vigamox alternative?

[yarrow]

A few ever-so-ucky people get tendinitis from fluoroquinolone antibiotics.  My rheumatologist confirmed that I am one of them, since I have gotten tremendous and long-lasting shoulder pain while on Cipro--and then a flareup later while using VIgamox, not yet understanding the possible connection.

Now I am scheduled for cataract surgery, and in the presurgical packet I received this weekend, there is an rx for Vigamox, even though I requested that a note about the Cipro/Vigamox problem be placed in my file.

I know the fluoroquinolones are appealing to docs because they are so tremendously effective, but for people who cannot tolerate them, are there acceptable substitutes?

[Frogigit]

Vigamox was also prescribed to me even though I said I couldn't take Cipro/ Levaquin/Avalox!  All in th same family!  I was damaged by Cipro in 1990 and have continued to suffer from it still today!  Shoulders/neck/Achilles tendon/ arms & hands!  Shoulders the worst and longest!   Levaquin prescribed several times even though I told Dr. No Cipro!  Wake up!  They all are the same cause same problems!  Vigamox caused 3 retinal tares and detachment in Oct of 2012!  Why don't we have anty re-course??  Bayer & J&J finally in 2010 put Black Box warning, but pharmacies don't even know to warn you!  This is serious even to a low percentage of individuals!!!  Take it off the market!  120.00 for Vigamox drops and the same compatible medication 11.99.  Figure that out!!

[eyesonyou]

Thanks.  I will mention it to him on the next follow-up visit.  I have had other problems with both of my shoulders three years ago (adhesive capsulitis), so perhaps my shoulders are my weak point, and that is where trouble is likely.

[yarrow]

As Dr. Hagan says, there is apparently no official record as yet of this kind of reaction to eye drops in the fluoroquinolone class.  I told my doctor about my reaction and you might want to mention your experience to your doctor also.

If I were you, I would now be very, very cautious about taking any of the antibiotics such as Cipro, Levaquin; in short, any with 'floxacin' or 'oxacin' in their generic names.

Thank you for your comment.

[eyesonyou]

Yarrow,
I wanted you to know that I had cataract surgery on my left eye on Jan. 11.  And I used the Vigamox drops pre and post-op as directed.

Three days after surgery, I woke up with a problem with my left shoulder.  I'm not sure it was tendinitis, and maybe it was a coincidence that I had it.  But I can tell you that it took about a month for it to finally get better!  I stopped the Vigamox drops around Jan. 26.

Just posting this as an FYI.

[yarrow]

Thank you very much.

[John C Hagan III, MD, FACS, FAAO]

I'm very happy for you and wish you a speedy recovery.
JCH MD

[yarrow]

Dr. Hagan, I had my cataract surgery last week, and at every step of the admitting procedure, I followed your advice--good thing, too, because my sensitivity to fluoroquinolones had not made into all the forms that supposedly had been filled out and sent to the hospital.  In addition, some of the nursing staff were unfamiliar with this potential problem.  Ultimately, though, no forbidden meds got anywhere near me, and I thank you for your advice on handling this matter.

The implant my surgeon chose was the reStor D-1, and elsewhere on this board, I have posted what seems (at this early stage) to be an astonishingly successful result.  The lens feels like my natural eye--but as it was twenty years ago!

[yarrow]

Thank you for your candor, Dr. Hagan.  I am most grateful for your counsel regarding fluoroquinolones and my surgery, and you may be sure I will take your advice.

[John C Hagan III, MD, FACS, FAAO]

I'm not feeling bold at all.

Ask the surgeon and the nursing staff put it on your orders, when you check in tell the nursing staff, before any drops are put in be sure its not a fluoroquinolone, you won't be put to sleep tell them yourself when you go into the ER.

JCH MD

[yarrow]

Dr. Hagan, my tendinitis first showed up at the 9th day of a 14 day course of Cipro for diverticulitis (yes, TMI, as my son would say).  I was counseled to soft-pedal, so to speak, all shoulder exercises, which was disgusting after so many years of regular and general exercise.  The pain backed off somewhat until one month later, when I used Vigamox for one day for an eye infection, when the pain recurred with fury about two hours after using the drops ..  My tendinitis is concentrated in the supraspinatus and the long head of the biceps tendon, and now, almost ten months after the original whatever-it-was, I still must use light weights at the gym for curls, bench press, and flyes--and cannot do these exercises on successive days.    Physical therapy has helped one shoulder quite a bit.  The other is problematic.

If you are feeling very, very bold, you might try risking a number of months of personal well-being by instilling adrop of Vigamox in your eye and watching for a reaction about two to three hours later.

Truthfully, I feel shy about asking my eye doctor to report this--though I will do so--since he has clearly either forgotten or not noticed my request to avoid fluoroquinolones.  And then there is the fact that apparently the eyes are irrigated with antibiotic solutions during cataract surgery.  How can I be sure that this otherwise rather conscientious man will not slip into habit and flood the operating field with a fluoroquinolone during the procedure, regardless of what rx he prescribes for my pre-and pos-op use?

[John C Hagan III, MD, FACS, FAAO]

My tendenitis was in quadraceps and really painful for a while. Medications was for sinus infection

Your eye surgeon might be more interested in writing the case up. The report you rheumatologist was talking is an adverse report to the FDA. They are a pain to fill out.

JCH MD

[yarrow]

Ah, so you understand the experience!

My rheumatologist did submit some kind of report concerning an adverse reaction.  Apparently it takes a bit of time, because he grumbled about not being paid for the number of pages involved.  However, I doubt he submitted anything to a journal.  Perhaps I will rattle his cage or that of my eye surgeon.

[John C Hagan III, MD, FACS, FAAO]

I personally have had tendonitis from those meds. As I said I do not think its ever been reported in the medical journals. If you and your MDs think it was the drop I suggest they write it up and submit to medical journals.

JCH MD

[yarrow]

Thank you for your response, Dr. Hagan.  Having been a gym rat for decades, I am familiar with several different kinds of musculoskeletal injury, but the pain of fluoroquinolone tendinitis is sui generis, quite particular.  Perhaps one such reaction sensitizes the body in some way to further exposure, even if the dose is small.

I will call my surgeon as soon as his office opens this week.  It was kind of you to answer, and I am reassured to know there are other antibiotics which can be used.

[John C Hagan III, MD, FACS, FAAO]

1. I do not believe that in the medical journals there has ever been a report of tendinitis due to fluo....eyedrops. You would be the first case.  Blood levels of medications are much much much lower with eye drops than pills.
2. call your surgeon and express your fears. there are multiple other eye drops not in that family of drugs that can be used

JCHMD