Links & Resources

FDA Datasheets

FDA general warning regarding all fluoroquinolones

08/15/13 – Announcement that peripheral neuropathy is to be added as a serious side effect to the package inserts for oral and injected fluoroquinolones

11/23/11 Pediatric Advisory Committee Meeting, “Pediatric Focused Safety Review: Levaquin (levofloxacin)”

Media

New York Times by Jane Brody, “Popular Antibiotics May Carry Serious Side Effects”

Video / Documentary PBS Frontline expose about fluoroquinolones

CBS News video, Antibiotics May Damage Human Tissues and Cells

Forbes article by Melanie Haiken, “Antibiotic Alert: The Drug the Doctor Ordered Could Cause Deadly Side Effects” (Please note that the author’s teenage daughter was prescribed Cipro.)

Articles from Dr. Mercola about fluoroquinolones
Antiobiotic Alert: The Drug the Doctor Ordered Could Cause Deadly Side Effects
Warning: Fluoroquinolone Antibiotics May Cause Permanent Nerve Damage

Video / Documentary specifically about Fluoroquinolone Toxicity – Certain Adverse Events. It is also available on Youtube.

Book – Bitter Pills: Inside the Hazardous World of Legal Drugs by Stephen Fried

Prohealth, by Jason Alexander Uttley, “The Poisoning of America: The Rise of “Mystery” Illnesses Including Chronic Fatigue Syndrome, Fibromyalgia and Gulf War Syndrome”

News piece on Youtube about fluoroquinolones, also called “Bitter Pills” (though not related to the book, I believe).

Wall Street Journal, “Surge in Use of Cipro Spurs Concerns About Side Effects”

The Ecologist article by Andrew Wasley, “Popular Antibiotic Ciprofloxacin Linked to UK Deaths.”

Medline Plus article by Robert Preidt, “Certain Antibiotics Tied to Blood Sugar Swings”

Point of Return, Description of Effects of Fluoroquinolones

Article in The Air Force Times: New FDA Warnings on Cipro May tie into Gulf War Illness

Science Daily, “Risk of Kidney Disease Doubled with use of Fluoroquinolone Antibiotics”

US News and World Reports, by Steven Reinberg, “Antiobiotics Linked to Retinal Detachment Risk: The Risk is Very Small and the Reasons aren’t Known, Researchers Say”

Fox News, “Common Antibiotics Tied to Eye Emergencies Study Says”

News@JAMA, by Mike Mitka “Retinal Detachment Risk Associated with Use of Some Antibiotics”

Dear Doctor letter written by Dr. Plumb, a doctor who was Floxed

Drug Safety Monitor, “Study Shows that Moxifloxacin Associated with High Rates of Hospitalizations Due to Drug Reactions”

Journal of Clinical Neuromuscular Disease, “Carpal tunnel syndrome after Ciprofloxacin-induced tendinitis“

Mail Online, “Taking Antibiotics Ruptured my Tendon: The Hidden Dangers of Everyday Drugs we Assume are Harmless“

Medscape Medical News, “New Evidence of Dysglycemia with Gatifloxacin“

Medscape MultiSpecialty, “Antibiotics and Neuropathy: What’s the Latest?“

Egyptian Newspaper article about FQs, in Arabic “Antibiotics: A Two Edged Sword“

Natural News, “Magnesium Heals Cipro Damage“

News Inferno, “Study: Fluoroquinolone-Cortisteroid Combo Increases Adverse Effects“

Boise Weekly, “The Cure that Kills: When the Side-Effects of Medications are Worse Than the Ailments They’re Prescribed For“

Medscape Heartwire, “Cardiac Risks with Antibiotics Azythromycin, Levofloxacin Supported by VA Data“

Oklahoma’s NewsOn6, “Broken Arrow Woman Deals with Medication Side-Effects 1 Year Later“

Green Med Info, “Fluoroquinolone Antibiotics Linked To Severe Liver Damage“

Los Angeles Times, “Downside of Widespread Cipro Use“

Salon, “In Cipro We Trust“

Research

Mechanisms in Medicine, video, “Fluoroquinolones: Mechanisms of Action and Resistance”

The Journal of Biological Chemistry, “The Mechanism of Inhibition of Topoisomerase IV by Quinolone Antibacterials.” The article also does an excellent job explaining how fluoroquinolones work.

