why do doctors prescribe levaquin??

22 comments

1. >why would a doctor prescribe something so dangerous like it was plain old amoxicillin? Is it another case of “Japanese people are built different than you americans”? do they just not believe it causes tendon ruptures? Is it because it was synthesized in japan and they’re being patriotic? Or they don’t care if I tear my Achilles?

   a very good question for the doctor to answer

2. I’m sorry that you went through this, and it’s good that you got better advice.

   But I don’t know what you expect by posting this kind of question here, when you have a family member who is a doctor and you two talked about this drug.

   Why do doctors prescribe levofloxacin? What did she say?

3. My father ruptured his Achilles after levaquin. Stuff is no joke.

4. Oh, is that why I hurt my heel last week??

   Interesting! I’m allergic to penicillin based antibiotics, so that makes sense!

5. You should ask the pharmacist that you got the prescription from. I am not a doctor or a pharmacist, so I cannot give you any opinions on levofloxacin, but according to

   [https://www.kegg.jp/medicus-bin/japic_med?japic_code=00067423](https://www.kegg.jp/medicus-bin/japic_med?japic_code=00067423)

   It mentions the possibility of tendon ruptures, but only for elderly patients. In any case, please talk to the doctor or the pharmacist if you have concerns.

6. I dealt with this issue last year. Unfortunately I took it for more days than you. I have been having some pain in that area for a while now. Not sure if it is due to that or just not being active enough.
   Hopefully people read this thread and request a safer antibiotic to try first / for minor issues!

7. Levaquin by itself is bad enough, but when combined with ロキソニン (loxoprofen) the possibility of connective tissue side effects gets exponentially worse. And they do this all the time. I was getting side-effects and asked for a different antibiotic and they gave me クラビット which is basically the same thing and definitely another fluoroquinolone. Weirdly I think caucasians are much more susceptible to these side effects than asian people in general.

   I was destroyed by the levaquin/loxoprofen combo. Connective tissue was burning all over my body and it even destroyed my bowels. 3 months of hell, joints cracking everywhere, lost 30lbs, and I got better. Super active baseball player, marathon runner and cyclist. Not being able to do anything was awful.

   Made a full recovery then years later I was taking ロキソニン for knee pain and everything came back even worse than it originally was. Thought it was just fluoroquinolones that I needed to avoid but maybe because of the initial reaction something changed and now even ibuprophen lays my body to waste.

   9 months of all my connective tissue burning and bowel pain. Was hell. Thankfully I have a wife and kids otherwise I would have ended my life. 9 months. It’s been almost 2 years since then and while the pain is mostly gone all my joints still crack and pop like crazy, and in weird places that never cracked before like my sternum, jaw and hips. Must’ve done something to the cartilage in my inner ear too because sometimes just with my heartbeat it feels like things are shaking like you feel at the very beginning of an earthquake.

   Kind of a weird shell of what I used to be. Still work out and exercise as much as I can but body is just, different. This isn’t mine. Wonder when something is gonna give but can’t really worry about that, just gotta live life. If I could turn back the clock and not take those medicines… oh wow I’d do anything. Love Japan but wish I knew.

8. クラビット is first line treatment in Japan and they give it out for everything. I got tendonitis from that, and when I told my doctor about it he had to look it up in his medicine book and just said “it seems there is such a side effect”. I think the manual in Japan is terribly out of date, and I always make sure to research whatever drugs they give me at the hospital.

   Just recently I was prescribed celecoxib for daily use. As I knew NSAIDs are not for daily use because of cardiac and bleeding risks, I asked the doctor if it was really safe. He assured me that this drug could be taken without side effects for a long time and there are no cardiac risks. As soon as I left the hospital I looked it up, and lo and behold celecoxib is known for cardiac side effects.

   It’s so tiring not being able to trust your doctor.

9. ITT: an American blows a *possible* side effect way out of proportion, and suggests that an evil Japanese doctor is out to end their athletic career because he prescribed one of WHO’s essential medicines..

   The tendons side-effect is linked with old age and steroid use. Athletes tend not to be old.. so.. something you want to tell us, OP?

