Muscular problem or drug side effect

[MikeJ]

I'm a 28 year old male, and recently took Cipro (4 weeks) and then Levaquin (4 weeks) for a prostate infection.  I was fine on the Cipro, but started to experience muscle twicting a couple of days after switching to Levaquin.  Since I've stopped taking the Levaquin (7 weeks ago), I've continued to have muscle twitching and burning muscle pain.  The muscle twitching involves just a small part of the muscle and is sporadic.  The twitching usually occurs in the calves, but I also notice it in the arms, back, butt, and feet.  Sometimes it is just a single twitch, and other times it is a couple in a row.  The burning/achy pain is somewhat all over (like after the flu), but usually in upper arms, shoulders and thighs.  One of my calves also seems a little stiff, but I don't know if it's related.  I can move my leg fine, just the upper part of the calf (below/around the knee) seems tight.

So far I've gone to my primary care physician, and he did some strength tests and tested my reflexes... he said all were perfectly normal, and there was no need for me to see a Neurologist.  He seemed to think everything could be benign, and possibly caused by stress/anxiety.  He didn't mention the Levaquin though.

My questions:
Do you think my symptoms could be caused by the Levaquin?
If not, what would cause them?
How does stiffness start in motor neuron disease, and would it start before weakness?
If I went to a Neuro, would they even do an EMG if strength and reflexes were fine?

Thanks for your time.

[CCF-Neuro-M.D.-CS]

I am aware of no relationship between your symptoms and Levaquin. I cannot find any references to suggest that the Levaquin caused this. It is possible that these symptoms are a reaction to a viral illness, or possible from stress (as your primary doctor suggested). If your examination is entirely normal then there may be no use for an EMG. I think it is unlikely that this represents motor neuron disease. Good luck.

[WRATL]

Mike...take a look at comments to my situation below.  Follow the comment trail. Looks like Levaquin MIGHT be a common denominator.  One thing I wasn't able to mention was the Anti-Inflammatory I was on (Voltaren).  I was on it for ~ a month 2/day.  I recently looked up the possible side affects and have had over half of them since starting it...including digestive issues. I stopped taking that, and the muscle-relaxers, and the muscle twitching/pulling and other side affects have let up significantly.

[barbeee234]

Hi,

    The muscle problems you are refering to are identical to what i have been suffering for years and it all came from the cipro and levaquin being given to me for kidney infections.  It is harder than hell to find anyone out there who will help find ways to help heal our bodies, they seem to be avoiding it at all cost.  I take msm/glusamine, glutamine zinc magnesium and a multi vitamin along with Ultram for the pain and soma to relax the muscles somewhat so I can try and function.  Today i am suffering from serious pain in my left elbow and I can't find anyone to take it serious, they checked for nerve damage bone damage and la la la .... they don't want to hear it's the cipro and my tendon is in danger.  My body hurts everywhere, my muscles are so big you would think i work out, but i don't i can barely walk on some days and lifting something is a joke.  Although the muscles are huge they are weak makes sense doesn't it.  Get a lawyer, get on the quinolone page RxBoard - Levaquin (levofloxacin) - Message Index  and find the petition for the congress to investigate this injustice done to so many of us who have lost everything.  Good luck in your search and your recovery.

Barb

[Al405]

I was about to discuss my problems regarding neuromuscular problems associated with levaquin when I read your question.I was very disappointed in the response. In July of this year I took levaquin for a prostate infection and it resulted in acute neuromuscular and joint problems. This episode has been even more frustrating in that I feel very confident in the connection between the levaquin and the adverse side affects I am still dealing with. The neurologists I have consulted seem to dismiss my concerns. If anyone knows of any physician who has experience with these type of drug reactions please post a comment.

[johnflox]

Quinolones, among them CIPRO and LEVAQUIN do cause extensive and devastating neurological damage to normal, young and healthy individuals.

There are thousands upon thousands of people damaged by quinolones each year. Yet the medical class ignores all about this daily tragedy.

The quinolones are very neurotoxic antibiotics. It is odd that in these forum no doctor tries to discard first thing that quinolones (and other drugs) are not behind every neurological disorder of unknown origin.

Most reactions to these antibiotics become symptomatic some weeks or even months after cessation of the treatment, making it very difficult to trace back the real cause of the problems.

