it is absolutely necessary.

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.

Participate in Research

Hormones MatterTM is conducting research on the side effects and adverse events associated with the fluoroquinolone antibiotics, Cipro, Levaquin, Avelox and others: The Fluoroquinolone Antibiotics Side Effects Study. The study is anonymous, takes 20-30 minutes to complete and is open to anyone who has used a fluoroquinolone antibiotic. Please complete the study and help us understand the scope of fluoroquinolone reactions.

Hormones MatterTM conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

To sign up for our newsletter and receive weekly updates on the latest research news, click here.

What Else Can I Do To Help?

Hormones MatterTM is completely unfunded at this juncture and we rely entirely on crowdsourcing and volunteers to conduct the research and produce quality health education materials for the public. If you’d like help us improve healthcare with better data, get involved. Become an advocate, spread the word about our site, our research and our mission. Suggest a study. Share a study. Join our team. Write for us. Partner with us. Help us grow.

To support Hormones Matter and our research projects – Crowdfund Us.

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Don’t Let Your Babies Grow Up to be Floxies

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Lisa Bloomquist

Moms and Dads, as your children get bacterial infections and are prescribed antibiotics, please be careful and note what kind of antibiotics are given to them. Not all antibiotics are benign. Truthfully, none of them are completely benign, even though they are thought of as such – but some are significantly more dangerous than others.

Not all Antibiotics are Created Equally

Most people are aware of the fact that many antibiotics (especially penicillin and sulfa antibiotics) can cause allergic reactions – some of which are serious and potentially deadly.  Many people are also aware of diarrhea, upset stomach and even c-difficile as potential side-effects of antibiotics. But most people aren’t aware that the side-effects of some antibiotics include destruction of cartilage and tendons throughout the body, seizures, hallucinations, depression, peripheral neuropathy, urticaria and many other severe reactions for which there are few treatments; and when they occur simultaneously make up a multi-symptom, chronic illness. Not all antibiotics can cause a multi-symptom, difficult to treat, chronic syndrome that includes the frightening side-effects listed (and more). Unfortunately, and frighteningly, some can though. The kind of antibiotics that can hurt children (and adults) by causing those symptoms are fluoroquinolone antibiotics – Cipro/Ciprofloxacin, Levaquin/Levofloxacin, Avelox/Moxifloxacin and Floxin/Ofloxacin.

The 43 page warning label for Cipro goes over some of the adverse effects of fluoroquinolones noted – but it fails to mention that many of the side-effects listed can happen simultaneously, that they don’t go away after administration of the drug has stopped, or that the drug can convert an acute health problem – an infection, into a chronic multi-symptom illness – fluoroquinolone toxicity syndrome – an illness that can last months, years, or a lifetime.

To put it as simply as possible, fluoroquinolone toxicity syndrome involves damage to connective tissue (tendons, ligaments, cartilage, fascia, etc.) throughout the body, damage to the nervous systems (central, peripheral and autonomic), and more.  An article going over the basics of fluoroquinolone toxicity can be found HERE, links and resources, including 100+ peer-reviewed journal articles about fluoroquinolone toxicity can be found HERE, and stories of pain and suffering experienced by those who are going through fluoroquinolone toxicity can be found HERE.

If you look through the stories of pain and suffering linked to above, you will note that these drugs brought strong, healthy adults to their knees. Some of the people hurt by fluoroquinolones are in their 20s and 30s, many of them are athletes. If these drugs can leave an athletic 25 year old unable to walk or think, can you imagine what it might do to a small child?

Fluoroquinolones are Given to Children – Despite Contraindications

Fluoroquinolones are contraindicated in the pediatric population because they have been shown to damage the cartilage and joints of juvenile animals (source).  A review in U.S. Pharmacist noted that:

“Fluoroquinolones have demonstrated adverse effects on cartilage development in juvenile animals through the inflammation and destruction of weight-bearing joints.  These arthropathies were often irreversible, and their potential occurrence in children limited the use of fluoroquinolones in this population.  In one pediatric study, ciprofloxacin had a 3.3% (9.3% vs. 6.0%) absolute risk increase in musculoskeletal events within 6 weeks of treatment compared with control agents used to treat complicated UTIs or pyelonephritis. Adefurin and colleagues found a 57% increased relative risk of arthropathy in children given ciprofloxacin (21% overall) versus those in a non-fluoroquinolone comparator arm. In contrast to animal models, neither dose nor duration had an effect on the rate or severity of arthropathy.  A 2007 study by Noel and colleagues determined the incidence of musculoskeletal events (primarily arthralgias) to be greater in children treated with levofloxacin compared with nonfluoroquinolone-treated children at 2 months (2.1% vs. 0.9%; P = .04) and 12 months (3.4% vs. 1.8%; P = .03).  These results and the severity of the effects should be weighed heavily when initiation of fluoroquinolones is being contemplated in pediatric patients.” (source)

To summarize, fluoroquinolones can cause irreversible musculoskeletal harm and in doing so, they can put an end to your child’s days of running, jumping, playing soccer, skiing, dancing, etc. Think about that for a second – a drug – an antibiotic no less – can cause permanent damage to the musculoskeletal system of a child.

