FDA issues warning on Cipro, similar antibiotics

Old Jul 8th, 2008, 01:16 PM
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FDA issues warning on Cipro, similar antibiotics

I was really surprised when I read this article ... like many of you we take Cipro on our trips to Africa (prescribed by a Mayo Clinic Travel specialist doctor) and I've taken it three times to clean out stomach problems, so it was a shock to see this problem. Here's the first sentence from the article:

<b>Drug safety officials Tuesday imposed the government's most urgent safety warning on Cipro and similar antibiotics, citing evidence that they may lead to tendon ruptures, a serious injury that can leave patients incapacitated and needing extensive surgery.</b>

Here's a link to the entire article:

http://www.usatoday.com/news/health/...-warning_N.htm

Bill
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Old Jul 8th, 2008, 02:37 PM
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This happened to my dog when she was on a different flouroquinolone antibiotic. I'm usually very good about reading the warning information before using any medication and was lax that time. She became unable to stand or walk without her front legs buckling. I was so upset at myself for not researching and discussing alternatives with our vet! I was upset at the vet for not mentioning the possibility too, but mostly I blamed myself because the information was readily available. Thankfully she recovered fully after about two months of being taken off of the medication. So that's how I knew about the issue with flouroquinolones and tendon damage.
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Old Jul 8th, 2008, 06:24 PM
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Ooooh. Good to know, but is there an alternative, and is not taking it the worse of 2 evils? eeek. Was gonna pick mine up soon.
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Old Jul 8th, 2008, 09:13 PM
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Thank for the great information Bill. I'm a firm believer in not taking antibiotics unless they've been prescribed for a specific purpose, so I never have a prescription to use &quot;just in case.&quot; I was actualy surprised to learn that over the past several year doctors were so willing to grant such prescriptions. I've only had stomach problems once when traveling, and I took charcoal tablets. To be honest, I'm not sure if that's good or bad, but it did work for me.
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Old Jul 9th, 2008, 04:19 AM
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Bill,
I think you were right to call attention to this matter but physicians have been aware of these effects for some time. The news media often distort such warnings for their sensational impact. The real concern of antibiotics of this class is in patients on steroids and to a lessor degree to those over 60 with heart or kidney problmes. As with all Rx drugs, your best bet is to aquire only those you have discussed with your doctor, don't get medical advice from internet forums ;-) and do not trade antibiotics (or other meds) with friends who took them on their last trip. I suggest any of you with concerns might want to ask your Docs about Xifaxan, an antimicrobial that confines its activity to only the GI system. A lot of Docs prefer this medication and use it themselves. It is more expensive but in the small quantities needed for safari travel it is not really very much. It is made by Silax Pharm. and, I beleive, it is mentioned on the CDC website.

http://www.docguide.com/news/content...mp;type=DGNews

Regards-Chuck
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Old Jul 9th, 2008, 05:03 AM
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antibiotics at hand in case off.......

i would strongly oppose that kind of swallowing bahaviour.

first - that leads to immunisation of the body to many antibiotics resulting in a lack of antibiotics available when desperately needed

second - gosh....swallowing meds in order to prevent ANYTHING makes the body even more vulnurable to ANY germ.

div
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Old Jul 9th, 2008, 06:58 AM
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1- There is a time to take antibiotics, and a time not to take them. I'll take my doctor's advice before any info on Fodors.

2- Cipro was taken by thousands of people in 2001 for <b>prevention</b> of anthrax.

3 - The side effect was known then. Why the attention now?

http://www.worldnetdaily.com/news/ar...TICLE_ID=25058
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Old Jul 9th, 2008, 08:51 AM
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I can't discount the possibility of problems with any meds, but as Jed, wonder why the headlines... a slow newsday!

We've all read that antibiotics are often being taken in excess, so unless under a doctors orders for specific illness/prevention, no one should simply be popping this or any other pills.
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Old Jul 9th, 2008, 09:18 AM
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<b>3 - The side effect was known then (2001). Why the attention now?</b>

Jud, that was an interesting article! If they knew about this 7 years ago then I also wonder why it has just now gotten the FDA 'urgent warning'.

I also checked the drugs.com site and there are 8 side-effects listed for Cipro but nothing about 'tendon ruptures', the closest being <b>'sudden pain or swelling near your joints (especially in your arm or ankle)'</b>

Sandi - <b>but as Jed, wonder why the headlines... a slow newsday!</b>

Well, it's headline news because the FDA issued <b>&quot;the government's most urgent safety warning&quot;</b> for those drugs on Tuesday and they are drugs that are often prescribed ... maybe the real Q is why the FDA acted so slowly if this was already known back in 2001 ...

Just curious, how many people are advised by their doctors to take antibotics like Cipro on their safaris? I've noticed in a couple of threads that people mention donating them to the locals when the safari is over so I thought it was fairly common.

Bill
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Old Jul 9th, 2008, 09:45 AM
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Mine have been prescribed for bacterial gut problems and only that. Though wonder how one knows, when out in the bush, whether it's bacterial or not? A stronger option than the likes of Immodium. I'd never give them away or share with another person.

