More Problems with Quinolone Antibiotics: FDA Warns of Aortic Rupture

By Chris Centeno, MD /

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more problems with quinolone antibiotics aortic rupture

It’s always disconcerting when medicine’s penchant for medications that fix one problem and cause another is exposed. Few drugs fit that category better than quinolone antibiotics. This morning we’ll review yet another side effect of this drug class that destroys the connective tissue of some patients, but this one is life-threatening.

Understanding Aortic Ruptures, Dissections, and Aneurysms

The aorta is the large main artery that carries oxygenated blood directly from the heart and distributes it into smaller arteries that supply oxygenated blood to the rest of the body. When depleted of oxygen, the blood then returns via the veins and the large main vein, the vena cava, back to the heart and lungs to be reoxygenated and repumped throughout the body again. This is appropriately called the circulatory system.

When something causes a bulge in the aorta, this is called an aortic aneurysm, and it can occur anywhere along the tubular-shaped aorta, which stretches from the heart through the chest cavity and down through the abdomen. An aortic aneurysm, due to the thinning of the aortic wall, increases the risk for aortic rupture and dissection, which is exactly what it sounds like: the wall tears open. The wall of the aorta has three layers. Tears in the inner two are aortic dissections, and emergency surgery at this stage may improve the chance of survival. An aortic rupture occurs when the dissection advances through the outer aortic wall, and it is typically fatal.

Those who are most at risk for aortic rupture or aneurysm include the elderly and patients who have high blood pressure or hypertension, peripheral vascular disease, or atherosclerotic heart disease. Obviously, anyone who already has a history of an aneurysm or other blood vessel disorder would have a much higher risk than most. In addition, there are some genetic disorders that are associated with blood vessel issues, such Marfan syndrome.

Now, it seems quinolone antibiotic use can be added to the risk list for aortic rupture and aneurysm. Quinolones are a huge family of antibiotic drugs that can be identified by -floxacin at the end of the generic drug name: ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox), and many, many more.

Quinolone Antibiotics, Aortic Rupture, and FDA Warning

A recent study found a substantial association between the use of fluoroquinolone antibiotics and aortic aneurysm and rupture. While the risk was already significantly elevated with 3 to 14 days of use, it jumped even higher in those taking quinolones for over 14 days. The risk didn’t stop when use of the drug stopped as the most at-risk period to experience aortic aneurysm or rupture was within 60 days of starting the drug.

Another study last year compared the rate of aortic rupture or aneurysm in those taking quinolone antibiotics to those taking amoxicillin (a penicillin antibiotic). Aortic ruptures or aneurysms in patients taking quinolones was increased by 66% over those taking amoxicillin within that most at-risk 60-day time period mentioned above. The study states this associates 82 aortic ruptures or aneurysms for every 1 million episodes of quinolone treatment with the drug. Other similar studies have placed the numbers of aortic ruptures or aneurysms in those taking quinolones anywhere from 9 (general population) to 300 (most at-risk population) for every 100,000 prescriptions. Whatever the number, considering quinolones are prescribed at the rate of about 30 million per year worldwide, the number of those experiencing aortic ruptures or aneurysms due to quinolones becomes quite staggering. Staggering enough, in fact, to capture the attention of the FDA…

These and other similar findings in additional studies prompted the FDA to issue a fluoroquinolone warning that requires the risk of aortic ruptures to be listed in patients’ prescription information and the medication guide.

What We Already Know About Quinolone Antibiotic Risks

Aortic ruptures and aneurysms, of course, adds to a list of problems associated with quinolone antibiotics, many of which I’ve covered here on this blog. Let’s take a look.

The upshot? You can’t make this stuff up. Avoid quinolone antibiotics if you’re able. If you have a pain problem and are unlucky enough to be one of the patients that this stuff effects, things could get much worse. If you’re one of those unlucky enough to be predisposed to an aortic rupture, it can get much worse from there.

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3 thoughts on “More Problems with Quinolone Antibiotics: FDA Warns of Aortic Rupture

  1. Mark A Girard

    Thanks for doing an article about fluoroquinolones, or FQs. The adverse reactions to this class of drugs can be HORRIFIC and they happen far far more often than the average MD believes they do. Unfortunately, those of us who have been harmed are routinely misdiagnosed with fibro, lupus, ALS, Parkinson’s, MS, autoimmune disorders, Gulf War Syndrome, Lyme and coinfections, chronic fatigue, the list of wrong conditions is almost endless.

    These drugs penetrate into every nook and cranny in the body, which is great if someone has a bacterial infection in their bone marrow or inside the blood brain barrier which has not responded well to safer antibiotics, but this is the same reason that when patients suffer adverse drug reactions (ADRs), they tend to experience a syndrome with head to toe devastation including many different serious, painful and often debilitating medical problems setting in either all at once or in rapid succession. The slang term for our terrible condition is “floxed”, which comes from the generic names for the fluoroquinolones, or FQs, most of which end in “…floxacin”.

    Dr. Flockhart of the University of Indiana claimed a third of patients experience neurological issues. Dr. Bennett of the University of South Carolina says they have killed 300,000 or more Americans. Dr. Jay Cohen, another expert, claims this is the biggest medical disaster in history. There are literally tens of millions of us globally. This is a disaster of almost unimaginable scope and scale, the Thalidomide story of our era, times ten thousand, and it is just exploding into the mainstream media now. You will be hearing a whole lot more about this for the next few decades.

    Thanks again for doing a story about FQs!

    Mark A Girard
    Fluoroquinolone Toxicity Advocate

  2. Arshad Hussain

    Thanks for your views and reviews about Quinolone antibiotics . i have seen general physician and urologist freely prescribe this , why not to choose the alternative which is available to Physician

  3. Sharon Figler

    Be aware of these insidious drugs. They cause delayed adverse reactions. They don’t always cause immediate reactions, like while on the drugs! Be aware that the Fluoroquinolones are given without your knowledge or permission.
    12 years ago I was given IV Levaquin as a prophylactic during minor surgery. I HAD NO INFECTION! Within a few months my body started to fall apart and I have not recovered.
    For me damage was permanent!

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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