Fluoroquinolone antibiotics have been associated with Achilles tendon ruptures and damage for over a decade. Other severe adverse events may also be associated with other systems requiring collagen formation.

According to Dr. Renata Albrecht, who heads the FDA’s Division of Special Pathogen and Transplant Products, this is one theory of how fluoroquinolones affect the body, as the drug affects how collagen is formed.

She warns patients taking these antibiotics should seek immediate medical care if they experience soreness or inflammation in muscles or tendons, and they should not exercise while the joints are affected. This may also explain, at least in part, how the drug increases your risk of aortic rupture or dissection, as collagen lines your arteries and veins to allow for stretch as the heart pumps blood.

The drugs are also powerful iron chelating agents that may trigger epigenetic changes through the loss of agents requiring iron as a cofactor. As noted in one study, this may also explain the classic renal toxicity associated with the antibiotics:

“At sub-millimolar concentrations, these antibiotics inhibited jumonji domain histone demethylases, TET DNA demethylases and collagen prolyl 4-hydroxylases, leading to accumulation of methylated histones and DNA and inhibition of proline hydroxylation in collagen, respectively. These effects may explain fluoroquinolone-induced nephrotoxicity and tendinopathy.” 

A recent study has linked the use of fluoroquinolones to the rising number of children and adults affected by kidney stones. The odds of stones increased 1.5 times with the use of fluoroquinolones and exposure within 3 to 12 months was associated with greater risk. It appeared children and adolescents were particularly susceptible.

Reactions can be bodywide, impacting your central nervous system and musculoskeletal, visual and renal systems, sometimes simultaneously. Among the serious reactions reported are:

  • Memory impairment
  • Delirium
  • Agitation
  • Disorientation
  • Retinal Detachment
  • Hearing Loss
  • Disturbance in attention
  • Kidney stones
  • Kidney failure
  • Hypoglycemia leading to coma
  • Aortic rupture or dissection
  • Tendon rupture or dissection

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