For years the FDA has been late to the game on many drugs. Alarm the public one day and pull back weeks or months later when they've been off the mark.

Another hole for our tax dollars. &quot;Shameful&quot; as my mom would say!
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Old Jul 9th, 2008, 09:47 AM
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Bill,
I don't think you can rely on sites like drugs.com to contain comprehensive information. I usually go to the manufacturer's site to download this.

http://www.univgraph.com/bayer/inserts/ciprotab.pdf

You'll see that it does mention tendon ruptures.

Dana,
I'm with you. I have a fairly sensitive stomach and have had problems during my travels, but nothing so far that hasn't resolved itself without me doing much other than making sure I keep myself hydrated. Prior to this last Africa trip, I had to go to a different physician to get vaccinated for YF as my GP doesn't administer it and he insisted on writing me a prescription for Xifaxan even though I didn't ask for anything.
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Old Jul 9th, 2008, 10:33 AM
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Here's a lawyer's site that was taking clients who had problems with Cipro or other similar antibiotics ... perhaps the additional cases and threats of lawsuits is what forced the FDA to issue a stronger 'black box' warning.

http://www.schmidtlaw.com/Cipro/

The numbers on this site simply do not add up for me ... here's a quote:

<b>Almost 1 in 250 patients suffer tendon ruptures after taking Cipro. Approximately 262 cases of tendon ruptures, 259 cases of tendonitis, and 274 cases of other tendon disorders have been reported to the FDA, with 23% of those being caused by Cipro.

The Achilles tendon is the most common rupture associated with these antibiotics. </b>

So it doesn't add up ... 262 x 23% =&gt; 60 tendon ruptures attributed to Cipro ... they claim &quot;almost 1 in 250 patients suffer tendon ruptures after taking Cipro&quot; so 60 x 250 =&gt; 15,000 people who have used Cipro ... I'm certain the actual number of prescriptions and users has to be much higher than that, right?

Bill
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Old Jul 9th, 2008, 11:07 AM
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I saw this warning too, and I had just picked up Cipro for my upcoming trip! Somewhere buried in the warning was this message:

&quot;many of the serious injuries appear to be preventable if patients stop taking the drug at the first sign of pain or swelling in a tendon, call their doctor, and switch to another antibiotic.&quot;

So, I plan on taking it if I have any problems. My doctor told me only to take it (and Immodium) for as long as I had symptoms and not more that 3 days anyway. If I notice any tendon problems I will stop, but I have taken it before and not noticed anything like this.
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Old Jul 9th, 2008, 11:17 AM
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Carl, that's exactly why I posted the link ... &quot;stop taking the drug at the first sign of pain or swelling in a tendon&quot; ... good info for anyone who has the drug.
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Old Jul 9th, 2008, 11:39 AM
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sandi:
&quot;Though wonder how one knows, when out in the bush, whether it's bacterial or not?&quot;

When caused by bacteria the picture is typically &quot;copious watery diarrhea with cramping&quot; and perhaps some nausea along with it. In that situation the antibiotic may knock it out quickly -- but if taken for milder symptoms (i.e. when the cause is probably not a bacteria) the antibiotic won't do anything.
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Old Jul 9th, 2008, 12:39 PM
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skibumette -

Good to know, and thankfully never such symptoms. Never taken the tabs... have them &quot;just in case.&quot;
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Old Jul 9th, 2008, 04:58 PM
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Well, I just picked mine up. Hopefully I won't need it. I have a &quot;stages&quot; plan that usually works...

1) Probiotics every day(I take these already)
2) Pepto tablets every day with meals as a &quot;preventive&quot;
3) If problems arise Imodium Advanced and then as a last resort...
4) Cipro

I've never had to take it before (knock on wood) and I've been to Egypt and China when others with me had pretty severe stomach issues so I'm hoping my luck will hold out for my safari.

Carrie
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Old Jul 10th, 2008, 08:17 AM
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carrie
that sounds like an absolut overkill to me.

have you ever discussed that &quot;plan&quot; with your physician?
in the end you will be vulnerable to every germ flying around. drinking appeljuice in europe would knock you out for a couple of days without all these drugs....

div
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Old Jul 11th, 2008, 08:44 AM
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Yes, my doctor actually recommends the pepto tablets before meals or at least in the mornings. And I've had good success by doing this, so I probably won't alter plans for the safari. I only take the others if I have problems.

Don't people usually take pepto and Imodium before they try the harsher cipro and the like?

Luckily I've never had to even take Imodium while on vacation, but I prefer to have it and not need it than need it and not have it. Better safe than sorry!

Carrie
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Old Jul 11th, 2008, 10:20 AM
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carrie
thanks for responding!

of course your body didn't show any symptoms as based on all the precautions it hasn't had to deal with nature yet. but that makes you extremly vulnurable to any germ in case you once skip all these meds.

div
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