Fluoroquinolone antibiotics

Some commonly used brand names include:

Cipro, Floxin, Maxaquin, Noroxin, Penetrex. Ciprofloxacin, (Ciloxan, Ciproxin), Enoxacin, Lomefloxacin, Norfloxacin, (Utinor), Ofloxacin (Tarivid) 

Before Using This Medication
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make.

May 2017 US FDA WARNING

These medicines are associated with disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system that can occur together in the same patient. As a result, we revised the Boxed Warning, FDA’s strongest warning, to address these serious safety issues. We also added a new warning and updated other parts of the drug label, including the patient Medication Guide.

More information: Please read the information oincluded in FDA announcements

Patient Safety Advocate Rachel Brummert has a new web site www.rachelbrummert.com

Rachel's previous web site is still worth browsing for information about fluoroquinolone antibiotics

www.saferpills.org/

 

Levofloxacin

Convulsions and toxic psychoses have been reported in patients receiving quinolonas, including levofloxacin.

Quinolones may also cause increased intracranial pressure and central nervous system stimulation that may lead to tremors, restlessness, anxiety, lightheadedness, confusion, hallucinations, paranoia, depression, nightmares, insomnia, and rarely suicidal thoughts or acts. These reactions may occur following the first dose.

 If these reactions occur in patients receiving levofloxacin, the drug should be discontinued and appropriate measures instituted.

As with other quinolones, levofloxacin should be used with caution in patients with a known or suspected CNS disorder that may predispose to seizures or lower the seizure threshold (e.g., severe cerebral arteriosclerosis, epilepsy)or in the presence of other risk factors that my predispose to seizures or lower the seizure threshold (e.g., certain drug therapy, renal dysfunction.)

Adverse reactions in clinical trials

The following events were considered likely to be drug-related in patients receiving multiple doses of levofloxacin: insomnia 0.3%, malaise 0.1%, nervousness 0.1%, sleep disorders 0.1%, tremor 0.1%.

In clinical trials, the following events occurred in 1 to 3% of patients, regardless of drug relationship: insomnia 2.9%, dizziness 2.5%.

The following adverse events occurred in clinical trials at a rate of 0.5 to less than 1%, regardless of drug relationship: agitation, anxiety, fatigue, nervousness, somnolence. Abnormal coordination, abnormal dreaming, aggressive reaction, anaemia, confusion, convulsions (seizures), emotionally lability, hallucination, impaired concentration, manic reaction, mental deficiency, sleep disorders, speech disorder, stupor...

Tequin

Side effects: Nervous System: abnormal dream, insomnia, paresthesia, tremor, vasodilatation, vertigo.

Additional drug-related adverse events considered clinically relevant that
occurred in <0.1% (rare adverse events) of patients receiving gatifloxacin in
single-and multiple-dose clinical trials are as follows:

Abnormal thinking, agitation, anxiety, arthalgia, confusion, convulsion, depersonalization, depression, euphoria, hallucination, hostility, nervousness, panic attack, paranoia, psychosis, taste loss.

Convulsions, increased intracranial pressure, and psychosis have been
reported in patients receiving quinolones.

Quinolones may also cause central nervous system (CNS) stimulation, which may lead to tremors, restlessness, lightheadedness, confusion, hallucinations, paranoia, depression, nightmares, and insomnia. These reactions may occur following the first dose.

Avelox / Moxifloxacin

Central Nervous System: insomnia, nervousness, anxiety, confusion, hallucinations, depersonalization, hypertonia, incoordination, somnolence, tremor, vertigo, paresthesia.

Nonsteroidal anti-inflammatory drugs (NSAIDs): Although not observed with
moxifloxacin in preclinical and clinical trials, the concomitant administration of a nonsteroidal anti-inflammatory drug with a quinolone may increase the risks of CNS stimulation and convulsions.

Convulsions have been reported in patients receiving quinolones.

Quinolones may also cause central nervous system (CNS) events including: dizziness,
confusion, tremors, hallucinations, depression, and, rarely, suicidal thoughts or acts.

These reactions may occur following the first dose. If these reactions occur in patients receiving moxifloxacin, the drug should be discontinued and appropriate measures instituted.

General Quinolones may cause central nervous system (CNS) events, including:
nervousness, agitation, insomnia, anxiety, nightmares or paranoia. 

Cipro   Ciprofloxacin

Central Nervous System: Dizziness, lightheadedness, insomnia, nightmares,
hallucinations, manic reaction, irritability, tremor, ataxia, convulsiveseizures, lethargy, drowsiness, weakness, malaise, anorexia, phobia, depersonalization, depression, paresthesia.

Less than 1 percent:Central Nervous System: Convulsive seizures, paranoia, toxic psychosis, depression, dysphasia, phobia, depersonalization, manic reaction, unresponsiveness, ataxia, confusion, hallucinations, dizziness, lightheadedness, paresthesia, anxiety, tremor, insomnia, nightmares, weakness, drowsiness, irritability, malaise, lethargy.

Convulsions, increased intracranial pressure, and toxic psychosis have been reported in patients receiving quinolones, including ciprofloxacin.

Ciprofloxacin may also cause central nervous system (CNS) events including: dizziness, confusion, tremors, hallucinations, depression, and, rarely, suicidal thoughts or acts.These reactions may occur following the first dose.

If those reactions occur in patients receiving ciprofloxacin, the drug
should be discontinued and appropriate measures instituted.

As with all quinolones, ciprofloxacin should be used with caution in patients with known or suspected CNS disorders that may predispose to seizures or lower the seizure threshold (e.g., severe cerebral arteriosclerosis, epilepsy), or in the presence of other risk factors that may predispose to seizures or lower the seizure threshold

 

Be aware of interactions with other medicines..

Reporting Adverse Drug Reactions (ADRs)
If you have suffered psychiatric adverse reactions please report them. There may be side effects not mentioned on the data sheets. You can request a list of drugs used pre surgery and during surgery. You should be given patient information for all drugs prescribed as you are discharged from hospital.

Please report Adverse Drug Reactions (ADRs) to:

UK Yellow Card Reporting for Patient and Health Professional reports of Adverse Drug Reactions

USA and worldwide to the Food and Drug Administration for Patients and Healthcare Professionals

Universal free, independent drug safety website - Rxisk/

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