10 ms·

Fluoroquinolone antibiotics like cipro, levaquin, (and generally anything ending in -ofloxacin), can cause permanent nerve damage and one of the presentations i

Fluoroquinolone antibiotics like cipro, levaquin, (and generally anything ending in -ofloxacin), can cause permanent nerve damage and one of the presentations is demyelination of the nerves. [1][2][3] Permanent nerve damage (neuropathy, pins and needles, tingling, muscle weakness, spasms, muscle twitches, heart palpitations) is a known side effect. There's been no attempt made to study if there's any long term delayed brain effects from fluoroquinolones. "Brain fog" is a commonly reported symptom of those who experience fluoroquinolone side effects. I hope there will be more studies on long term brain health from these drugs, as they're given out liberally. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006604/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006604/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667412/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667412/ [3] https://pubmed.ncbi.nlm.nih.gov/10832955/ https://pubmed.ncbi.nlm.nih.gov/10832955/

strstr 6y ago
Those are also known for damaging tendons. I was already planning on avoiding them, but now I have even more reasons!
- stevebmark 6y ago
  I would also avoid them because: https://pubmed.ncbi.nlm.nih.gov/7678175/ https://pubmed.ncbi.nlm.nih.gov/7678175/ > Compared to a potent eukaryotic DNA topoisomerase type II poison ... ciprofloxacin produced comparable dose-dependent SCE frequency increases. Translated: Compared to a chemotherapy drug designed to cause DNA breaks to prevent cell replication, ciprofloxacin produced similar "sister chromatid exchange" counts, which happen when damaged DNA strands need to pull in duplicate material from "sister" strands. Counting SCEs is also used to measure human DNA mutations from things like carcinogens and radiation.
  - exikyut 6y ago
    Interesting. How is "counting SCEs" done? A sibling comment (https://news.ycombinator.com/item?id=26473638 https://news.ycombinator.com/item?id=26473638) mentions the difficulty of acquiring pre-event context for these kinds of situations. Could this sort of testing be useful here?
Aeolun 6y ago
If they have such nasty side effects, why do we even use these at all?
- aidenn0 6y ago
  Because the side effects are considered better than dying? None of them are drugs of first resort for bacterial infection.
  - stevebmark 6y ago
    They're a first resort for urologists, especially for people with any kind of prostate pain, even if there's no clear sign of infection.
  - bongoman37 6y ago
    At least in India, they are often given as first line treatments sometimes even when there is no infection prior to surgery to prevent infections later.
    - amanaplanacanal 6y ago
      I had same thing done in US for prostate surgery.
  - 3131s 6y ago
    I've gotten these OTC at pharmacies in Southeast Asia, but didn't take them because I look up every medicine that I get.
    - bottled_poe 6y ago
      OTC ffs... This is why we can’t have nice things.
      - tim333 6y ago
        They are available everywhere in SE Asia, sometimes even in supermarkets in places like Nepal.
selimthegrim 6y ago
I believe retinal damage (a higher likelihood of spontaneous tears) has been reported too. I was given Cipro as a child for diarrhea in a foreign country and recently suffered tears in both retinas. I have to wonder if that wasn't a contributing factor.
- wallaBBB 6y ago
  if you have myopia, or high IOP I wouldn't look into Cipro for blame.
  - yalok 6y ago
    Could be a compound effect - myopia plus this drug - not a good combination. I have pretty severe myopia, and had laser treatment for tears in it earlier, so have to be very careful about these drugs I guess...
  - selimthegrim 6y ago
    High myopia (between -5 and -6) but IOP was fine...
    - wallaBBB 6y ago
      Well that puts you in a high risk group. Any temporarily high increase in IOP can trigger a tear easily, e.g. an accidental poke. Giving birth is risky with such high myopias. Aging of course... once in 50s I'd do annual checkups on the posterior of the eye if I was a high myope. And drugs for sure didn't affect the shape of your eyeball. I'm not saying antibiotics don't do any damage, I'm just saying that in such a case those would be at the back of the blame list...
0xbkt 6y ago
I was prescribed cipro after a rectal surgery (chronic anal fissure and hemorrhoids) in Feb 2020. By that time, I wasn't aware that cipro was actually a poison. Fortunately, I haven't experienced any such side effects so far, except occasional palpitations (likely due to loneliness, my increased anxiety because of the pandemic and staying indoors all the time).