In addition to the horrible musculoskeletal adverse effects of fluoroquinolones, they also have multiple mental side-effects. Just a small sample of the mental side-effects of fluoroquinolones listed on the FDA warning label for cipro/ciprofloxacin are, “dizziness, confusion, tremors, hallucinations, depression, and, rarely, psychotic reactions have progressed to suicidal ideations/thoughts and self-injurious behavior such as attempted or completed suicide.”  No loving parent would want their child to experience any of those things.

If Cipro Can Tear Down a 32 Year Old, Imagine What it Can Do to a 3 Year Old

FDA warning labels are official and credible, but people tend to assume that what is listed on the warning label won’t happen to them or their children. So, to make things a bit more personal, I’ll tell you what happened to me when I was a strong and healthy (other than a urinary tract infection) 32 year old.  After taking Cipro, I could barely walk. My feet and hands were swollen to the point that it hurt to use them. My legs became weak and my muscles simply didn’t work.  I lost my flexibility and balance. My tendons were inflamed and painful.  I was exhausted and if felt as if I had a constant flu. I had hives/urticaria all over my body.  I was anxious, depressed and scared. I lost cognitive skills – my memory, reading comprehension, concentration, motivation and ability to connect with other people in a conversation. This went on, to varying degrees (I got worse for a period of time, then I slowly got better – with some bumps in the road) for 18 long and frightening months.

I dealt with the ordeal of having my body and mind fall apart quite badly, despite having 32 years of coping skills built up. Children haven’t built up the capacity to deal with pain, fear, depression, anxiety, loss of motivation, loss of physical capacity, etc. I can only imagine how frightening it would be for a child to go through even a portion of what I went through and, believe it or not, my reaction was not as severe as many.

Under-recognition of Adverse Effects: Delayed Reactions,Tolerance Thresholds and More

Adverse reactions to fluoroquinolones are often delayed (they can occur weeks or months after administration of the drug has stopped) and there is a tolerance threshold for them (meaning that people can tolerate fluoroquinolones up to their personal threshold and only fall ill after their threshold is crossed).  Because of these features of fluoroquinolone toxicity, and because of the absurdity of a prescription antibiotic causing a multi-symptom chronic illness, adverse effects of fluoroquinolones are under-recognized. No one really knows how common adverse reactions are.  People say that adverse reactions are rare; but if delayed effects, tolerance thresholds, multiple exposures and even individual genetic profiles aren’t being taken into consideration, how would they know?  And how is a parent (or doctor) supposed to know how much of a risk these drugs pose to a child?  These variables are too hard to know enough about, so I suggest that every parent reading this err on the side of caution and avoid Cipro/Ciprofloxacin, Levaquin/Levofloxacin, Avelox/Moxifloxacin and Floxin/Ofloxacin in all situations that are not life-threatening.

If you have a child who has a mysterious multi-symptom illness (which can, admittedly, have many causes), I suggest that you look through his or her medical records. Despite the official contraindication in the pediatric population, children are given fluoroquinolones all the time. They often come as ear and eye drops, in addition to pills and IVs.

Protecting Your Children

Please be careful with your babies. Know that there are some dangerous drugs out there.  One category of dangerous drugs is fluoroquinolone antibiotics – again, Cipro/Ciprofloxacin, Levaquin/Levofloxacin, Avelox/Moxifloxacin and Floxin/Ofloxacin (they have different names in different countries and ear and eye drops also often have different names – please ask a pharmacist if a drug is a fluoroquinolone before taking it). Iatrogenic multi-symptom chronic illness is not something that you want inflicted on your child and, as absurd as it may be, multi-symptom chronic illness can be the result of taking a fluoroquinolone antibiotic.

As someone who has experienced fluoroquinolone toxicity, I cannot begin to express the horror of thinking of a child going through what I experienced.  It was as if a bomb had gone off in my body and mind. Everything fell apart at once. It was terrifying. The thought of a child going through what I went through is even more terrifying though. I hope that Moms and Dads who read this heed my warning and keep their children far, far away from these drugs. They are too harsh and too dangerous for children.

I wish all parents the best of luck in keeping their babies safe. Staying away from fluoroquinolone antibiotics is one thing that can be done. There are safer antibiotics available. Please use them, and keep your children away from fluoroquinolones if at all possible.

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.

Participate in Research

Hormones Matter is conducting research on the side effects and adverse events associated with the fluoroquinolone antibiotics, Cipro, Levaquin, Avelox and others: The Fluoroquinolone Antibiotics Side Effects Study. The study is anonymous, takes 20-30 minutes to complete and is open to anyone who has used a fluoroquinolone antibiotic. Please complete the study and help us understand the scope of fluoroquinolone reactions.

Hormones MatterTM conducts other crowdsourced surveys on medication reactions. To take one of our other surveys, click here.

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Related posts:

beyond the ER with FQWhen Investigating Fluoroquinolone Reactions, Move Beyond the ER

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