After taking levofloxacin, reader has painful side-effects

I’m writing in to warn readers of a possible side-effect of an antibiotic known as levofloxacin. I was recently treated with this medication for a sinus infection that would not clear up with amoxicillin. After five days of taking the medication, my joints became very inflamed, especially my ankles, and it was painful. I discontinued the medication, but almost three weeks later, I still have pain in my joints.

My doctor never told me of this horrible possible side-effect. Levofloxacin is the generic form of Levaquin, which was removed from the market years ago due to these issues. Why wasn’t the generic form taken off the market as well? Articles state that the symptoms can be permanent. I’m hoping they eventually lessen because it’s miserable. K.S.

Levofloxacin is a powerful medication that should not be used lightly. Janssen Pharmaceuticals did indeed stop making brandname Levaquin in 2017; although the company did not specify why, a spokesperson said “[t]he decision to discontinue Levaquin was made due to the wide availability of alternative treatment options and our focus on developing innovative medicines designed to address unmet medical patient needs.”

Levofloxacin, like all drugs in the fluoroquinolone class, has the potential for serious harm. I believe you have tendinopathy (inflammation in the tendons), which is among the more serious side effects, partly because it can lead to rupture of the tendon. Although this is reported to be rare (3 per 100,000 cases), I have personally seen more cases than I would expect to with those numbers. Most people recover in two months, but some cases were reported to last between one to two years.

The U.S. Food and Drug Administration put a “black box” warning (the highest possible warning) on levofloxacin to remind physicians of the danger of this sideeffect and the danger of another symptom called neurological toxicity, which can cause delirium and memory impairment. There are more side-effects that occur less commonly.

I hardly ever prescribe this medicine, but I don’t think it should be banned entirely. There are a few times when this class of medications alone can be lifesaving. But physicians shouldn’t be prescribing it lightly. I’m afraid too many physicians prescribe antibiotics for viral diseases too often.

Patients want them and sometimes demand them, but we still shouldn’t prescribe them when we know they won’t help. Doctors who refuse antibiotics are at risk for bad reviews from patients, and these can have a significant impact on a physician’s practice. All antibiotics have the potential for adverse effects, and overuse contributes to resistance. But fluoroquinolones, in particular, should be used extremely sparingly.