The reaction to quinolone antibiotics can be mild, intermediate or severe. Long treatments or high doses mean intermediate to severe reactions. Most side effects are mild.

That has nothing to do with the acuteness of the reaction. Any reaction can be very acute on its onset, to gradually turn to a mild, intermediate or severe one. The process to clear an acute reaction takes on average 4 months.

Mild reactions heal in some 6 to 12 months.
Intermediate reactions need some 12 to 24 months.
Severe reactions take from 3 to 5 years and usually end up with very extensive permanente and irreversible damage, mainly neurologic, in vision and cartilages plus connective tissues.

The neurological reactions typical of a quinolone reaction are already well known by you, that are experiencing it. They include all sorts of peripheral neuropaties (sensory, motor, autonomic, with dozens of symptoms) as well as Central Nervous System (heart, organs, brain) plus many others systemic (optical neuritis).

Recently, it has been added a warning in all the package inserts of quinolones stating that they can cause IRREVERSIBLE NEUROPATIES. This should be known by all doctors because it is not a rare adverse effect.

The main point has already been suffered by all of you: no doctor admits that quinolones do such devastating lesions, but they do, so you, like many many thousands are unreported cases.

Think for instance of the New York's postal workers that received 2 months of cipro. How many of those that completed the treatment got undamaged? Apparently, no one.

Quinolones are not recommended by manufacturers and FDA for people under 18 because of the high risk of irreversible cartilage damage.

You can consult near 4.000 medical and research documents about all the kinds of lesions that quinolones cause in some forums and organisations. For instance fqresearch.org and drugvictims.com.

The bad news is that there is no protocol or treatment. Only some recommendations to follow: do not take any NSAIDS or similar, and stay away of meat that is not certified antibiotic-free because common poultry for instance has a lot of quinolones and other antibiotics on it (do not believe that the quinolones are excreted a few days before slaughter because that is another lie that has been proved false).

You are going to need the help of a caring and informed doctor. Keep on searching for one. Not all are so arrogant as to dismiss your linking between your symptoms and levaquin. Many doctors never prescribe quinolones because of the serious adverse reactions that they cause. Some pharmacists do not sell quinolones because of the same reason.

It is a shame that young athletes, very healthy become crippled by quinolones and need on average 13 doctors before they meet one that leasen to them. The rest either dismiss them or prescribe treatments for other disorders, many of which are completely counterindicated for the quinolone-toxicity-syndrome.

Some groups of medical researchers are trying to convince the FDA that the quinolones phase II and III postsurveillance are insuficient, poorly conducted and that have intentionally failed to report the elevated and disproportionate ratio of adverse effects. But the FDA isn't prone to admit any adverse effect of already marketed drugs.

Since their invention, more of half of the quinolones have been withdrawn from the market due to their fatal or dangerous profile. The remaining ones are not much different.

What the medical class needs is to become aware of this enormous tragedy, and spare the quinolones for life or death issues, where becoming crippling for many years or for life is not the question, and never use them as a first line of treatment for upper respiratory or prostate infections.

This forum should also be aware of this. Because it is a matter of time that all  will become commmon knowledge, showing clearly who cares and updates his/her education and what doctors just prescribe basing his/her decisions solely on manufacturer's advertisements or completely false rules of the thumb ("quinolones are very effective drugs with negligible side effects") and insist in handing their patients long term misery.

[pwdrskiers]

Mike,

I'm not sure what books the MD looked at when stating he could find no reference to levaquin or cipro causing any of the problems you described in your email.  With that kind of research skills, I wonder how he/she got through med school.  I sure wouldnt want to visit this doc if I was sick.

In fact, all of the things you mention in your post are clearly listed as potential side effects of cipro and levaquin in the manufacturers product inserts, in the physicians desk reference and in hundreds if not thousands of medical articles that can be found on medline or entrez pub med.

I guess the guys at Cleveland clinic don't do their homework.  I actuall visited a rheumatologist at CC in 2001 after a horrific reaction to levaquin.  He blew me off.  Back in Ga, I found a rheum, an internist and an ortho that all trace my many problems back to the levaquin.

Clearly, you should get all the tests necessary to rule out other problems, but if they all come back normal, any semi smart individual would see cause and effect in your antibiotic use and the resulting symptoms of a classic adverse reaction to an antibiotic.