- techrat 6y ago
  Everything is a poison to some extent. Antibiotics are poison to bacteria. The difference here is that you're not a bacteria and can safely metabolize the drug itself. Chocolate is poison to dogs. Not to humans. One course of an antibiotic isn't going to rot your brain or nerves... and even then, chronic use isn't a problem but for a small percentage of people who do experience these adverse reactions.
  - cmrdporcupine 6y ago
    "The difference here is that you're not a bacteria and can safely metabolize the drug itself." All eurkaryotic cells have little trapped bacteria inside themm -- your mitochondria. The mutualistic cooperation between the mitochondria and the surrounding cell is an ancient and delecate dance. And lo and behold, mitochondrial toxicity from antibiotics is a thing, and fluoroquinolones are suspected to cause it.
  - scaladev 6y ago
    One course of an antibiotic might not "rot your brain", but one course of a corticosteroid certainly can. https://en.wikipedia.org/wiki/Steroid_dementia_syndrome#Case_Studies https://en.wikipedia.org/wiki/Steroid_dementia_syndrome#Case... I was on prednisolone for a couple of months a few years ago. I can't say I was very intelligent before that, but it's certainly took a toll on my memory and cognitive abilities. (No, it's probably not hypochondria, I didn't even know corticosteroids could have such consequences when I noticed the problem.)
    - techrat 6y ago
rini17 6y ago
Whoa. I "only" got very severe painful diarrhea twice from cipro (likely clostridia - https://en.wikipedia.org/wiki/Ciprofloxacin#Other https://en.wikipedia.org/wiki/Ciprofloxacin#Other). Since that I always preemptively say to doctor I reject it.
blauditore 6y ago
I recently got ear drops for a somewhat mild issue I had. The issue didn't go away, but after your comment I remember occasional "pins and needles" in my leg - just looked it up and those drops contain Ciprofloxacin! Though it seems a bit unusual that drops in one of my ears would first cause symptoms in a leg. OTOH, that would be a curious coincidence... Luckily the pins and needles were only mild and transient, so if there was a causation I hope it was only temporary.
cableshaft 6y ago
I was prescribed Cipro for a urinary tract infection and the doctor didn't once mention anything about dangers or side effects for the drug, just said he's 'prescribing an antibiotic'. After the very first pill I was feeling pins and needles in my extremities later that day. I stuck with it for a few more days, each pill feeling even more pins and needles, more intensely and in more places on my body. Once I started feeling it in my face, I called the doctor and they got me on a different antibiotic. Then I started reading horror stories about the drug and it made sense. I also didn't exercise for a year afterwards out of fear that my achilles tendon would snap, one of the biggest warnings that was on the box and one of the things many of the online horror stories said happened to them. The neuropathy (pins and needles) lasted for six months before it started going away, and it comes and goes periodically, years later (it's mostly gone now, thankfully). I've had other health issues since that are known possible health issues from Cipro (it's so invasive and effects so many systems of your body). One of the more annoying ones lately is the onset of Tinnitus, which Cipro is known to cause. Maybe it's just a coincidence, but I'll never know for sure since most doctors still don't treat Cipro toxicity seriously or know how to test for it. I don't think it caused brain fog, but who's to say? I don't feel as mentally acute since then, but I'm also older. Not really looking forward to any future health problems it may lead to, and I only ever took like 5 pills of the damn thing (it was over 7 years ago now). I'm so pissed off I wasn't even warned about this, and that it was so casually prescribed without warning. I've taken other antibiotics before and only had to worry about my gut biome getting screwed up, so I wasn't expecting to have such a terrible reaction to the meds.
- throwaway584568 6y ago
  I have a similar story, with an antibiotic that is also an immunosuppressant (I was taking it for that effect). After taking it for just 2 weeks, I had terrible pain in my arms and legs. My doctor suggested I keep taking it for a couple of weeks more, to see if it went away. It got worse, and I stopped it a week or so later. I understand this is a very rare side effect, so rare I don't think it was even mentioned in the leaflet - I'm just incredibly unlucky to have such a reaction. I was left with small fiber neuropathy (nerve damage) in my arms and legs, and with CFS (Chronic Fatigue Syndrome) too. This means I'm in constant, unending pain (which takes a huge mental toll), that I'm tired all the time, and if I do any more than the gentlest of exercise, I fall asleep and am more tired and in even more pain for days or even weeks afterwards. It's fucking horrible. This was about 6 years ago, and I'm pretty sure it's permanent. I haven't quite given up hope though - I have several Google Scholar alerts setup, and read several papers every week, in the hope of finding something that might reverse things even a bit.
