Levaquin and Cipro Increase Risk of Aortic Aneurysms and Dissections

According to a new study recently published in the Journal of the American College of Cardiology, exposure to drugs found in the family fluoroquinolone increased the risk of aortic aneurysms and dissections. Fluoroquinolone drugs include Levaquin and Cipro.

What are fluoroquinolones?

aveloxFluoroquinolones are a family of antibacterial agents that are used primarily for respiratory and urinary tract infections. Drugs found in this family include Levaquin, Cipro, and Avelox.

What is Levaquin, and what is it used for?

Levofloxacin, most commonly known as Levaquin, is a fluoroquinolone used to treat bacterial infections in the lung, sinus, skin or urinary tract.

What is Cipro?

Ciprofloxacin, most commonly known as Cipro, is a fluoroquinolone used to treat bone and joint conditions, endocarditis, gastrointestinal infections, intra-abdominal infections, and meningitis. It can also be used to treat anthrax exposure or plagues.

What is Avelox?

Moxifloxacin, most commonly known as Avelox, is a fluoroquinolone used to treat bacterial infections of the skin, sinuses, lungs, and stomach.

What are aortic aneurysms and dissections?

An aortic aneurysm is an irregular bulge that occurs in the aorta’s wall. The aorta is the major blood vessel that transports blood from the heart to the rest of the body. Aortic aneurysms can occur anywhere in the aorta. They can be either tube-shaped or round. There are two types of aortic aneurysms: abdominal and thoracic. An abdominal aortic aneurysm occurs in the part of the aorta that goes through the abdomen. A thoracic one occurs along the part of the aorta that goes through the chest cavity. Some individuals may have both abdominal and thoracic aortic aneurysms. Aortic aneurysms increase the risk of having an aortic dissection.

An aortic dissection occurs when the aorta’s inside walls tear. Blood surges through the tear, which causes the aorta to separate, or dissect. An aortic dissection can be fatal if the blood surge ruptures outside the aortic wall. They are relatively uncommon and occur mostly in men in their 60s and 70s. Aortic dissection symptoms are similar to other diseases, which leads to late diagnoses. If an aortic dissection is detected and treated early enough, chances of survival significantly improve.

Details of the Taiwanese study

Taiwanese researchers studied the relationship between taking fluoroquinolone drugs and the risk of aortic aneurysms and dissections. They gathered data from Taiwan’s National Health Insurance Research Database (NHIRD). The data was used it to conduct a nested case-control analysis of 1,477 case-patients and 147,700 control cases. A nested case-control study is a study that draws cases and controls from the same population. Case-patients consisted of individuals hospitalized for aortic aneurysms or dissections. Control patients were individuals who were not hospitalized for aortic aneurysms or dissections. Researchers matched 100 control patients to each individual case-patient based on age and sex.

Researchers looked at varying exposures to fluoroquinolone in patients who developed aortic aneurysms or dissections. They had three different categories that defined varying degrees of exposure. These categories are current, past, or any prior-year use. Current-use exposure meant having a filled fluoroquinolone prescription within the past 60 days of the aortic. Past-use meant having a filled prescription between 61 to 365 days. Prior-year use meant having a prescription filled for three or more days at any time during a one-year period prior to aortic aneurysm or dissection.

The study’s results showed increased exposure to fluoroquinolones increased the risk of aortic aneurysms and dissections. Both current and past use were associated with an increased risk for aortic aneurysms or dissections.

What has a previous study say about this issue?

Swedish researchers published a study that concluded that fluoroquinolone use increased the risk of an aortic aneurysm or dissection. They looked at connections between fluoroquinolone and aortic problems within the Swedish population. In addition, they compared amoxicillin use to fluoroquinolone use within a 60-day period. They gathered data from four different sources over a seven-year span. The first source was the National Prescribed Drug Register. This register records all prescriptions filled at all Swedish pharmacies. The second source was the National Patient Register. This register records hospital admissions, outpatient, and emergency department visits in Sweden. The third source was Statistics Sweden, which keeps track of demographics. The fourth source was the Swedish Cause of Death Register. This register keeps track of causes of death in Sweden and death certificates. They concluded that fluoroquinolone use was associated with a 66% increased risk of an aortic aneurysm or dissection within a 60-day period. However, they noticed no increased risk of an aortic aneurysm or dissection after a 61 to 120-day period.

Other health risks associated with fluoroquinolones

There are other serious health risks that are associated with fluoroquinolones. One such health risk is lowered blood sugar. The FDA announced in July that they were strengthening label warnings that note fluoroquinolone side effects of lower blood sugar level. Lower blood sugar levels can result in a coma, especially in diabetic patients.

Another health risk associated with fluoroquinolones is mental health issues. Fluoroquinolone may cause hallucinations, psychosis, confusion, depression, anxiety, and paranoia. In addition to blood sugar, the FDA also included mental health in its July announcement.

Fluoroquinolones can also increase the risk of getting permanent nerve damage. In August 2013, the FDA announced they would be requiring label changes that emphasize the risk of peripheral neuropathy. It consists of conditions that damage the peripheral nervous system. Peripheral neuropathy occurs in the arms and legs. Symptoms include pain, burning, tingling, and numbness. Its effects can last for months or even years after one stops taking fluoroquinolones. It can sometimes be permanent as well.

Should I stop taking fluoroquinolones?

If you have experienced side effects such as the ones listed above, you should stop taking your medication. Always contact your doctor to let them know of any side effects you may have experienced upon taking fluoroquinolones.