When antibiotics turn toxic
nature.com
nature.com
I took one dose of Cipro and developed permanent tendinosis. My career was ruined. On top of the tendon damage, my nerves were on fire for about three years, and I went from being extremely mentally sharp to pretty foggy with trouble concentrating or multitasking. Though I can't prove the extent of its reach, I went from being an extremely healthy person to someone plagued by seemingly mysterious health issues -- many ususally found in people twice my age or more -- for years, and my best guess to this day is that damn drug.
Cipro robbed me of my career, my identity, and my 20s. I've never quite fully recovered or found a job I loved as much/was as good at as playing guitar.
Fuck Cipro.
That's horrible, I'm sorry.
Have a similar story to yours but early adolescence. More severe, but full physiological recovery after years. The life knock-on effects however remain, and those can hurt more than any physical pain.
Having your life ruined by a rare side effect—especially one that's not outwardly visible—is like being run over by an invisible bus. You're road kill, and yet nobody gives a shit, just another statistic. Worse yet is when you're met with incredulity by the bus driver (in this case medical professionals) as to whether you were actually run over in the first place.
Without going into too much detail, I had a physician refer me to a pediatric psychiatrist on the basis that I was somehow imagining my symptoms, only to later to be completely vindicated by hard diagnostics proving severe, life-threatening illness. It disturbs me to think of kids that weren't as lucky.
Do you mean that you took one run of Cipro as a perscription, or do you seriously mean you only took a single dose?
Did they warn you about the known side effects involving tendon damage?
I called the doctor and they advised that I stop taking it immediately, but clearly the damage was done.
I had no idea about any of the side effects. I was just a kid so I wasn't yet in the habit of researching drugs or (stupid!) even looking up which side effects are signs of a serious reaction. All I knew was I had a bacterial infection, had been given antibiotics a couple times before in my life without issue, so why worry?
I guess it's technically on me to read the literature, but again...I was a kid. I think this was the second time I'd ever seen a doctor without my parents present. A drug this serious should require a stern talking-to by the doc and written consent/understanding of the risks by the patient before it's prescribed. I know that had I been warned, I would've said "fuck no." Sure, I was a dumb kid, but even a dumb kid who is essentially a serious athlete (one who just happens to use really small muscles with an instrument rather than big ones) would've known that "irreversible nerve damage" isn't worth tempting fate.
There isn't a day that goes by without me regretting taking that pill. Again, I don't know the full extent of the damage, but I know that at least it ruined my career just as it was getting started.
Edit: What's really fun is that I may still be seeing new symptoms. I recently suffered Sudden Hearing Loss -- while I'm no longer a professional guitarist, I am a pro musician -- and of course the cause couldn't be pinned down (I know it's not due to loud noises, since you won't meet anyone more careful with their ears than me). This article stating that these drugs may be ototoxic is quite terrifying. My ears have been sort of deteriorating over the last year or so, and if it's Cipro continuing its reign of terror, I don't know what I'll do. File a lawsuit, maybe?
Apparently cipro and other similar antibiotics can cause severe mitochondrial dysfunction due to damage to your mitochondria. PQQ and Coq10 can eventually undo the mitochondrial damage by killing off damaged mitochondria and triggering biogenesis in healthy mitochondria.
I believe the drug acquired the FDA black-box warning only very recently. Many doctors were not aware of the danger.
Cipro saved my life.
My only side-effect is that it left me with not being able to eat anything heavy. I can only digest something like Soylent now, so happy that Soylent is a thing otherwise life would suck.
My Ibuprofen bypackage lists "severe intestinal bleeding, shock, cardiac arrest and coma" at the bottom "less than 1 in 10 million" (IIRC that was the category).
There is a youtube channel that details some of these mishaps and a recent episode detailed someone who took anti-depressants, which lead to being unable to sleep and that person taking sleep drugs in response. Which eventually cause her colon to explode because the drugs in conjunction stopped almost all stomach movement (She survived but her colon was removed due to extensive necrosis).
Medicine/Drugs is always a risk game. There is always a chance that a simple appendectomy goes sour and you die on the operating table. Or that a vaccination leads to a fatal infection at the puncture site. Usually medical professionals try to play it safe and the actual risk for any individual is very low or as low as it can safely be made.
If it goes sour, it can go sour really fast, which is why IMO it's important that you speak with a professional instead of self-medicating for anything beyond cough drops and headache pills atleast once to ask if you can safely take it (even if they disagree that taking is necessary), especially when you already take other medication.
Glad it saved your life, however I must say that's a pretty severe side effect.
On an earlier occasion I was making detailed suicide plans the second week in on ciprofloxacin, which resolved itself shortly after discontinuation.
It has not caused permanent damage to me but this I have to list it as "allergy" for doctors not to prescribe it to me. I had problems doctors not believing the mental issues that this antibiotic cause.
Believe me, the reports of side effects are real.
It took me about 2 years to recover, and probably only because I had a mild case.
God help those pour souls who have a severe case.
To this day if I go back and read the 'floxie' forums it makes me feel blue for the rest of the whole day.
For every person that recovers, it seems like two new cases appear on the forums.
Also, there are many parallels between FQ toxicity and so called 'Gulf War Syndrome'. The soldiers were ordered to take the stuff for months on end to protect against Anthrax attacks.
When prescribed, I was given no warnings. Not even a pamphlet with tiny print. When I returned to the pharmacists with my complaints and research, they were literally Googling it--they had no idea about the FDA warnings.
That's malpractice by your pharmacist. In my state they are required to give you the "label" (that handout) and discuss the drug with you if you haven't been prescribed it before.
> When I returned to the pharmacists with my complaints and research, they were literally Googling it--they had no idea about the FDA warnings.