Proceedings of the National Academy of Sciences of the United States, Biochemistry, “Quinolone Binding to DNA Mediated by Magnesium Ions”

Mutation Research, “Ciprofloxacin: Mammalian DNA Topoisomerase Type II Poison In Vivo“

International Journal of Developmental Neuroscience, “Analysis of age dependent changes of Topoisomerase II alpha and beta in rat brain.“

PNAS, “Target genes of Topoisomerase IIβ regulate neuronal survival and are defined by their chromatin state“

Annals of Epidemiology, “Peripheral Neuropathy and Guillain-Barre Syndrome Risks Associated with Exposure to Systemic Fluoroquinolones: A Pharmacovigilance Analysis“

The British Journal of General Practice, “Benzodiazepine tolerance, dependency, and withdrawal syndromes and interactions with fluoroquinolone antimicrobials“

Turkish Journal of Hemotology, “Ciprofloxacin: A Novel Therapeutic Agent for Iron Overload?“

Antimicrobial Agents and Chemotherapy, “Levofloxacin and Moxifloxacin Increase Human Gut Colonization by Candida Species.“

BMC Microbiology, “Comparative Transcription Analysis and Toxin Production of Two Fluoroquinolone-Resistant Mutants of Clostridium Perfringens” FDA write-up

Current Medicinal Chemistry, “Recent Advances in the Discovery and Development of Quinolones and Analogs as Antitumor Agents”

Urology, “Quinolone antibiotics: a potential adjunct to intravesical chemotherapy for bladder cancer“

Asian Pacific Journal of Cancer Prevention, “Comparative Evaluation of Antiproliferative Activity and
Induction of Apoptosis by some Fluoroquinolones with a Human Non-small Cell Lung Cancer Cell Line in Culture“

Biochemical Pharmacology, “Quinolone analogue inhibits tubulin polymerization and induces apoptosis via Cdk1-involved signaling pathways“

Toxicological Sciences, “Inhibition of Human Topoisomerase IIa by Fluoroquinolones and Ultraviolet A Irradiation“

Experimental Gerontology, “DNA topoisomerases in mtDNA maintenance and ageing”

Nature, “Unexpected Link Between and Antibiotic, Pannexin Channels and Apoptosis“

Cancer Biol. Ther., “Ciprofloxacin-induced G2 arrest and apoptosis in TK6 lymphoblastoid cells is not dependent on DNA double-strand break formation”

The Journal of Biological Chemistry, “Cytotoxicity of Quinolones toward Eukaryotic Cells: Identification of Topoisomerase II as the Primary Cellular Target for the Quinolone CP-115,953 in Yeast“

Inorganic Chemistry, “New uses for old drugs: attempts to convert quinolone antibacterials into potential anticancer agents containing ruthenium.“

Journal of Physiology and Pharmacology, “Ciprofloxacin Inhibits Proliferation and Promotes Generation of Aneuploidy in Jurkat Cells“

Nepal Medical College Journal, “Genotoxic and cytotoxic effects of antibacterial drug, ciprofloxacin, on human lymphocytes in vitro”

Antimicrobial Agents and Chemotherapy, “Ciprofloxacin Induces an Immunomodulatory Stress Response in Human T Lymphocytes“

Journal of Leukocyte Biology, “Several Gene Programs are Induced in Ciprofloxacin Treated Human Lymphocytes as Revealed by Microarray Analysis“

Archives of Toxicology, “A Comparative Analysis of Chromosomal Abberations in Cultured Human Lymphcytes Due to Fluoroquinolone Drugs at Different Expression Periods“

Science Translational Medicine, “Bactericidal Antibiotics Induce Mitochondrial Dysfunction and Oxidative Damage in Mammalian Cells“

African Journal of Pharmacy and Pharmacology, “Effect of ciprofloxacin and levofloxacin
on some oxidative stress parameters in brain regions of male albino rats“

Antimicrobial Agents and Chemotherapy, “Adverse Effects of Antimicrobials via Predictable or Idiosyncratic Inhibition of Host Mitochondrial Components“

Wyss Institute for Biologically Inspired Engineering at Harvard University, “Dodging Antibiotic Side Effects“

Journal of Advanced Pharmacy Education and Research, “Fluoroquinolone Induced Neurotoxicity: A Review“

Antimicrobial Agents & Chemotherapy, “Diminished Ciprofloxacin-Induced Chondrotoxicity by Supplementation with Magnesium and Vitamin E in Immature Rats“

Archives of Toxicology, “Ciprofloxacin Causes Cytoskeletal Changes and Detachment of Human and Rat Chondrocytes in Vitro“

Veterinary Pathology, “In Vitro Evidence of Effects of Magnesium Supplementation on Quinolone Treated Horse and Dog Condrocytes“

Archives of Toxicology, “Integrins on Joint Cartilage Chondrocytes and Alterations by Ofloxacin or Magnesium Deficiency in Immature Rats“

European Journal of Cell Biology, “Integrins Mediate the Effects of Quinolones and Magnesium Deficiency on Cultured Rat Chondrocytes“

Journal of Pharmacology and Experimental Therapeutics, “Effects of fluoroquinolones on cultured articular chondrocytes flow cytometric analysis of free radical production“

Antimicrobial Agents and Chemotherapy, “Magnesium deficiency induces joint cartilage lesions in juvenile rats which are identical to quinolone-induced arthropathy.”

