Nerve pain and nerve damage are side effects of antibiotics in the fluoroquinolone class (Avelox, Cipro, Levaquin, and more). In August 2013, the FDA strengthened warnings about antibiotics and nerve damage (also known as “peripheral neuropathy”). Although antibiotic labels have carried warnings since 2004, the FDA was concerned that the warnings were not strong enough.

UPDATE: FDA Says Fluoroquinolone Risks Outweigh Benefits for Common Infections

May 2016 — Due to the risk of disabling side effects, the FDA is warning against prescribing Avelox for people with sinus infections, bronchitis, or uncomplicated urinary tract infections when they have other options. Click here to read more.

The FDA also recommends that patients seek emergency medical attention if they develop severe side effects:

“Some signs and symptoms of serious side effects include tendon, joint and muscle pain, a “pins and needles” tingling or pricking sensation, confusion, and hallucinations.”

Nerve Damage Risk Doubles for Users of Some Antibiotics

August 25, 2014 — A study published in Neurology has found a doubled increased risk of peripheral neuropathy (nerve damage) from the use of antibiotics in the fluoroquinolone (FQ) class. Click here to read more.

Fluoroquinolone Antibiotics and Nerve Damage

Antibiotics in the fluoroquinolone class are associated with a risk of nerve damage (peripheral neuropathy). Although rare, this serious side effect can occur rapidly and cause permanent nerve pain and nerve damage.

In 2011, over 23 million Americans received a prescription for an oral antibiotic in the fluoroquinolone class. Over 70% received Cipro. These antibiotics are typically prescribed to treat bacterial infections of the skin, respiratory tract (pneumonia, sinusitis, etc.), urinary tract, and gastrointestinal system.

Fluoroquinolone antibiotics include:

What is Nerve Damage?

Nerve damage (peripheral neuropathy) is a debilitating condition that affects sensory nerves, motor nerves, and nerves in vital organs. Damage to these nerves can cause problems with coordination, muscle weakness, muscle cramps, and spasms. It can also cause problems with sensation, including problems feeling the temperature or texture of an object.

Antibiotic Nerve Damage Risk Information

  • Symptoms typically begin rapidly. Nerve damage can occur in as little as 24 hours after starting the antibiotic. According to study published in Annals of Pharmacotherapy in 2001, symptoms appear within 24 hours for 33% of people, within 3 days for 58% of people, and within 1 week for 84% of people.
  • Symptoms can last for months or permanently. Stopping the antibiotic may not prevent severe, disabling nerve pain and damage. Over 70% of people still have symptoms after 3 months, and 58% have symptoms persist for at least one year.
  • People with nerve damage may need to switch to another drug. Do not stop taking an antibiotic without first talking to your doctor.

FDA Warnings for Fluoroquinolone Antibiotics and Nerve Damage

The U.S. Food and Drug Administration (FDA) first warned about the risk of antibiotics and nerve damage in 2004. Labels on all fluoroquinolone antibiotics were updated to include information about peripheral neuropathy.

Unfortunately, these warnings were inadequate. In August 2013, the FDA published a Safety Communication because they continued to receive reports of disabling peripheral neuropathy even after the side effect was added to the drug label.

According to the FDA:

“In some patients the symptoms had been ongoing for more than a year despite discontinuation of the fluoroquinolone.  Several patients were continued on the fluoroquinolone drug despite the occurrence of neuropathic symptoms.”

Symptoms of Nerve Damage from Antibiotics

Contact your doctor immediately if you develop any of the following symptoms of nerve damage while taking an antibiotic:

  • Nerve pain
  • Tingling, prickling
  • Numbness
  • Weakness
  • Burning
  • Shooting pain
  • Extreme sensitivity to touch
  • Decreased muscle coordination
  • Paresthesia
  • And more


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