Investigations: Levaquin and other Fluoroquinolones

Read about Levaquin Tendinopathy

See a List of Fluoroquinolones on the U.S. Market Today

Read about Fluoroquinolones Removed from the Market

Tendinopathy associated with Levaquin and other Fluoroquinolones.

Fluoroquinolones are in a class of antibiotics known for their anti-bacterial activity.  They are specifically indicated for bacterial infections and are commonly prescribed for upper respiratory infections, sinus infections, prostatitis and diverticulitis.

Manufacturers of the various fluoroquinolones report a variety of rare side effects associated with ingesting these antibiotics, and tendon injury is one of them. However, the rapid rate by which Levaquin-associated tendon injuries are being reported to the FDA suggest that Levaquin-tendon injuries may not be so rare.

As early as 1983, fluoroquinolones were linked to Achilles tendonitis. Between 1987 and 1996, the FDA received over 200 reports of quinolone-induced tendon ruptures, prompting the FDA to revise the class labeling for all quinolones to include a tendon injury warning. Thereafter, in 1997, Levaquin was introduced in the United States. Although the package insert carried the typical standard quinolone warning, it also indicated that in clinical trials, tendon injury occurred in less than 1 percent of all patients. The Levaquin label did not warn nor recommend to modify or decrease strenuous activities while taking Levaquin to decrease the chance of tendon injury.

Tendon injury associated with Levaquin or other quinolones differs from other forms of tendonitis by its acute onset of sharp pain that occurs when the associated extremity is used or touched.  Usually, there is marked swelling and involvement bilaterally.  Although tendon ruptures can occur spontaneously while on Levaquin, they may be more likely to occur if the tendonitis is not immediately diagnosed.  Although tendonopathy is a known side effect of all quinolones, there have been increasing reports of tendon problems with the use of Levaquin. 

Post-marketing surveillance has shown a number of factors which increase the risk of tendonopathy such as concomitant use with corticosteroids and non-steroidal anti-inflammatories such as Advil and Motrin.  Other conditions that may predispose a person to tendon rupture are age, prior tendonopathy, magnesium deficiency, hyperparathyroidism, diuretic use, peripheral vascular disease, rheumatoid arthritis, diabetes mellitus, renal insufficiency, and strenuous sports activities.

If you have suffered tendon problems while taking Levaquin or other Fluoroquinolones, please call Lewis Saul & Associates toll-free at (888) 747-5342 or fill out our convenient online contact form and a member of our firm will contact you by the next business day for a free consultation.

Most Common Fluoroquinolones Available in the U.S.

• Cipro (ciprofloxacin)
• Levaquin (levafloxacin)
• Floxin (ofloxacin)
• Avelox (moxifloxacin)
• Noroxin (norfloxacin)
• Penetrex (enoxacin)
• Maxaquin (lomefloxacin)

Five Fluoroquinolones Removed from the Market

In total, five fluoroquinolones have been removed from the general marketplace: Omniflox was removed in 1992 because it caused low blood sugar, kidney failure and a certain rare form of anemia; Raxar (grepafloxacin) and Zagam (sparfloxacin) were removed because of QT-interval prolongation and increased risk of heart arrhythmias; Trovan (trovafloxacin) was severely limited in use in 1999 due to severe liver toxicity; and most recently, Tequin (gatifloxacin) was pulled from the market amid reports of severe blood sugar reactions such as hyperglycemia and hypoglycemia.