Nature Reviews: Microbiology, “How Antibiotics Kill Bacteria: From Targets to Networks“

Nature, “Topoisomerases Facilitate Transcription of Long Genes Linked to Autism” (Note that Fluoroquinolones are topoisomerase interrupters and I wrote this post about the Nature article –http://www.collective-evolution.com/2013/09/18/a-horrifying-cause-of-autism-dna-damage-from-synthetic-antibiotics/)

Journal of Neurosciences in Rural Practices, “Levofloxacin Induced Acute Anxiety and Insomnia”

Antimicrobial Agents and Chemotherapy, “Effects of Novel Fluoroquinolones on the Catalytic Activities of Eukaryotic Topoisomerase II: Influence of the C-8 Fluorine Group“

Pharmaceutics, “Pharmacokinetic Drug Interactions of Antimicrobial Drugs: A Systematic Review of Oxazolidanones, Rifamycines, Macrolides, Fluoroquinolones, and Beta Lactams“

Chemistry and Biology, “Trovofloxacin, a Fluoroquinolone Antibiotic with Hepototoxic Potential, Causes Mitochondrial Peroxinitrate Stress in a Mouse Model of Underlying Mitochondrial Dysfunction“

Drug Metabolism and Disposition, “Trovafloxacin-Induced Gene Expression Changes in Liver-Derived in Vitro Systems: Comparison of Primary Human Hepatocytes to HepG2 Cells“

Medication Sense articles by Jay S. Cohen, M.D.
New Warnings for Cipro, Levaquin, and other Quinolone Antibiotics
Peripheral neuropathy associated with fluoroquinolones

Molecular Pharmacology, “Delayed Cytotocicity and Cleavage of Mitochondrial DNA in Ciprofloxacin Treated Mammalian Cells”

MIT Media Relations, “Pinpointing How Antibiotics Work”

European Journal of Medicinal Chemistry, “Antibacterial Action of Quinolones: From Target to Network“

Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, “Damage to Mitochondrial DNA Induced by the Quinolone Bay y 3118 in Embryonic Turkey Liver”

Molecular Nutrition and Food Research, “Medication Induced Mitochondrial Damage and Disease” (Note that this article is about drug induced mitochondrial damage generally, not about fluoroquinolones specifically.)

Alternative and Complimentary Therapies, “Mitochondria and Disease – What Clinicians Need to Know and Why” (Also about mitochondria generally – and the author didn’t get his note about what antibiotics damage mitochondria right, but it’s still a decent article.)

Cleveland Clinic Journal of Medicine, “Mitochondrial cytopathy in adults: What we know so far“

Toxicology and Applied Pharmacology, “Mitochondrial abnormalities–a link to idiosyncratic drug hepatotoxicity?“

American Physiological Society, “Exercise-Induced Oxidative Stress: Cellular Mechanisms and Impact on Muscle Force Production“

Molecular Neurodegeneration, “Oxidative stress inhibits axonal transport: implications for neurodegenerative diseases“

Toxicological Sciences, “Review: Mitochondria as a Target of Environmental Toxicants“

Human Molecular Genetics, “Mitochondrial dynamics – fusion, fission, movemente, and mitophagy – in neurogenerative diseases“

Antimichrobial Agents and Chemotherapy, “Calcium Signals are Affected by Ciprofloxacin as a Consequence of Reduction of Mitochondrial DNA content in Jurkat Cells“

Journal of Antimicrobial Chemotherapy, “Peripheral Sensory Disturbances Related to Treatment with Fluoroquinolones”

The Canadian Journal of Infectious Diseases, “Safety of Fluoroquinolones: An Update“

Clinical and Experimental Allergy, “T Cell Mediated Hypersensitivity to Quinolones: Mechanisms and Cross-Reactivity” delayed reactions

Clinical Infectious Diseases, “Quinolone Arthropy in Animals vs. Children” (When you see the conclusion that these drugs are safe for children, please take into consideration that the study was commissioned by Pfizer.)

