Q: I have had a number of bladder infections in the last 5-6 years, for which my doctor has always given me an antibiotic called Cipro, which usually has worked well. Last week, I saw her again for this problem and was given a different antibiotic.
When I asked why I wasn’t receiving Cipro, she told me there were problems with side effects, but she didn’t have time to explain what they were. Can you help?
A: Cipro is part of a class of antibiotics known as quinolones, which includes ciprofloxacin (Cipro), gemifloxacin, levofloxacin, moxifloxacin, ofloxacin, and delafloxacin. As these medications have been prescribed over the 35+ years since the first one was introduced, the FDA has been receiving reports of various events that have followed their use, including: 1. Potentially permanent and disabling tendon and muscle ruptures. 2. Rare, but serious, joint and nerve damage. 3. Potentially fatal irregularities in the heart’s electrical activity.
A newly recognized problem with these medications is coma, resulting from a very low blood sugar; most of these cases involved elderly patients or those with kidney damage or diabetes; most of the diabetic patients were receiving one of several diabetes medications called sulfonylureas; however, nearly 1/3 of the reported cases had no history of diabetes and were not taking any anti-diabetes medications; nearly 20 percent of the affected patients died as a result of the coma, while another 13 percent of all of the reported cases suffered permanent disability.
Psychiatric side effects, including agitation, confusion, disturbance in attention, memory impairment, and nervousness have also been reported. What is even more worrisome is that these side effects have been seen after as little as a single dose of these medications.
A number of less severe reactions have also been seen, including tremor, dizziness, insomnia, and generalized weakness. As a result of these reports, the FDA has strongly recommended to physicians that they prescribe these drugs only when no other medication will take care of the problem.
To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website familydoctor. org, where you can click on the Search box in the upper right corner of the website, and enter your topic of interest.
I want to thank Marie M. for this question; if you have any particular topic you would like to hear more about, please message me at paulmdake@gmail.com.
