Fluoroquinolones: Safety, Risks, and Side Effects

Medically Reviewed by Nayana Ambardekar, MD on April 27, 2023
2 min read

Fluoroquinolones are a class of antibiotics approved to treat or prevent certain bacterial infections. The fluoroquinolone antibiotics include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), and ofloxacin (Floxin).

However, some people who take these medicines may develop disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system. A person can experience more than one of these side effects at the same time.

The U.S. Food and Drug Administration (FDA) advises against using fluoroquinolone antibiotics for the treatment of three common infections: acute sinusitis, acute bronchitis, and urinary tract infections (UTI) without complications. The agency made this decision because the chances of serious side effects outweigh the benefits for most people.

The FDA says it’s OK to use fluoroquinolones for other serious infections or for patients who have no other choice of treatment. This might include patients with allergies to other antibiotics or infections caused by hard-to-treat, resistant bacteria.

The FDA approved changes to the labels and medication guides of fluoroquinolones taken by mouth or by injection based on patient reports of side effects. The FDA revised the boxed warning, the agency’s strongest, to address these serious safety issues, and updated the patient medication guide. The medication guide is a paper handout that comes with many prescription medicines.

Serious side effects reported to the FDA include an increase in ruptures or tears in the aorta, which is the main artery in the body, significant drops in blood sugar levels, ruptured tendons, pain, “pins and needles” sensations, and depression, anxiety, thoughts of suicide and other mental health issues. About half of the patients who had serious side effects from fluoroquinolones said the side effects began after the first or second dose and included:

  • Long-term pain
  • Pain, burning, tingling, numbness, weakness
  • Symptoms affecting tendons, muscles, and joints, including swelling, pain, and tendon rupture
  • Symptoms that lasted longer than a year
  • Depression, anxiety , or other changes in mental health
  • Sensation changes or nerve damage in hands, feet, arms, or legs
  • Dramatic impact on quality of life such as job loss, financial problems, and increased family tension

Since most patients reported symptoms lasting longer than a year, it is possible that some of these effects will be permanent.

If you have side effects while on a medication, you can file a report with the FDA's MedWatch program.