Toxicology and Applied Pharmacology, “TNF/TNFR1 pathway and endoplasmic reticulum stress are involved in ofloxacin-induced apoptosis of juvenile canine chondrocytes“

The Journal of Immunology, “Mitochondrial Reactive Oxygen Species Control T Cell Activation by Regulating IL-2 and IL-4 Expression: Mechanism of Ciprofloxacin Mediated Immunosuppression“

Antimicrobial Agents and Chemotherapy, “Calcium Signals are Affected by Ciprofloxacin as a Consequence of Reduction of Mitochondrial DNA Content in Jurkat Cells“

Molecular Systems Biology, “Gyrase Inhibitors Induce an Oxidative Damage Cellular Death Pathway in Escherichia Coli“

Clinical Infectious Diseases, “Risk of Severe Dysglycemia Among Diabetic Patients Receiving Levofloxacin, Ciprofloxacin, or Moxifloxacin in Taiwan“

BMJ, “Diabetes Inspidus Induced by Ofloxacin“

Canadian Medical Association Journal, “Risk of Acute Kidney Injury Associated With the Use of Fluoroquinolones”

Toxicology Letters, “Disturbance of Cellular Glucose Transport by Two Prevalently Used Fluoroquinolone Antibiotics Ciprofloxacin and Levofloxacin Involves Glucose Transporter Type 1″

The Journal of the American Medical Association (JAMA), “Oral Fluoroquinolones and the Risk of Retinal Detachment”

Journal of Rheumatology, “Malignant hyperthermia susceptibility revealed by myalgia and rhabdomyolysis during fluoroquinolone treatment.”

Intensive Care Medicine, “Moxiﬂoxacin-induced rhabdomyolysis“

Antimicrobial Agents and Chemotherapy, “Effects of Ciprofloxacin and Ofloxacin on Adult Human Cartilage In Vitro“

Physical Medicine and Rehabilitation (PM & R) “Musculoskeletal Complications of Fluoroquinolones: Guidelines and Precautions for Usage in the Athletic Population“

Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology, “Deciphering the pathogenesis of tendinopathy: a three-stages process”

Journal of Antimicrobial Chemotherapy, “Contribution of Reactive Oxygen Species to Pathways of Quinolone Mediated Bacterial Cell Death“

The American Journal of Sports Medicine, “The Effect of Ciprofloxacin on Tendon, Paratenon, and Capsular Fibroblast Metabolism“

Toxicology, “Fluoroquinolones cause changes in extracellular matrix, signalling proteins, metalloproteinases and caspase-3 in cultured human tendon cells“

The Tohoku Journal of Experimental Medicine, “Fluoroquinolone Induced Tendinopathy: Etiology and Preventative Measures“

International Journal of Antimicrobial Agents, “Synergystic Effects of Dexamethasone and Quinolones on Human Derived Tendon Cells“

Antimicrobial Agents and Chemotherapy, “Ultrastructure of Achilles Tendons of Rats Treated with Ofloxacin and Fed a Normal or Magnesium Deficient Diet“

Laboratorie de Toxicologie, “In Vitro Discrimination of Fluoroquinolones Toxicity on Tendon Cells: Involvement of Oxidative Stress“

Arthritis and Rheumatism, “Ciprofloxacin Mediated Cell Proliferation Inhibition and G2 M Cell Cycle Arrest in Rat Tendon Cells”

Journal of Young Pharmacists, “Oxidative Stress Induced by Fluoroquinolones on Treatment for Complicated Urinary Tract Infections in Indian Patients“

Chemotherapy, “Fleroxacin Enhancement of Superoxide Production by Polymorphonuclear Leukocytes: The Role of Protein Kinases“

Archives of Biochemistry and Biophysics, “Participation of reactive oxygen species in phototoxicity induced by quinolone antibacterial agents“

Drug Metabolism and Disposition, “Acyl Glucuronidation of Fluoroquinolone Antibiotics by the UDP-Gulucuronosyltransferase 1A Subfamily in Human Liver Microsomes“

Current Drug Metabolism, “Acyl Glucuronides: Mechanistic Role in Drug Toxicity?“

Expert Opinion on Drug Metabolism & Toxicology, “Metabolic activation of carboxylic acids“

Molecular Interventions, “Mechanisms of Pathogenesis in Drug Hepatoxicity Putting the Stress on Mitochondria“

Medical Hypotheses, “Epigenetic side-effects of common pharmaceuticals: A potential new
ﬁeld in medicine and pharmacology“

Chemico-biological Interactions, “Trovafloxacin, a fluoroquinolone antibiotic with hepatotoxic potential, causes mitochondrial peroxynitrite stress in a mouse model of underlying mitochondrial dysfunction.”