mancerayder 6y ago
I had very horrible side effects from Levaquin for an asymptomatic infection I was diagnosed with. They gave me 12 hour doses, which I took twice .. I had fever, nausea, severe joint pain, and a lot more. Later, both in the US and the UK, future doctors, when describing this to them, said I was misinformed, that probably I was sick, these are not side effects. No, they're misinformed, and I'm deeply suspicious of the medical profession.
ctrlp 6y ago
I can attest. This happened to my wife 15+ years ago. The reaction began after two doses of Levaquin and was 3 months of non-stop living hell. Seriously painful neuropathy, burning all over her body. Profuse sweating all night. Brutal nightmares. Brain fog. Crippling pain in her appendages, melting walls. Extremely distressing. The doctors were completely dismissive of and uninterested in the symptoms -- it really shook my faith in medical practice. We were on an oddessey to determine what was wrong and could be done to help. It took her 6 months to resume walking more than a short distance. She still has foot and hand problems from permanent neuropathy that affect her daily. A few years after, Levaquin was black-labelled, and I believe no longer the first line of defense for children at least. The whole thing still burns me. I suspect this sort of information is no longer rare but if anyone is having this experience then a GABA agonist like benzodiazepine may help you, but be extremely careful as they are quickly dependence forming and must be weened. Small dose.
- ctrlp 6y ago
  There was a book, Bitter Pills, by a journalist who's wife had years long neurological side effects from a flouroquinolone, iirc. It's an investigation into the world of drug testing, prescribing, and side effects. https://www.amazon.com/Bitter-Pills-Inside-Hazardous-World/dp/055337852X https://www.amazon.com/Bitter-Pills-Inside-Hazardous-World/d...
- throwaway584568 6y ago
  > The doctors were completely dismissive of and uninterested in the symptoms I had exactly the same issue! GPs ran a few tests and couldn't figure it out. They labelled is as fibromyalgia, even though I didn't fit the criteria. I pushed to see a neurologist, who ran a few tests and couldn't figure it out - he also labelled it as fibromyalgia, even though when I questioned it he admitted he knew almost nothing about it! There was a lot of back and forth, with GPs and neurologists being really dismissive. I forget how long this went on for, but a couple of years at least. So I did my own research over a long period of time. I found only a handful of other cases, but with the symptoms I came to the conclusion that I must have small fibre neuropathy. I pushed the neurologist, who grudgingly did a nerve biopsy, which confirmed small fiber neuropathy. He stopped being dismissive after that. For pain, I ended up with a similar situation. I tried gabapentin, pregbalin and all the usual things like topical capsicain, TCAs, SNRIs, diazepam, opioids etc. They either didn't help, couldn't be tolerated, or caused more problems. Within the public healthcare systems, the list was eventually exhausted, and they weren't interested in trying anything else. They didn't believe how bad the pain was, and were unwilling in any case to go beyond their list of standard treatments. In the end, I paid to see a private pain specialist, and eventually found ketamine to be really helpful - not just with the pain, but my mental ability to live with it.
andrewl 6y ago
For those interested, there is lots of discussion of fluoroquinolones on this site. Make sure you're searching for the term in the comments, otherwise you won't get any hits. I had my own bad experience with them, and know others who did as well.
notabee 6y ago
Let's not forget to add aortic dissection risk to this. In the experimental setup, all it took was exposure to Cipro and elevated blood pressure in the lab animals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233654/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233654/
pnutjam 6y ago
Does gabapentin do something similar? I've seen this prescribed more and more for pain relief, and it seems to have some serious side effects. My wife refuses to take it after taking it for just afew days.

