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Find out more about Dr. Delia: Dr. Delia Chiaramonte is the founder and president of Insight Medical Consultants, a private medical advising and patient advocacy company. She is board certified in family medicine and is Medical Director for Hospice of Baltimore. |
Two weeks after getting bronchitis your heel is killing you. Is it just a coincidence? Maybe not. Some medicines have unusual side effects, but did you know that an antibiotic can cause your tendons to rupture?
A class of antibiotics called fluoroquinolones can cause tendon rupture, the FDA warned recently. This side effect has been known about for years, but the incidence may be higher than was previously thought – it seems that people taking these drugs have 3 to 4 times the risk of the general population. Drug companies will now be required to include a “Black Box” warning on their packaging of these drugs to draw doctors’ attention to the risk.
The drugs affected include common antibiotics such as Cipro, Avelox, Noroxin, and Levaquin. These medications appear to damage the tendons, causing tendonitis and occasionally tendon rupture. Both tendonitis and tendon rupture cause pain and limited function of the affected area -- shoulders, elbows, fingers, the Achilles tendon, and others. So if you have been on a fluoroquinolone and then feel a “snap” in your shoulder or heel followed by bruising and pain, you’ll need a trip to the doctor and maybe even the O.R. The people at highest risk are patients over 60, those taking steroids, and transplant patients.
Many patients notice mild pain and swelling for several weeks before the rupture occurs. Stopping the medicine immediately may prevent a rupture, although it can occur many months after the antibiotic is stopped.
So if you are over 60 and taking prednisone, you might think twice about accepting a prescription for Avelox, Cipro or their cousins. If there is an acceptable alternative, it might be worth considering. Talk it over with your doctor.
Be Well,
Dr. C.
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