Fluoroquinolone Antibiotics: what you need to know about side effects
What antibiotics are involved?
Fluoroquinolone antibiotics are used to treat serious and life-threatening infections and include: Ciprofloxacin, Levofloxacin, Moxifloxacin, Ofloxacin and Delafloxacin.
What do I need to know?
These antibiotics are carefully chosen based on the type of infection you have, or in some cases, infections we are trying to prevent, and your individual circumstances, for example, known allergies. It is important that we have the correct and most up-to-date information for you, so please discuss any allergies with your healthcare professional.
Although most patients tolerate these antibiotics well, a few patients may develop serious side effects that involve tendons, muscles, joints, and nerves.
In a small proportion of patients these side effects cause long lasting or permanent disability.
Taking a steroid in addition to a fluroquinolone antibiotic may increase the risk of tendon problems. This risk will be carefully considered by your doctor on a risk / benefit basis.
The following patients may also have a higher risk of side effects:
- If you are over 60 years of age
- If your kidneys do not work well
- If you have had an organ transplant
- If you suffer from depression of psychiatric problems – as this treatment may cause changes to your mood or behaviour including confusion, disorientation, anxiety, depression, and suicidal thoughts.
It is therefore important that you discuss any concerns with your healthcare professional before starting treatment.
How likely are these side-effects?
From the currently available data it is not possible to calculate exactly how frequent these side effects occur.
The picture below represents 10,000 people; each circle represents 100 people. It appears that these side effects occur at least as often as between 1 and 10 people in every 10,000 who take a Fluoroquinolone antibiotic.
Proportion of people affected indicated by the red box.
STOP taking the antibiotics if you experience any of the following side effects and contact your doctor or the unit / team looking after you. If you’re unable to see your doctor, call 111 for advice.
Side effects
- Tendon pain or swelling, often beginning in the ankle or calf
- Pain in your joints or swelling in your shoulder, arms or legs
- Abdominal or back pain
- Weakness in your body, or unusual sensations (such as persistent pins and needles, tingling, numbness or burning), especially in your legs or arms
- Severe tiredness or sleepiness, depressed mood, anxiety or memory problems
- Changes in your vision, taste, smell or hearing.
In addition to contacting your doctor, you can also report side effects to the Medicines and Healthcare products Regulatory Authority (MHRA) through the Yellow Card Scheme: www.yellowcard.mhra.gov.uk You can also view further information from the (MHRA): Fluoroquinolone antibiotics (-oxacins): what you need to know about tendons, muscles, joints, nervous system, and psychological side effects
What shall I do if I am worried about the side effects?
Tell your doctor or speak to the unit / team that is looking after your treatment.
Call the Medicines Resource Centre on 01296 838220 between 9am and 4pm.
Outside these hours, please contact your Doctor or attend the Emergency Department (A&E).
Why have I been given this leaflet?
You will only be given this medication if the experts feel that the benefits of fighting an infection are greater than the potential side effects. This will have been discussed with you.
Early identification of side effects is essential to reduce further complications.
You may not notice some changes in your mood and behaviour, so it is very important to tell your friends and family that you are taking these medicines, and that they have rare psychiatric side effects associated with them – others may notice changes and help you quickly identify any symptoms and that you need to talk to your doctor about.