Fluoroquinolone-induced Achilles tendon rupture [Article in German]
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Maurin N.
Dtsch Med Wochenschr. 2008 Feb;133(6):241-4
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Google scholar search on this.
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Here is a rport from an Infectious Disease conference:
Achilles Tendon Rupture After Use of Antibiotics
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Management of bilateral Achilles tendon rupture associated with ciprofloxacin: a review and case presentation.
Akali AU, Niranjan NS
J Plast Reconstr Aesthet Surg. 2008 Jul;61(7):830-4
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In addition, due to the frequent reporting of tendinopathy after Fluoroquinolone use the FDA has included a "Black box"warning when prescribing these drugs.
FDA ALERT [7/8/2008]: FDA is notifying the makers of fluoroquinolone antimicrobial drugs for systemic use of the need to add a boxed warning to the prescribing information about the increased risk of developing tendinitis and tendon rupture in patients taking fluoroquinolones and to develop a Medication Guide for patients. The addition of a boxed warning and a Medication Guide would strengthen the existing warning information already included in the prescribing information for fluoroquinolone drugs.
Fluoroquinolones are associated with an increased risk of tendinitis and tendon rupture. This risk is further increased in those over age 60, in kidney, heart, and lung transplant recipients, and with use of concomitant steroid therapy. Physicians should advise patients, at the first sign of tendon pain, swelling, or inflammation, to stop taking the fluoroquinolone, to avoid exercise and use of the affected area, and to promptly contact their doctor about changing to a non-fluoroquinolone antimicrobial drug.
Selection of a fluoroquinolone for the treatment or prevention of an infection should be limited to those conditions that are proven or strongly suspected to be caused by bacteria.
This information reflects FDA's current analysis of data available to FDA concerning fluoroquinolone antimicrobials. FDA intends to update this sheet when additional information or analyses become available. -
Death following bilateral complete Achilles tendon rupture in a patient on fluoroquinolone therapy: a case report.
Gottschalk AW, Bachman JW.
J Med Case Reports. 2009 Jan 6;3(1):1. [Epub ahead of print]
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The Texas Record are reporting:
Class action alleges antibiotic causes tendon damage
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Levofloxacin-Induced Achilles Tendinitis in a Young Adult in the Absence of Predisposing Conditions
Areum Durey, Yong Soo Baek, Jin Seok Park, Kwangsoo Lee, Jeong-Seon Ryu, Jin-Soo Lee, and Moon-Hyun Cheong
Yonsei Med J. 2010 May;51(3):454-456.
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Four consecutive cases of Achilles tendon disorders associated with levofloxacin treatment in hemodialysis patients
Shin-ichi Takeda, Toshimi Imai, Yuko Chaki, Eiji Kusano
Clinical and Experimental Nephrology; October 2012
(no abstract available) -
Letter to the Editor in Jnl Of Rheumatology:
Achilles Tendinopathy After Treatment with Ophthalmic Moxifloxacin -
Pharmacokinetic Prediction of Levofloxacin Accumulation in Tissue and Its Association to Tendinopathy
Loan Pham, John M. Christensen2, Rosita Rodriguez-Proteau
Pharmacology & Pharmacy, 2013, 4, 121-131
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Tendon Injury and Fluoroquinolone Use: A Systematic Review
Anne L. Stephenson, Wei Wu, Daniel Cortes, Paula A. Rochon
Drug Safety; July 2013
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Bilateral rupture of the Achilles tendons after treatment with ciprofloxacin.
Attarzadeh AP, Ryge C
Ugeskrift for Laeger 2013, 175(39):2264-2265
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Fluoroquinolones and Tendinopathy: A Guide for Athletes and Sports Clinicians and a Systematic Review of the Literature
Trevor Lewis and Jill Cook
Journal of Athletic Training In-Press. ONLINE AHEAD OF PRINT
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Ciprofloxacin-Induced Tendinopathy of the Gluteal Tendons
Kaumakaokalani Shimatsu MD, Somasundaram Subramaniam MD, Helen Sim MD, Paul Aronowitz MD
Journal of General Internal Medicine; July 2014
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Bilateral Achilles Tendon Ruptures Associated with Ciprofloxacin Use in the Setting of Minimal Change Disease: Case Report and Review of the Literature
Firas Kawtharani, MD, Karim Z. Masrouha, MDemail, Nadim Afeiche, MD
The Journal of Foot and Ankle Surgery; Articles in Press
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I see they also a risk factor for peripheral neuropathy. I was alerted to the study below via this lawyers website. Guess what they were touting for?