10. I also try to avoid fluoroquinolones but quickly found that many doctors don’t have enough knowledge of antibiotics to prescribe effective alternatives. One doctor even asked me what I would like him to prescribe…

    Then I lucked into finding a knowledgeable physician and no longer have this issue.

11. I also try to avoid fluoroquinolones but quickly found that many doctors don’t have enough knowledge of antibiotics to prescribe effective alternatives. One doctor even asked me what I would like him to prescribe…

    Then I lucked into finding a knowledgeable physician and no longer have this issue.

12. My wildest experiences in japan always involved dealing with doctors here. When I got into a motorcycle accident (which wasn’t life threatening), my doctor took one look at my X-ray and said my leg wasn’t broken and sent me home without cleaning the wound and bandaging it. I was shocked that I had to end up doing that part myself….

13. Levofloxacin is prescribed because it’s an extremely effective broad-spectrum antibiotic.

    It’s part of a family of antibiotics known as fluoroquinolones or FQ. This family of drugs does have a **very** rare side effect of tendon rupture. Older drugs in the FQ family had a slightly higher incidence of this, but for levofloxacin it’s estimated to be about 4 instances per million prescriptions or 0.0004% of prescriptions.

    A slightly less uncommon side effect (yes, the wording is odd, but it is still a very rare side effect) of FQ family drugs is aches and pains. If you experience them the general advice seems to be to stop taking the drug and to ask your doctor for something else.

    > I talk the next day to a family member who’s a doctor, she is horrified bc levofloxacin literally has a black box warning for causing tendon ruptures

    As strange as it sounds, doctors are not great people to talk to about drugs, drug interactions, and drug side effects. They are not typically specialists in these areas. The specialists are pharmacists.

    (For those of us outside the medical community, including myself, it can be easy to think that doctors know everything about anything related to medicine & treatment, but it’s really not true. There is far too much to know, which is why there are specialists who are experts in specific areas.)

    > only prescribed if theres absolutely no other option

    It’s very commonly prescribed in many countries. In the US it was the #1 most prescribed antibiotic in 2010, for example. It’s use has fallen off somewhat since then but FQ drugs in general are still one of the most-prescribed types of antibiotics.

    > do they just not believe it causes tendon ruptures?

    It’s an exceedingly rare side effect, as mentioned above.

    Ultimately it’s up to you what to do. If you’re a really active person you might want to avoid all FQ family drugs. Talk to your doctor and ask for something else.

14. There’s an increase risk of tendinopathy associated with fluoroquinolones but the incidence is on the order of 3-4 cases per 100,000
    [PMID 10510157](https://pubmed.ncbi.nlm.nih.gov/10510157/) [PMID 17334751](https://pubmed.ncbi.nlm.nih.gov/17334751/)

    Amoxicillin alone wouldn’t provide adequate coverage if the concern was a skin infection from a foreign object.

    There’s generally other options depending on the indication, and there’s an increased risk of tendon rupture and c diff [[PMID 29732377]](https://pubmed.ncbi.nlm.nih.gov/29732377/) compared to other antibiotics, but the risk is relatively small. Doctors still prescribe quinolones in the states all the time.

    Warrants concern, but probably not as risky as reads here.

15. I’ve had that reaction to that drug. It completely immobilized me when I was a kid.

16. My dermo has prescribed me Keflex twice…when it’s in the record that I’m allergic to it. Didn’t notice that it was what was prescribed. The pharmacist filled it, when it was in their records that I’m allergic to it… I called it out during the pharmacist “sit down,” and they freaked a little. Someone ran across the street and came back with a new prescription for… Levofloxacin.

    I read the side effects for everything, and was horrified that they prescribed that shit. It literally says it’s a last-string antibiotic. So I went to another clinic, described the mess, and the doc gave me good ‘ol Amox.

17. I was also prescribed this horror for a relatively mild UTI… reading the side effect risks, I didn’t take it and went for a second opinion.

    As I’m not allergic to any medication, the second doctor I went to prescribed me with Keflex. Much better!

18. I just wanted to comment on this as I’ve warned others about this dangerous antibiotic and this information is not shared enough. I almost died in Japan from taking levofloxacin.

