Fluoroquinolone Antibiotics (Ciprofloxacin, Moxifloxacin, Levofloxacin, Ofloxacin) What you need to know | Hull University Teaching Hospitals NHS Trust

Reference Number: HEY1067/2022
Departments: Pharmacy
Last Updated: 9 May 2022

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Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What are fluoroquinolone antibiotics?

Fluoroquinolone antibiotics are a class of medicines that kill bacteria and fight infections. They are important for treating certain bacterial infections, some of which may be serious or life-threatening. This group of antibiotics includes ciprofloxacin, moxifloxacin, levofloxacin and ofloxacin. This advice only applies to medicines that are injected, swallowed or inhaled into the body.

Why do I need a fluoroquinolone?

Fluoroquinolones are important antibiotics for fighting certain types of serious infections. Medicine experts recommend that these antibiotics should not be used in conditions that are not serious or get better without antibiotics. However, your doctor may prescribe you one of these medicines for a severe infection if the expected benefit is greater than the risk. If you are unsure why you have been prescribed this antibiotic or how long you should take it for, talk to your doctor.

Can there be any complications or risks?

Fluoroquinolones have been linked to very rare but serious side effects involving tendons, muscles, joints and nerves. In a small proportion of patients, these effects may lead to long-lasting or permanent disability.

Your doctor will be more careful about prescribing you this medication if you are over 60 years or have a history of kidney problems or organ transplant as your risk of developing tendon problems is greater.

Tell your doctor if you take corticosteroid medication (such as prednisolone or hydrocortisone) as the risk of tendon problems is greater if taken with a fluoroquinolone.

Stop taking your fluoroquinolone antibiotic (ciprofloxacin, moxifloxacin, levofloxacin, ofloxacin) and contact your doctor immediately if you experience the following side effects:

Tendon pain or swelling, often beginning in the ankle or calf – if this happens, rest the painful area until you can see a doctor
Pain in your joints or swelling in your shoulders, arms or legs
Abnormal pain or sensations e.g. pins and needles, tingling, tickling or burning
Severe tiredness, anxiety, depression, poor memory or severe problems sleeping
Changes in sight, hearing, taste or smell

You should tell your doctor if you have a history or seizures or epilepsy or if you take a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen, naproxen or diclofenac.

Fluoroquinolones may cause your skin to be more sensitive to sunlight during and immediately after treatment. You should avoid exposure to direct sunlight and artificial UV rays (e.g. sunbed).

Please ensure you tell your doctor if you are pregnant or breastfeeding.

If you require further information, this can be found on the European Medicines Agency website by using the following link: https://www.ema.europa.eu/en/medicines/human/referrals/quinolone-fluoroquinolone-containing-medicinal-product

What will happen afterwards?

Your doctor may continue to monitor you if you still experience side effects after stopping treatment. If antibiotic therapy is still required, you may be prescribed an alternative from a different family of medicines. You should avoid fluoroquinolone antibiotics. Tell your healthcare team if you receive treatment in the future.

Report any side effects to the Yellow Card Scheme via the website or on the Yellow Card App on the Apple App Store or Google Play Store. These reports are confidential and will help to improve the safety of medicines. https://yellowcard.mhra.gov.uk/

If you require further advice, please contact the Pharmacy Department at Castle Hill Hospital on (01482) 623277 or Hull Royal Infirmary on (01482) 674412.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You. www.hey.nhs.uk/privacy/data-protection

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