strstr 6y ago

Those are also known for damaging tendons. I was already planning on avoiding them, but now I have even more reasons!

stevebmark 6y ago
I would also avoid them because: https://pubmed.ncbi.nlm.nih.gov/7678175/ https://pubmed.ncbi.nlm.nih.gov/7678175/ > Compared to a potent eukaryotic DNA topoisomerase type II poison ... ciprofloxacin produced comparable dose-dependent SCE frequency increases. Translated: Compared to a chemotherapy drug designed to cause DNA breaks to prevent cell replication, ciprofloxacin produced similar "sister chromatid exchange" counts, which happen when damaged DNA strands need to pull in duplicate material from "sister" strands. Counting SCEs is also used to measure human DNA mutations from things like carcinogens and radiation.
- exikyut 6y ago
  Interesting. How is "counting SCEs" done? A sibling comment (https://news.ycombinator.com/item?id=26473638 https://news.ycombinator.com/item?id=26473638) mentions the difficulty of acquiring pre-event context for these kinds of situations. Could this sort of testing be useful here?

Aeolun 6y ago

If they have such nasty side effects, why do we even use these at all?

aidenn0 6y ago
Because the side effects are considered better than dying? None of them are drugs of first resort for bacterial infection.
- stevebmark 6y ago
  They're a first resort for urologists, especially for people with any kind of prostate pain, even if there's no clear sign of infection.
- bongoman37 6y ago
  At least in India, they are often given as first line treatments sometimes even when there is no infection prior to surgery to prevent infections later.
  - amanaplanacanal 6y ago
    I had same thing done in US for prostate surgery.
- 3131s 6y ago
  I've gotten these OTC at pharmacies in Southeast Asia, but didn't take them because I look up every medicine that I get.
  - bottled_poe 6y ago
    OTC ffs... This is why we can’t have nice things.
    - tim333 6y ago
      They are available everywhere in SE Asia, sometimes even in supermarkets in places like Nepal.

selimthegrim 6y ago

I believe retinal damage (a higher likelihood of spontaneous tears) has been reported too. I was given Cipro as a child for diarrhea in a foreign country and recently suffered tears in both retinas. I have to wonder if that wasn't a contributing factor.

wallaBBB 6y ago
if you have myopia, or high IOP I wouldn't look into Cipro for blame.
- yalok 6y ago
  Could be a compound effect - myopia plus this drug - not a good combination. I have pretty severe myopia, and had laser treatment for tears in it earlier, so have to be very careful about these drugs I guess...
- selimthegrim 6y ago
  High myopia (between -5 and -6) but IOP was fine...
  - wallaBBB 6y ago
    Well that puts you in a high risk group. Any temporarily high increase in IOP can trigger a tear easily, e.g. an accidental poke. Giving birth is risky with such high myopias. Aging of course... once in 50s I'd do annual checkups on the posterior of the eye if I was a high myope. And drugs for sure didn't affect the shape of your eyeball. I'm not saying antibiotics don't do any damage, I'm just saying that in such a case those would be at the back of the blame list...

