Common antibiotics cause tendon ruptures; Public Citizen demands black box warningsWednesday, August 30, 2006 by: NaturalNews, citizen journalist
Full article(NaturalNews)
"Tendon ruptures associated with these drugs continue to occur at a disturbing rate, but could be prevented if doctors and patients were more aware of early warning signals, such as the onset of tendon pain, and switched to other antibiotics," said Sidney Wolfe, director of Public Citizen's Health Research Group."According to the Public Citizen's petition, Achilles tendons were the most frequently ruptured, which can cause sudden, severe pain and difficulty walking. It added that tendon ruptures in rotator cuffs, shoulders, biceps, hands and thumbs had also been reported. The petition theorized that the ruptures could be occurring because fluoroquinolones are toxic to tendon fibers and may restrict blood supply in tendons, where it is already limited. Read the rest of the storyWhat are fluoroquinolone antibiotics? click here for a listFrom the FDA - A black box warningBackground Information
A warning about the increased risk of tendinitis and tendon rupture in patients taking fluoroquinolones was previously added to the prescribing information for fluoroquinolones. However, FDA’s recent evaluation of the medical literature and the post-marketing adverse event reports submitted to the Adverse Events Reporting System (AERS) confirmed that
serious reports of tendinitis and tendon rupture with the fluoroquinolones continue to be reported in similar or increased numbers.
Tendinitis and tendon rupture most frequently involves the Achilles tendon, and rupture of the Achilles tendon may require surgical repair.
Tendinitis and tendon rupture in the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported.The risk of developing fluoroquinolone-associated tendinitis and tendon rupture is especially increased in patients over 60 years, in those concomitantly taking corticosteroid drugs, and in patients with kidney, heart or lung transplants.Tendon rupture
can occur during or after completion of fluoroquinolone use; cases occurring up to several months after completion of therapy have been reported.
Tendon rupture is a serious adverse event that could potentially be prevented or reduced in frequency or severity by appropriate use of a fluoroquinolone, patient selection, and careful monitoring.
Therefore, FDA is notifying the makers of the fluoroquinolones of the need to add a Boxed Warning to the prescribing information for fluoroquinolones to highlight and strengthen the existing warning about the increased risk of fluoroquinolone-associated tendinitis and tendon rupture. FDA is also notifying the makers of fluoroquinolones of the need to develop and distribute a Medication Guide to alert patients about these possible side effects.
*This notification was made under FDA’s new authority to require safety labeling changes
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more bad newsFluoroquinolone antibiotic side effects can be very serious, even permanent.
Fluoroquinolones—have all been documented to have side effects such as tendon and nerve damage. In 1986, the FDA gave its first approval of a fluoroquinolone antibiotic in the United States ─ norfloxacin (
Noroxin), and reports of severe side effects started cropping up soon thereafter.
Fluoroquinolone antibiotics are designed to kill bacteria that cause infections such as pneumonia, cystitis, prostatitis, and sinusitis.
Despite the benefits of fluoroquinolones, the potential side effects are serious and should not be overlooked.
Many Fluoroquinolones PrescribedMany fluoroquinolone antibiotics were approved and released on the U.S. market, including:
·
ciprofloxacin / Cipro® in 1987· ofloxacin / Floxin® in 1990· enoxacin / Penetrex® in 1991· lomefloxacin / Maxaquin® in 1992· levofloxacin /
Levaquin® in 1996· trovafloxacin /Trovan® in 1997· gatifloxacin / Tequin® in 1999· moxifloxacin / Avelox® in 1999
Tendon Damage Is PrevalentAs the use of fluoroquinolones increased in the late 1990s, more reports of their damaging side effects accumulated in the FDA's database. Finally, in 2004, the FDA required updated warnings on the packaging for all of the fluoroquinolone antibiotics used in the U.S. The revised labeling cited nerve damage and tendon rupture as possible side effects of the drugs.
Other Side Effects of FluoroquinolonesTendon damage and nerve injuries are not the only possible side effects of the fluoroquinolones; other potential adverse events following treatment with these medications are:
· heart problems· Stevens-Johnson syndrome · hypoglycemia · kidney stones· seizures· confusion, hallucinations· tremors· easy bruising or bleeding· unusual thoughts or behavior· nausea, stomach pain, low fever, loss of appetite· sudden pain or swelling near jointsMore info:The mechanism by which fluoro-quinolone antibiotics cause this problem is not clear.
In animal studies, they can cause arthropathy.
There is evidence of
collagen depletion and disruption of the extracellular matrix.
The antibiotics in this class available in New Zealand are
ciprofloxacin and norfloxacin.
They are best avoided in children, adolescents and pregnancy.Care should be taken when prescribing for those on steroids.
If tendon pain develops, the antibiotic should be stopped and the patient advised to rest the limb and avoid exercise. Diagnostic ultrasound is the most convenient and cheapest way to prove the diagnosis.