This is even more shocking. If you're not exaggerating, you really should call the pharmaceutical licensing agency and the attorney general's office (who will send to the right agency for your state). Your pharmacy has unqualified people who are putting lives at risk. If they don't even know these basics who knows what other errors they are making?
I am not kidding about calling the authorities. I don't like the "self-righteous complainers" but this is a genuine public health risk.
FWIW I studied for a pharmaceutical license (but thankfully didn't have to take it as it became obvious to all of us that we shouldn't cut that corner and instead should hire an in-house pharmacist experienced with drug development)
My take-away from this, is that once you know you can't take a family of antibiotics you've "walked off the reservation" for standard treatment guidelines and made their job harder in ways which can potentially go to equally bad outcomes for you. Do they have a competent alternative? Whats the implications of moving up the drug "defcon" chart to something stronger?
Its not win-win to know you can't take a drug, its possibly lose-lose.
Not that there is an alternative. I'm just saying, that empowerment with knowledge you can't take eg Cipro has a consequence bigger than just "don't take Cipro"
Some time later I rejected a prescription of Levofloxacin, and asked my physician for Doxycycline, which I tolerate well. I discussed it with my pharmacist and she agreed with my decision. She had taken Levofloxacin for a few days three years earlier and it gave her permanent (so far) neuropathy in hip and leg, and balance problems.
This 2016 posting includes discussion of Cipro and other drugs in this class:
https://news.ycombinator.com/item?id=13273770
Here are some relevant articles:
Fluoroquinolone-Induced Serious, Persistent, Multisymptom Adverse Effects. BMJ Case Reports, 2015:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600819/
Levofloxacin-Induced Acute Psychosis. Indian Journal of Psychiatry, 2008:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745871/
American Academy of Family Physicians (AAFP) warning:
https://www.aafp.org/news/health-of-the-public/20160727fluor...
I was released from the hospital the day after. Nothing reported to the FDA, barely a mention of a reaction in the paperwork. I was too young to pursue any legal action.
Then over the course of 6 months my health deteriorated. Insomnia, joints started to click, got floaters in my vision. Then clicking turned into joint pain. Also, got nerve buzzing, frequent headaches, IBS, frequent heartburn. There was a time when I could not walk for weeks. Doctors would simply give up and give very little help just pain meds. Mayo clinic diagnosed my tendon issues as tendon overuse because I was athletic prior.....
I work now and can push myself to do many things. I manage the issues quite well and I would say it is a bit better than 7 years ago. However, fuck the medical community, I swear I have seen close to 100 doctors over the course of the last few years from Mayo, Rush, Northwestern and more and only two doctors agreed that it could be Cipro. One doctor refused to note it in my paperwork, and suggested to wait it out as it should get better. Later I found out he is an expert witness for pharma....
As someone that has researched problems since I was little.....I just cannot accept that people with a PhD can be that fucking terrible at typing "cipro tendon" into google search bar and reading studies, stories, and the black label. Or doctors are too much in debt and worry about the risk of going against the medical community. I don't know. The system is simply broken, these issues are under reported as symptoms can show up to 12 months after last dose. Doctors don't report shit and won't even ask if you took fqs.
Interesting fact is that many UTIs are treated with fluoroquinolones. 90% of people diagnosed with fibromyalgia( I have received this diagnosis a few times) are women. They also get diagnosed with UTIs a lot more than men.
I had had several exposures to levofloxacin (a very bad ear infection) and ciprofloxacin (post-surgery prophylaxis) several years apart and was fine. A few months after that latter exposure, I took one dose of levofloxacin for an apparent infection, and within less than a day I started experiencing pain in one and then the other ankle. It was very painful to walk for about a month, my ankles were creaky and sore, and there was transitory soreness in my wrists as well. The acute pain subsided after that month but it took about five months total before my ankles were completely pain-free.
Don't use these antibiotics except to treat something that will kill you otherwise.
https://jamanetwork.com/journals/jamasurgery/article-abstrac...
Cipro greatly increased the rate of aortic aneurysm/dissection in mice when they were challenged with high blood pressure. The examination goes into detail about the reasons. Essentially the drug both inhibits connective tissue repair and starts degrading it. So the black box warning is about tendons, but there's connective tissue all over the body (like in the aorta). There's probably a subset of individuals more genetically susceptible to the disruption, but it looks like this could worsen lots of latent issues in just about anyone.
An example of a different class: "Researchers have shown, for example, that aminoglycoside antibiotics can cause deafness by damaging mitochondria in the hair cells of the ear."
More general statement: "They reported that antibiotics in several classes triggered oxidative stress — a build-up of reactive, oxygen-containing molecules — in mitochondria, inhibiting their function across a range of mammalian cells, as well as in mice."
I interpreted the article as saying that quins are the most obvious example of antibiotics causing harm, but one example for where they cause harm (mitochondria) is a problem shared by other antibiotics. Unfortunately there isn't a test for evaluating mitochondrial damage in the body. Since we can't test, we don't know the real extent of damage done by any antibiotic to human cells. More research is needed.
One of the problem is that they also work really well. A broad spectrum bactericidal antibiotic that works really well, isn't in the beta-lactam family (dodging both beta-lactam resistance and penicillin allergies) is very tempting to use.
It's a hard fight, especially in the outpatient setting, because of this.
Funny enough I was prescribed a fluoroquinolone a few months back without even asking; the condition was so benign that using it was left up to me as optional. The risk calculus there was unfathomably bad, and suffice it to say I didn't take any.
"Until recently, investigations into the side effects of antibiotics have focused on how the drugs disrupt the human microbiome, says James Collins, a medical engineer at the Massachusetts Institute of Technology in Cambridge."