0xbkt 6y ago

I was prescribed cipro after a rectal surgery (chronic anal fissure and hemorrhoids) in Feb 2020. By that time, I wasn't aware that cipro was actually a poison. Fortunately, I haven't experienced any such side effects so far, except occasional palpitations (likely due to loneliness, my increased anxiety because of the pandemic and staying indoors all the time).

techrat 6y ago
Everything is a poison to some extent. Antibiotics are poison to bacteria. The difference here is that you're not a bacteria and can safely metabolize the drug itself. Chocolate is poison to dogs. Not to humans. One course of an antibiotic isn't going to rot your brain or nerves... and even then, chronic use isn't a problem but for a small percentage of people who do experience these adverse reactions.
- cmrdporcupine 6y ago
  "The difference here is that you're not a bacteria and can safely metabolize the drug itself." All eurkaryotic cells have little trapped bacteria inside themm -- your mitochondria. The mutualistic cooperation between the mitochondria and the surrounding cell is an ancient and delecate dance. And lo and behold, mitochondrial toxicity from antibiotics is a thing, and fluoroquinolones are suspected to cause it.
- scaladev 6y ago
  One course of an antibiotic might not "rot your brain", but one course of a corticosteroid certainly can. https://en.wikipedia.org/wiki/Steroid_dementia_syndrome#Case_Studies https://en.wikipedia.org/wiki/Steroid_dementia_syndrome#Case... I was on prednisolone for a couple of months a few years ago. I can't say I was very intelligent before that, but it's certainly took a toll on my memory and cognitive abilities. (No, it's probably not hypochondria, I didn't even know corticosteroids could have such consequences when I noticed the problem.)
  - techrat 6y ago

rini17 6y ago

Whoa. I "only" got very severe painful diarrhea twice from cipro (likely clostridia - https://en.wikipedia.org/wiki/Ciprofloxacin#Other https://en.wikipedia.org/wiki/Ciprofloxacin#Other). Since that I always preemptively say to doctor I reject it.

blauditore 6y ago

I recently got ear drops for a somewhat mild issue I had. The issue didn't go away, but after your comment I remember occasional "pins and needles" in my leg - just looked it up and those drops contain Ciprofloxacin! Though it seems a bit unusual that drops in one of my ears would first cause symptoms in a leg. OTOH, that would be a curious coincidence... Luckily the pins and needles were only mild and transient, so if there was a causation I hope it was only temporary.

cableshaft 6y ago

I was prescribed Cipro for a urinary tract infection and the doctor didn't once mention anything about dangers or side effects for the drug, just said he's 'prescribing an antibiotic'. After the very first pill I was feeling pins and needles in my extremities later that day. I stuck with it for a few more days, each pill feeling even more pins and needles, more intensely and in more places on my body. Once I started feeling it in my face, I called the doctor and they got me on a different antibiotic. Then I started reading horror stories about the drug and it made sense. I also didn't exercise for a year afterwards out of fear that my achilles tendon would snap, one of the biggest warnings that was on the box and one of the things many of the online horror stories said happened to them. The neuropathy (pins and needles) lasted for six months before it started going away, and it comes and goes periodically, years later (it's mostly gone now, thankfully). I've had other health issues since that are known possible health issues from Cipro (it's so invasive and effects so many systems of your body). One of the more annoying ones lately is the onset of Tinnitus, which Cipro is known to cause. Maybe it's just a coincidence, but I'll never know for sure since most doctors still don't treat Cipro toxicity seriously or know how to test for it. I don't think it caused brain fog, but who's to say? I don't feel as mentally acute since then, but I'm also older. Not really looking forward to any future health problems it may lead to, and I only ever took like 5 pills of the damn thing (it was over 7 years ago now). I'm so pissed off I wasn't even warned about this, and that it was so casually prescribed without warning. I've taken other antibiotics before and only had to worry about my gut biome getting screwed up, so I wasn't expecting to have such a terrible reaction to the meds.

throwaway584568 6y ago
I have a similar story, with an antibiotic that is also an immunosuppressant (I was taking it for that effect). After taking it for just 2 weeks, I had terrible pain in my arms and legs. My doctor suggested I keep taking it for a couple of weeks more, to see if it went away. It got worse, and I stopped it a week or so later. I understand this is a very rare side effect, so rare I don't think it was even mentioned in the leaflet - I'm just incredibly unlucky to have such a reaction. I was left with small fiber neuropathy (nerve damage) in my arms and legs, and with CFS (Chronic Fatigue Syndrome) too. This means I'm in constant, unending pain (which takes a huge mental toll), that I'm tired all the time, and if I do any more than the gentlest of exercise, I fall asleep and am more tired and in even more pain for days or even weeks afterwards. It's fucking horrible. This was about 6 years ago, and I'm pretty sure it's permanent. I haven't quite given up hope though - I have several Google Scholar alerts setup, and read several papers every week, in the hope of finding something that might reverse things even a bit.

