Levaquin And Connective Tissue Disorders Warning

[firewatcher]

For those of you with EDS or suspected connective tissue disorders, be aware that if you get a sinus infection that you could have some BAD side effects depending on the drug they give you.

Since POTS is so common with EDS and I just finished my physical therapy for a partial rotator cuff tear, I thought I'd share this info. Levaquin (fluoroquinolone antibiotics) is being more frequently prescribed for sinus infections as the little nasties in our nosies get more resistant. Unfortunately, the side effects for taking these types of antibiotics increases the risk of tendon rupture (usually 1 in 250,000 people) but this number is much higher in those with connective tissue disorders! I had been on Levaquin when I tore my shoulder during Pilates. My allergist no longer prescribes it at all, he says the incidence is higher than reported. He also said that if you have EDS or a suspected connective tissue disorder to either NOT take one of these antibiotics or NOT exercise at all for the time you are on them and then for one to two weeks after.

I'm not saying it will happen with everyone, very likely it won't at all. But after all this, my PT and GP now suspect I have a connective tissue disorder of some type. I "graduated" from my shoulder PT, but will have to keep doing the exercises for a long time because of the tear.

Am J Rhinol. 2005 Jul-Aug;19(4):395-9.

Fluoroquinolone-induced arthralgia and myalgia in the treatment of sinusitis.

O-Lee T, Stewart CE 4th, Seery L, Church CA.

Division of Otolaryngology-Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, California, USA.

BACKGROUND: Because of their broad-spectrum coverage, fluoroquinolone antibiotics are widely used in the treatment of acute sinusitis and acute exacerbations of chronic sinusitis. Generally, they are well tolerated, and adverse effects are usually mild. In our experience with quinolones, patients have frequently complained of arthralgias and/or myalgias. Although tendon rupture has been described as one of the more severe side effects, there are few published reports of arthralgias and/or myalgias associated with these drugs. METHODS: A retrospective review of fluoroquinolone prescriptions in a tertiary rhinology clinic was completed. Patients treated with oral levofloxacin for sinusitis over a 12-month period were contacted by mail and asked to complete an anonymous survey regarding adverse effects. Of 81 patients identified, 36 responses were received. RESULTS: Among respondents, the incidence of arthralgias and/or myalgias was 25%, which was more than twice the incidence of any other adverse effect reported. Occurrence of arthralgias and/or myalgias did not appear to be influenced by respondent age, course length, concurrent use of oral steroids, or a history of arthritis. Among those reporting arthralgia or myalgia, symptoms began after an average of 3 days of therapy and resolved an average of 7.5 days after cessation of treatment. Fourteen percent of respondents were unable to complete their course of therapy because of arthralgias and/or myalgias. CONCLUSION: Although effective and generally well tolerated in the treatment of sinusitis, fluoroquinolone antibiotics may produce adverse effects of arthralgia and/or myalgia.

[lifesaver]

Hard to put thoughts together--but I want to add something to this thread because taking a drug related to levaquin, called Avelox, caused a horrid drug interaction and all of my symptoms went into overdrive. This was before we knew what was wrong with me too.

If you are already very medication sensitive, please consider taking any drug in the fluoroquinolone class only if it is the only choice to treat a life-threatening infection. Taking these meds for sinus/ear infections can be a true form of overkill.

Levaquin is contraindicated if you are taking Cymbalta, an anti-depressant and probably any other antibiotic in its class by default. I was taking cymbalta, prilosec, zantac, and aleve when the ENT put me on Avelox for an ear infection. The fluoroquinolones are used for flesh-eating bacteria, severe pneumonia, peritonitis, and other very severe infections. They raise the blood levels of SSRI/SNRI's 6 times or more or more the therapeutic level--hence the reaction and risk of serotonin syndrome too.

I broke out in a rash with itching, all over my body, had leg and facial edema, and blistery rash in my throat and genitals. Even after going off the Avelox, I still cannot take Cymbalta, zoloft, or celexa--get the rash and itch. My psychiatrist will not let me try any other SSRI or SNRI because of the severity of the reaction and because I am so sensitized I get a rash and itch with them too. I cannot use cipro ear drops--it is a fluoroquinolone and I get the genital/throat blisters. I took Zantac later and ended up in the ER with breathing problems. We rechallenged all the meds that interacted with the avelox and still had severe reactions.

Luckily I can take Remeron for my depression and I was not sensitized to NSAIDs by it. But I am very cautious with all my meds now and read the information online very thoroughly before taking any new medication. I did end up in the psych hospital because I was not on any antidepressant after the reaction and my trigeminal neuralgia pain had become so intense. This is a side effect I don't wish on anyone.

As firewatcher said, these kind of reactions will not happen to everyone. Choose your medication carefully and stay alert for early warnings of problems. If there is an effective alternative antibiotic, seriously consider taking it instead.

lifesaver

[firewatcher]

I so completely agree! I'd already been on a month of antibiotics to get rid of my sinusitis, so my GP (not my allergist) decided to squash it with "the big hammer!" Well, I got squashed instead!

[Maxine]

My neurologist told me about this, and I was pretty impressed that he was even interested. He's the new neurologist that I'm seeing at the Cleveland Clinic.

Here's what I posted a while ago.

http://dinet.ipbhost.com/index.php?showtop...eds+antibiotics

Pretty Serious stuff.

Maxine :0)

[Dizzysillyak]

I'm just getting over a bad reaction to this. I was given this med in Jan for pyelonephritis (kidney, bladder, ureter infection).

It's been a month and I still can't move my arms over my head all the way, reach behind my back or keep my hands on the top of the steering wheel. My knees feel like they're going out on me so I have to use a motorized cart to go grocery shopping. I'm still getting tired extremely easy.

My reaction from this medication is almost exactly the same way my CFS/ME/FM (with OI and ataxia) started back in 1990. I took 3 rounds of antibiotics (not sure which meds yet) in Jan 1990 for green gunk in my lungs and was never the same. Due to the similiarity in my reaction, I suspect it was a quinolone tho.

IMHO, this med needs to be taken off the market. tc ... D

http://articles.mercola.com/sites/articles/archive/2009/07/18/Antibiotics-to-Avoid-Like-the-Plague-Due-to-FDAs-Oversight-Failure.aspx

[Katybug]

Dizzy,

Sorry it happened to you. My Lyme doc a few years ago tried me on it and within 24 hours I had tendonitis in most of my large joints and hands. It was so painful. I didn't know I had EDS back then but luckily the doc warned me that this is possible and to look out for it, so I knew to stop taking it and call her right away. Hope you feel better soon.

Katie

[Dizzysillyak]

Thanks Katy. You're so lucky your doc warned you about this. I didn't realize what was happening until the pain became severe and I couldn't walk or move my shoulders. I was on Tyl with codeine AND Ibuprofen with codeine for at least a week. Then I was on Aleve and Advil 24/7 for a couple of weeks after that. Thankfully, that parts over ...

I even had both of my knees go out on me while shopping a couple of days before the extreme pain hit but didn't realize what was up. When I fell I damaged my left knee which isn't helping now either.

I had to google this to figure out what was happening.

It's sad to think how many people are taking this medication and not realizing it's causing joint problems for them. I have a freind who complains about her knees and has taken this med several times but never made the connection.

tc ... d

[Katybug]

It is a shame. I actually have it listed in my drug allergies now so no one tries to give it to me ever again. I know you didn't need another thing on top of the problems you already had. Wishing you a speedy recovery from this.