Oral fluoroquinolone use and risk of peripheral neuropathy
A pharmacoepidemiologic study
Mahyar Etminan, PharmD, James M. Brophy, MD, PhD and Ali Samii, MD
Neurology; August 22, 2014
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Fluoroquinolone-Mediated Achilles Rupture: A Case Report and Review of the Literature
Adam M. Budny, DPM, FACFAS, Alexis N. Ley, DPM, AACFAS
The Journal of Foot and Ankle Surgery;Articles in Press
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Fluoroquinolone-induced Achilles tendinitis
PK Tam, MB, BS, FHKAM (Medicine); Carmen TK Ho, MB, BS, FHKAM (Medicine)
Hong Kong Med J 2014 Dec;20(6):545–7
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To Cipro or Not to Cipro.
Bilateral Achilles Ruptures with the Use of Quinolones
Jay Seidel, Terry Clarke, and Bindu Mathew
Journal of the American Podiatric Medical Association: March 2015, Vol. 105, No. 2, pp. 185-188.
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“Levofloxacin induced bilateral achilles tendonitis”
Muhammad Ishaq, Chand Sudham, Kumar Ajeet, Adnan Baig, Shaikh M. Ishaq
Source (full text)
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Fluoroquinolones and collagen associated severe adverse events: a longitudinal cohort study
Nick Daneman et al
BMJ Open 2015;5:e010077 doi:10.1136/bmjopen-2015-010077
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Levofloxacin-associated bilateral Achilles’ tendon rupture, in patient with two secondary hip fractures
P. Lopez Pardo et al
European Geriatric Medicine; in press
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FDA News Release
FDA updates warnings for fluoroquinolone antibiotics
Limits use for acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis and uncomplicated urinary tract infections
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A Case-Based Approach to Evaluate the Potential Risks Associated with Fluoroquinolones and Steroids
Nguyen, Timothy; Gelband, Karin
The Consultant Pharmacist®, Volume 31, Number 11, November 2016, pp. 646-649(4)
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A study of association of fluoroquinolones in tendinitis and associated complications.
Jaiswal A, Khan MA.
J. Evid. Based Med. Healthc. 2017; 4(31), 1855-1858. DOI: 10.18410/jebmh/2017/362
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Fluorquinolones and the Risk of Achilles Tendon Disorders: Update on a Neglected Complication.
Godoy-Santos AL et al
Urology. 2017 Oct 23. pii: S0090-4295(17)31100-7. doi: 10.1016/j.urology.2017.10.017
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Fluoroquinolone (Levofloxacin)
Induced Tendinopathy with Partial Tearing of the
Achilles Tendon -
Sharma A, Baldi A, Sharma DK, Singh R,
Anghore D
J Clin Case Stu (2017)
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From Podiatry Today:
How Antibiotics Can Affect Achilles Tendinopathy In Athletes -
The relative risk of Achilles tendon injury in patients taking quinolones
Daniel C. Jupiter Xiao Fang Zachary Ashmore Naohiro Shibuya Hemalkumar B. Mehta
Pharmacotherapy: 04 July 2018
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Drug treatments associated with Achilles tendon rupture. A case‐control study involving 1118 Achilles tendon ruptures
Timo Nyyssönen Iikka Lantto Peter Lüthje Tuomas Selander Heikki Kröger
18 August 2018 https://doi.org/10.1111/sms.13281
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Relative and Absolute Risk of Tendon Rupture with Fluoroquinolone and Concomitant Fluoroquinolone/Corticosteroid Therapy: Population-Based Nested Case–Control Study
Daniel R MoralesJim SlatteryAlexandra PacurariuLuis PinheiroPatricia McGettiganXavier Kurz
Clinical Drug Investigation: 21 November 2018
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The FDA is now warning that they increase the risk for rupture of the aortic wall:
https://www.fda.gov/Drugs/DrugSafety/ucm628753.htm -
Cephalexin-associated Achilles Tendonitis: Case Report and Review of Drug-induced Tendinopathy
Philip R. Cohen
Cureus 10(12): e3783. doi:10.7759/cureus.3783
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Bilateral Levofloxacin-Induced Achilles Tendon Rupture: An Uncommon Case Report and Review of the Literature
Marcos Edgar Fernández-Cuadros, Luz Otilia Casique-Bocanegra, María Jesús Albaladejo-Florín, ...
Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders March 5, 2019
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Association Between Peripheral Neuropathy and Exposure to Oral Fluoroquinolone or Amoxicillin-Clavulanate Therapy
Daniel Morales et al
JAMA Neurol. April 29, 2019
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Fluoroquinolone Use and the Risk of Collagen-Associated Adverse Events: A Systematic Review and Meta-Analysis
Xinyu YuDing-sheng JiangJing WangRui WangTaiqiang ChenKan WangShiyi CaoEmail authorXiang Wei
Drug Safety: 10 May 2019
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Tendon Rupture as a Probable Side Effect of Ciprofloxacin: A Review
Nazanin Foroutan
Adv Pharmacoepidemiol Drug Saf 8:1. doi:
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