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Fluoroquinolones (FLQs)

Fluoroquinolone Antibiotics

What are Fluoroquinolone Antibiotics?

Fluoroquinolones (FLQs) are antibiotics that are used to stop the growth of or kill bacteria, and as a result, can be used to treat a wide range of bacterial infections. The product contains fluoride, a neurotoxin, which can enter the brain and central nervous system through sensitive tissues.

Avelox (moxifloxacin), Cipro (ciprofloxacin), Factive (gemifloxacin), Levaquin (levofloxacin), and generic ofloxacin are all common fluoroquinolone antibiotics.

FLQs are often used when a patient has built up an immunity to other antibiotics, prompting the use of this very strong class of drugs. Most often, FLQ antibiotics are used to treat the most severe bacterial infections.

The U.S. Food and Drug Administration (FDA) has stated that patients should strongly weigh the benefits and risks of taking fluoroquinolone antibiotics. Specifically, fluoroquinolone antibiotics should be reserved for instances of severe bacterial infection.

What are the Side Effects of Fluoroquinolone Antibiotics?

Fluoroquinolones are associated with side effects involving tendons, muscles, joints, nerves, and the central nervous system. The side effects can include tendon damage or rupture, permanent nerve damage in extremities, liver toxicity, kidney failure, hearing or vision problems, or psychiatric side effects. Many of these symptoms can be irreversible.

Fluoroquinolone Antibiotics Timeline

  • July 2008: Black Box Warning (link here) issued for the increased risk of tendinitis and tendon rupture
  • February 2011: Risk of increased side effects for those suffering from myasthenia gravis was added to the existing Black Box Warning
  • August 2013: Updates were added to the label that warned of the risk for developing irreversible peripheral neuropathy
  • November 2015: A FDA Advisory Committee concluded risks of taking Fluoroquinolone antibiotics outweighed the benefits for those suffering from less severe bacterial infections.
  • May 2016: A drug safety communication warned doctors and patients that Fluoroquinolone antibiotics should be reserved only for patients suffering from severe bacterial infections.
  • July 2016: Major updates were added to the drug’s label that included the potential for disabling and potentially permanent damage to tendons, joints, muscles, nerves, and central nervous system that can occur simultaneously in an individual. The patient Medication Guide was also updated.


+ - References

"Bitter Pill: Serious Side Effects of Fluoroquinolone Antibiotics.", 1 Nov. 2014,

“FDA Drug Safety Communication: FDA Updates Warnings for Oral and Injectable Fluoroquinolone Antibiotics Due to Disabling Side Effects.” Drug Safety Communications,

Kroll, David. “Yet Another Warning On Fluoroquinolone Antibiotic Side Effects.” Forbes, Forbes Magazine, 1 Aug. 2016,

“Press Announcements - FDA Updates Warnings for Fluoroquinolone Antibiotics.” U.S. Food and Drug Administration Home Page, 26 July 2016,


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