American Journal of Health-System Pharmacy, “Risk of hepatotoxicity associated with fluoroquinolones: A national case-control safety study“

The Journal of Pharmacology, “In Vetro Discrimination of Fluoroquinolones on Tendon Cells: Involvement of Oxidative Stress”

Journal of Pharmacy Practice, “What Role do Fluoroquinolone Antimicrobial Agents Play in Cardiac Dysfunction and Altered Glycemic Control?“

Annals of Family Medicine, “Azithromycin and Levofloxacin Use and Increased Risk of Cardiac Arrhythmia and Death“

Emergency Medicine News, “Adverse Reactions to Fluoroquinolones”

BMC Infectious Diseases, “Unnecessary Use of Fluoroquinolone Antibiotics in Hospitalized Patients”

Mayo Clinic Proceedings, “The Fluoroquinolones” (“Because they may affect the development of cartilage, all fluoroquinolones are contraindicated in children, adolescents, and pregnant or breast-feeding women.”)

Clinical Infectious Diseases, “Antimicrobial Safety: Focus on Fluoroquinolones“

Drug Safety (Journal), “Drug Interactions with Quinolone Antibacterials“

Department of Pharmacology and Therapeutics, University of Florida College of Medicine, “4 Quinolones Cause a Selective Loss of Mitochondrial DNA from Mouse L1210 Leukemia Cells“

International Journal of Oncology, “Ciprofloxacin is a potential topoisomerase II inhibitor for the treatment of NSCLC“

Antimicrobial Agents and Chemotherapy, “Ciprofloxacin, a Quinolone Carboxylic Acid Compound Active Against Aerobic and Anaerobic Bacteria“

Antimicrobial Agents and Chemotherapy, “Protein Binding: Do We Ever Learn?“

Post Marketing Surveillance, “NSAIDs Quinolones and Convulsions: An Epidemiologic Approach“

The Annals of Pharmacotherapy, “Neurologic adverse effects during concomitant treatment with ciprofloxacin, NSAIDS, and chloroquine: possible drug interaction.”

The Annals of Pharmacotherapy, “Peripheral Neuropathy Associated with Fluoroquinolones“

The Journal of Family Practice, “The Perils of Prescribing Fluoroquinolones“

The European Respiratory Journal, “Ciprofloxacin-induced Acute Interstitial Pneumonitis“

JAMA Ophthalmology, “Acute Psychosis Following the Use of Topical Ciprofloxacin“

Indian Journal of Psychiatry, “Levofloxacin Induced Acute Psychosis“

Indian Journal of Pharmacology, “Ofloxacin-induced hallucinations“

Neurological Sciences, “Levofloxacin-induced delirium“

Journal of Rheumatology, “Achilles Tendinopathy After Treatment With Ophthalmic Moxifloxacin“

Journal of Medical Microbiology, “Comparison of the Effects of Subinhibitory Concentrations of Ciprofloxacin and Colistin on the Morphology of Cardiolipin Domains in Escherichia Coli Membranes“

Biophysical Journal, “Characterization of the Interactions between Fluoroquinolone Antibiotics and Lipids: a Multitechnique Approach“

Brain Research, “Effects of the quinoline derivatives quinine, quinidine, and chloroquine on neuromuscular transmission.”

Clinics and Practice, “Fluoroquinolone Toxicity Symptoms in a Patient Presenting with Back Pain“

Biomed Central: Journal of Medical Case Reports, “Death Following Bilateral Complete Achilles Tendon Rupture in a Patient on Fluoroquinolone Therapy: A Case Report“

Indo American Journal of Pharmaceutical Research, “CIPROFLOXACIN INDUCED SYSTEMIC LUPUS ERYTHEMATOSUS“

Life Extension Magazine (it’s well researched enough to put it in the research section as opposed to the media section) “Superoxide Dismutase Boosting the Body’s Primary Antioxidant Defense“

Yes, I know that wikipedia isn’t the most credible source, but these articles have good information and citations and they’re easy to read:
Fluoroquinolone
Levofloxacin
Ciprofloxacin
Avelox

Stories of Adverse Effects

Facebook Fluoroquinolone Wall of Pain containing various stories of pain and suffering told by victims of fluoroquinolone toxicity. Click on the photos and scroll through them for the stories.

Ask a Patient
Cipro
Levaquin
Avelox

Consumer Affairs: Cipro

FQ Victims

Oliver Newell’s story