mancerayder 6y ago

I had very horrible side effects from Levaquin for an asymptomatic infection I was diagnosed with. They gave me 12 hour doses, which I took twice .. I had fever, nausea, severe joint pain, and a lot more. Later, both in the US and the UK, future doctors, when describing this to them, said I was misinformed, that probably I was sick, these are not side effects. No, they're misinformed, and I'm deeply suspicious of the medical profession.

ctrlp 6y ago

I can attest. This happened to my wife 15+ years ago. The reaction began after two doses of Levaquin and was 3 months of non-stop living hell. Seriously painful neuropathy, burning all over her body. Profuse sweating all night. Brutal nightmares. Brain fog. Crippling pain in her appendages, melting walls. Extremely distressing. The doctors were completely dismissive of and uninterested in the symptoms -- it really shook my faith in medical practice. We were on an oddessey to determine what was wrong and could be done to help. It took her 6 months to resume walking more than a short distance. She still has foot and hand problems from permanent neuropathy that affect her daily. A few years after, Levaquin was black-labelled, and I believe no longer the first line of defense for children at least. The whole thing still burns me. I suspect this sort of information is no longer rare but if anyone is having this experience then a GABA agonist like benzodiazepine may help you, but be extremely careful as they are quickly dependence forming and must be weened. Small dose.

ctrlp 6y ago
There was a book, Bitter Pills, by a journalist who's wife had years long neurological side effects from a flouroquinolone, iirc. It's an investigation into the world of drug testing, prescribing, and side effects. https://www.amazon.com/Bitter-Pills-Inside-Hazardous-World/dp/055337852X https://www.amazon.com/Bitter-Pills-Inside-Hazardous-World/d...
throwaway584568 6y ago
> The doctors were completely dismissive of and uninterested in the symptoms I had exactly the same issue! GPs ran a few tests and couldn't figure it out. They labelled is as fibromyalgia, even though I didn't fit the criteria. I pushed to see a neurologist, who ran a few tests and couldn't figure it out - he also labelled it as fibromyalgia, even though when I questioned it he admitted he knew almost nothing about it! There was a lot of back and forth, with GPs and neurologists being really dismissive. I forget how long this went on for, but a couple of years at least. So I did my own research over a long period of time. I found only a handful of other cases, but with the symptoms I came to the conclusion that I must have small fibre neuropathy. I pushed the neurologist, who grudgingly did a nerve biopsy, which confirmed small fiber neuropathy. He stopped being dismissive after that. For pain, I ended up with a similar situation. I tried gabapentin, pregbalin and all the usual things like topical capsicain, TCAs, SNRIs, diazepam, opioids etc. They either didn't help, couldn't be tolerated, or caused more problems. Within the public healthcare systems, the list was eventually exhausted, and they weren't interested in trying anything else. They didn't believe how bad the pain was, and were unwilling in any case to go beyond their list of standard treatments. In the end, I paid to see a private pain specialist, and eventually found ketamine to be really helpful - not just with the pain, but my mental ability to live with it.

andrewl 6y ago

For those interested, there is lots of discussion of fluoroquinolones on this site. Make sure you're searching for the term in the comments, otherwise you won't get any hits. I had my own bad experience with them, and know others who did as well.

notabee 6y ago

Let's not forget to add aortic dissection risk to this. In the experimental setup, all it took was exposure to Cipro and elevated blood pressure in the lab animals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233654/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233654/

pnutjam 6y ago

Does gabapentin do something similar? I've seen this prescribed more and more for pain relief, and it seems to have some serious side effects. My wife refuses to take it after taking it for just afew days.