My mother spoke at the meeting preceding the FDA [1] requiring a black-box warning be added to that class of antibiotics. Rupturing tendons is bad, but it gets a lot worse than that.

She suffered life-altering symptoms which ended her career of 25 years in insurance sales.

The drug is routinely prescribed and dispensed without patients being warned of these symptoms. Just a few months ago, she was at a pharmacy and overheard the drug being dispensed and asked the pharmacist why she didn’t warn the person who received it about the possible reactions.

It apparently takes too much time to tell them, according to that pharmacist.

[1]: https://www.fda.gov/drugs/drug-safety-and-availability/fda-d...

Cipro does far worse than rupture tendons.

It has two black box warning labels on it, the other is for nerve damage (causes peripheral neuropathy).

It has been implicated in retinal detachment, kidney failure, heart damage, brain fog, and some have tied it to fibromyalgia.[1] Which makes some potential sense given the rate at which women have taken it for UTIs.

With the damage that it is now known to cause, veterans groups have been looking at Cipro as the cause of Gulf War Syndrome.[2] Soldiers were forced to take Cipro as a guard against anthrax during the Gulf War, with little evidence at the time that it would do anything to protect against it.

There may be no drug more vile - outside of opioids - that is being very routinely given to people in the US than Cipro.

It strips magnesium from your body and leaves necrotic damage behind (the only partial counter to it, prior to taking it and after, is supplementation with something like eg magnesium citrate). In addition to tendons, it can also destroy cartilage.

And if you make the mistake of taking it with NSAIDs or steroids, watch out (there is a warning for that, but one can imagine many people ignoring it in regards to something like Advil). That can amplify the damage dramatically.

[1] https://well.blogs.nytimes.com/2012/09/10/popular-antibiotic...

[2] https://www.militarytimes.com/2013/11/01/new-fda-warnings-on...

It should be illegal to classify fluoroquinolones as antibiotics. The point of an antibiotic is that it specifically targets bacterial cells while doing no damage to multicellular organisms. Fluoroquinolones indiscriminately damage everything they touch, so they're just a really fancy and strange poison. They don't just rupture tendons, people will often experience waves of intense pain throughout their entire body for the rest of their life from the damage done to their nervous system. Many suspect that "gulf war illness" was in fact soldiers reacting to fluoroquinolone "antibiotics" which they were the guinea pigs for. Always check the acting component of an antibiotic that a doctor prescribes to you, and if it contains fluoroquinolones then you should frankly treat their act of prescribing it to you as barely any different than a murder attempt.

Fluoroquinolones can do worse than tendon ruptures. One possible side effect is neuropathy. I got a bit of this the last time I took levofloxacin. My skins felt...wrong, for a couple of months. I had random painful prickly sensations. I absolutely can't drink caffeine anymore. And my case is hardly a serious one. Imagine the sensation of being on fire--some people have ended up in exactly that situation.

I'll never take another fluoroquinolone as long as I live.

It's not so much that it ruptures tendons, as they were some studies in dogs a while ago that showed that if you marinate canine achilles tendons in cipro some of the fibroblasts die off - which has the effect of diminishing the tendon structural integrity over time. The study was in achilles tendons, so you only ever heard about it being associated with achilles tendonitis. As a foundation of knowledge this was crap, but it made it into the med school curricula and textbooks. Which... well, when every med student in the country is taught "CIPRO = ACHILLES TENDONITIS" (and has it on their board exams that it can occur even years out), it's going to tend to create a certain bias for detecting and reporting. I mean, "Oh, my patient tore their achilles, and I treated them for a UTI three years ago. It must be the cipro!" I mean, no one would ever think that if they hadn't had it drilled into their heads in school.

It's /probably/ bullshit... but there are better UTI meds, so most practitioners don't use it first-line regardless.