For the doc that replied to your question, I would encourage him/her to do a little more homework before being so cavalier in their responses.

CB

[pwdrskiers]

To Al,

Dr. David Flockhart, head of clinical pharmacology at Indiana University, has seen well over 100 cases personally of fluoroquinolone adverse reactions.  These reactions include severe severe muscular skeletal reactions, severe peripheral neuropathies and severe central nervous problems.

Good luck.

CB

[Kathynev]

With enough of us suffering from the various side effects from Levaquin and it's relatives, has there been any progress made in treating the various ailments we now have? Has anyone had any luck with supplements or physical therapy? Have there been any clinical studies at all on people experiencing Levaquin-related ailments? I'v had the joint pains, rashes, night sweats and eye pain for long enough--I'm desperate for relief. If anyone had had any help from a physician in the Las Vegas area with knowledge about these side effects, please email me at ***@****. I'm at the end of my rope.

[Kathynev]

With enough of us suffering from the various side effects from Levaquin and it's relatives, has there been any progress made in treating the various ailments we now have? Has anyone had any luck with supplements or physical therapy? Have there been any clinical studies at all on people experiencing Levaquin-related ailments? I'v had the joint pains, rashes, night sweats and eye pain for long enough--I'm desperate for relief. If anyone had had any help from a physician in the Las Vegas area with knowledge about these side effects, please email me at ***@****. I'm at the end of my rope.

[Kathynev]

With enough of us suffering from the various side effects from Levaquin and it's relatives, has there been any progress made in treating the various ailments we now have? Has anyone had any luck with supplements or physical therapy? Have there been any clinical studies at all on people experiencing Levaquin-related ailments? I'v had the joint pains, rashes, night sweats and eye pain for long enough--I'm desperate for relief. If anyone had had any help from a physician in the Las Vegas area with knowledge about these side effects, please email me at ***@****. I'm at the end of my rope.

[Kathynev]

With enough of us suffering from the various side effects from Levaquin and it's relatives, has there been any progress made in treating the various ailments we now have? Has anyone had any luck with supplements or physical therapy? Have there been any clinical studies at all on people experiencing Levaquin-related ailments? I'v had the joint pains, rashes, night sweats and eye pain for long enough--I'm desperate for relief. If anyone had had any help from a physician in the Las Vegas area with knowledge about these side effects, please email me at ***@****. I'm at the end of my rope.

[Cat2]

Hope this information will be helpful to patients and Physicians alike.

FDA WARNINGS Product - FLUOROQUINOLONES ANTIBIOTICS - http://www.fda.gov/medwatch

"Peripheral Neuropathy: Rare cases of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias (abnormal sensation) and weakness have been reported in patients receiving quinolones, including [name of fluoroquinolone antibiotic]. [Name of fluoroquinolone antibiotic] should be discontinued if the patient experiences symptoms of neuropathy including pain, burning, tingling, numbness, and/or weakness, or is found to have deficits in light touch, pain, temperature, position sense, vibratory sensation, and/or motor strength in order to prevent the development of an irreversible condition."
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NOTE: If you are taking a fluroquinolone antibiotic and experience pain, burning, tingling, numbness, and weakness or both, or have problems with light touch, pain, temperature, position sense, vibratory sensation, and or motor strength or both you should stop the medication immediately and contact your physician.

Dear Doctor Letters issued overseas for Levaquin web links below/ France and Italy in 2001, 2002.  

http://www.orl-france.org/medicalnews.html  

Here is the Italy URL

http://www.ministerosalute.it/medicinali/resources/documenti/note_inf

http://www.ministerosalute.it/medicinali/farmacovigilan

Articles: Peripheral Neuropathy and Fluoroquinolones.[PubMed Citations) National Library of Medicine

Zehnder D, Hoigne R, Neftel KA, Sieber R. Painful dysaesthesia with ciprofloxacin. British Medical Journal. 1995 Nov 4;311(7014):1204. “One case of peripheral neuropathy has been reported.3 We report two cases of generalised painful dysaesthesia due to ciprofloxacin, a reaction not previously associated with this particular fluoroquinolone

J Antimicrob Chemother. 1988 Aug;22(2):221-8. No Authors listed. Therapy of acute and chronic gram negative osteomyelitis with Ciprofloxacin, Report from a Swedish Study Group Ten adverse events related to ciprofloxacin treatment were observed in nine patients; two phototoxic reactions, two cases of impaired colour vision, and one each of exanthema, abdominal pain, malaise, drug fever, peripheral neuropathy and eosinophilia.