    I was prescribed levofloxacin after seeing a Japanese doctor for a sinus infection. I had no medical history of any kind of allergic reactions prior. He never told me anything about the antibiotic and the warnings it has. And stupidly, I trusted him without asking any questions as I was told by my Japanese coworkers to just follow a doctor’s orders and not question them in Japan. After taking the antibiotic, I experienced a severe anaphylactic reaction within minutes where I was left unable to speak and could barely breathe from the swelling around my mouth and throat as well as other parts of my body. Had I not been with my Japanese spouse at the time who was able to call 119 for an ambulance on my behalf and get me to a hospital ASAP, I do believe I probably would have died that day. I ended up being hospitalized for 2 days due to it.

    I was also furious when I found out just how dangerous of an antibiotic it is. Just like you said OP, it has a black box warning and at least in the US, is only prescribed for treatment of conditions that are otherwise difficult to treat with no other alternative options. In addition to tendon ruptures, levofloxacin can cause other severe side effects, like for muscles, joints, and the nervous system.

    I contacted the Japanese doctor from the hospital who prescribed it to me to inform him what happened and he basically dismissed me and quickly hung up on me. It was honestly one of the worst experiences of my life and made me really question my safety and health in Japan. But just sharing my story so that others can make informed decisions about their health. And I now personally never take a new antibiotic or any kind of medication alone anymore. I even sometimes insist on staying at the doctor’s office and taking it right there to see if I have any reaction before I leave after having experienced this.

19. Yeah I also got prescribed levofloxacin, the very first time I went to a doctor in Japan.

    But honestly the risk is very very small.

    After the FDA black box warning, the EU did a review since something like 300 million daily dosages are prescribed in the EU each and every year. In 20+ years of use, the found like 300 potential cases total (around 15 per year).

    So yes the risk is real but **you’re more likely to get hit by a lightning** than getting a debilitating condition from levofloxacin.

    Now that’s small comfort to those who do unfortunately suffer serious side effects from the drug, especially when alternatives are available.

    Hence the FDA black box warnings, etc. (which shows how risk-averse the FDA can be.)

20. I actually had an allergic reaction and tendon reaction where they felt frozen and could barely walk after 3 doses of levaquin. Got in the States for tonsilitis and flew back to Japan the next day. This was 20 years ago. So I frantically search what could be causing it and find out about the warning on fluoroquinones and go to a Japanese doctor and basically they told me it was all in my head even after I showed them the warning printed out. But I hadn’t looked at the side effects beforehand so I know it wasn’t my imagination. Took a good month or so to get back to normal, and luckily no rupture.

    I’ve also had inner ear complications from tetracycline, so here’s the thing: almost ALL antibiotics have potential side effects that can be serious, from heart irregularities to kidney issues to causing overgrowth of bad actors like C. diff. Japanese doctors are still regularly throwing antibiotics at things like colds and flu that don’t require them, so it’s good to ask them if they are really necessary or not when prescribed.

21. While I’m not a doctor, digging into some articles about this seems to indicate that the dangers of levaquin alone and in particular might be overstated. Articles published since 2010 mainly find risks when it’s used in combination with steroids (so when being used for major infections like pneumonia). A review of incidents in Japan, where it’s commonly prescribed for a wider variety of minor cases, don’t find a particularly notable risk of tendon issues compared to other anti-biotics like ofloxacin, or in patients below 75 years old. In other words, it’s mainly a risk if you’re elderly and when the drug is used in combination with a steroid, which I think yours wasn’t. Anyway, I think it’s fine for you to ask the doctor prescribe something else, but it’s also fine that the doctor prescribed something commonly given for cuts etc in Japan that isn’t shown – as it’s prescribed in Japan – to be particularly higher risk than any other anti-biotic. Anyway, sometimes when things are prescribed different ways, they may have different risks and things may be given warnings in some places in an overly cautious way. If you don’t want to get it, don’t, but there doesn’t realistically seem to be a risk of what you were worried about for your case.

22. There are some great comments here, but just wanted to say that I was also prescribed levofloxacin for a minor UTI. I had never heard of it but asked my mom (a nurse) about it and she was confused, too.

    Very weird that it’s the first thing prescribed. I took it with no issue, but weird.