Bad Medicine? Watch out for CIPRO

Cipro is bad.jpg

Feb 23, 2019



Everyone in healthcare knows Ciprofloxacin is a great drug.  It has good coverage and is typically well tolerated.  Skin infections, UTI, infectious diarrhea; these are all common reasons to use this antibiotic. HOWEVER, warnings have been circulating for several years now, and they just get worse.  Remember, these warnings are from the FDA, which is never quick to warn us about anything. 


Fluoroquinolone Safety Alerts from the FDA summarized:


1)     Oral or injectable fluoroquinolone use can increase the occurrence of aortic dissections or ruptures. Avoid use of systemic fluoroquinolones in patients with an existing aortic aneurysm or in patients at an increased risk for developing an aortic aneurysm.  Also avoid using it in patients with peripheral atherosclerotic vascular diseases, hypertension, genetic disorders involving blood vessel changes (eg, Marfan syndrome, Ehlers-Danlos syndrome), and the elderly, unless there are no other treatment options available.

2)     Hypoglycemia resulting in coma is a possibility in patients with low blood glucose.

3)    Fluoroquinolones have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together, including: tendinitis and tendon rupture, peripheral neuropathy, and CNS effects. Discontinue ciprofloxacin immediately and avoid the use of fluoroquinolones in patients who experience any of these serious adverse reactions. Because fluoroquinolones have been associated with serious adverse reactions, reserve ciprofloxacin for use in patients who have no alternative treatment options for the following indications: acute exacerbation of chronic bronchitis, acute sinusitis, and acute uncomplicated cystitis.

4)    Exacerbation of myasthenia gravis: Fluoroquinolones may exacerbate muscle weakness in patients with myasthenia gravis. Avoid ciprofloxacin in patients with known history of myasthenia gravis.


Seems like Cipro is MUCH more dangerous that we previously thought. Many of these adverse reactions are not reversible, so be careful when you use it, and consider other drugs if possible.  We never want to get blamed for using a dangerous drug when something more benign will do.