Chan PC, Cheng IK, Chan MK, Wong WT. Br J Clin Pract. 1990 Dec;44(12):564-7. Clinical experience with pefloxacin in patients with urinary tract infections. “The incidence of possible side-effects was high, occurring in 59% of the patients. Nausea, dizziness and vomiting were the most common. These were mild and did not require termination of treatment. Peripheral neuropathy, which disappeared four weeks after stopping pefloxacin, occurred in one patient.

Aoun M, Jacquy C, Debusscher L, Bron D, Lehert M, Noel P. )letter). Lancet 1992;340:127 Peripheral neuropathy associated with fluoroquinolones

Rollof J, Vinge E.  Ann Pharmacother. 1993 Sep;27(9):1058-9 Neurologic adverse effects during concomitant treatment with Ciprofloxacin, NSAIDS and chloriquine, possible drug interaction. “After indomethacin was reintroduced, the patient developed signs and symptoms of peripheral neuropathy, which partially subsided when ciprofloxacin was discontinued.

Hedenmalm K, Spigset O. Peripheral sensory disturbances related to treatment with fluoroquinolones.
J Antimicrob Chemother 1996 Apr;37(4):831-7
Division of Clinical Pharmacology, Norrland University Hospital, Sweden.
The symptoms and possible risk factors of peripheral sensory disturbances related to fluoroquinolones are reviewed on the basis of 37 reports submitted to the Swedish Adverse Drug Reactions Advisory Committee. In 25 patients (68%), symptoms occurred within 1 week after start of treatment.  

Sieb JP. Fluoroquinolone antibiotics block neuromuscular transmission. Neurology 1998;50:804–7

Murray CK, Wortmann GW. Trovafloxacin-induced weakness due to a demyelinating polyneuropathy. South Med J 2000;93:514–5.

Jay S. Cohen, Peripheral Neuropathy Associated with Fluoroquinolones, Vol 35. No.12, Pages 1540-1547  The Annals of Pharmacotherapy Dec 2001.

Canadian Adverse Drug Reaction Newsletter, Volume 12, Issue 4, October 2002
Optic Neuritis Moxifloxacin (Avelox)

http://www.cfpc.ca/cfp/2002/Nov/vol48-nov-critical-2.asp
Canadian Family Physician Nov 2002.
26. Gatifloxacin.. (Tequin®) Fluoroquinolone antibiotic. Product monograph. Ottawa, Ont: Bristol-Myers Squibb Canada Inc; 2001.
27. Moxifloxacin hydrochloride (Avelox®). Fluroquinolone antibiotic. Product monograph. Ottawa, Ont: Bayer Inc; 2000. Adverse effects. Gatifloxacin and moxifloxacin have tolerability profiles similar to other fluoroquinolones. Adverse effects include gastrointestinal upset (nausea, diarrhea, vomiting, and abdominal pain), headache, and dizziness. Adverse effects reported since marketing are ventricular tachycardia, renal failure, peripheral neuropathy, myositis, and tendonitis.26,27

Websites with information regarding Reactions: Fluoroquinolone Antibiotics

http://www.geocities.com/quinolones/

http://health.groups.yahoo.com/group/quinolones/messages/?threaded=1

http://www.drugvictims.org/

http://www.fqvictims.org/

http://www.fqresearch.org/

http://www.rxlist.com/rxboard/levaquin.pl

http://www.medicationsense.com/articles/july_sept_03/reactions_cipro_other.html

http://www.medicationsense.com/articles/jan_mar_04/congress_ltr.html

http://medications.com/index.php?act=se&drug=Levaquin

http://www.askapatient.com/viewrating.asp?drug=20635&name=LEVAQUIN

http://www.askapatient.com/viewrating.asp?drug=19537&name=CIPRO

http://www.worstpills.org/recent_postings.cfm   Drug Induced Peripheral Neuropathy From Fluoroquinolone Antibiotics
(Nov 2004)

http://groups.yahoo.com/group/fq_research

FDA report your reaction to the FDA 1-800-FDA-1088 OR http://www.fda.gov/medwatch