By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    headphones can create health problems
    The Harmful Health Effects of Using Headphones
    September 24, 2021
    Headache causes
    4 Causes Of Headache You Probably Didn’t Know About
    December 28, 2021
    follow these steps to recover from your injury
    What Steps Should You Take to Recover More Quickly from an Injury?
    April 12, 2022
    Latest News
    7 Most Common Healthcare Accreditation Programs: Which Should You Use?
    August 20, 2025
    Hospital Pest Control and the Fight Against Superbugs
    August 20, 2025
    Hygiene Beyond The Clinic: Attention To Overlooked Non-Clinical Spaces
    August 13, 2025
    5 Steps to a Promising Career as a Healthcare Administrator
    August 3, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    private
    Private Exchanges: Getting Ready for Individual Health Insurance to Be the Standard
    January 9, 2014
    valueable healthcare programs
    5 Most Valuable Healthcare Programs in 2023
    March 8, 2023
    Johnson & Johnson to Release Clinical Trial Data in Agreement with Yale Medical School
    February 4, 2014
    Latest News
    How Social Security Disability Shapes Access to Care and Everyday Health
    August 22, 2025
    How a DUI Lawyer Can Help When Your Future Health Feels Uncertain
    August 22, 2025
    How One Fall Can Lead to a Long Road of Medical Complications
    August 22, 2025
    How IT and Marketing Teams Can Collaborate to Protect Patient Trust
    July 17, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Got Cipro? If You Exercise, Be Careful!
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Public Health > Got Cipro? If You Exercise, Be Careful!
NewsPublic Health

Got Cipro? If You Exercise, Be Careful!

Dov Michaeli
Dov Michaeli
Share
5 Min Read
SHARE

 

 

 

 

More Read

How To Attract Patients in a Consumer-Driven Healthcare Market
GlobalMed Introduces Teleaudiology Station
The Shocking Truth About Death!
Even 9-Year Olds Hate Waiting Rooms
The Bionic Man Makes History in Mind-Controlled Prosthetics

A couple of weeks ago I got sick and self-medicated myself for two days with a course of ciprofloxacin (or Cipro), until I got a chance to talk to my primary physician. She agreed with my tentative diagnosis and prescribed a full course of Cipro. Now, I had used Cipro before. In fact, whenever we travel we pack it in case we get a case of turista. I viewed it as necessary and commonplace as ibuprofen for pain. So I was surprised when my doctor cautioned me against strenuous exercise, because a major side effect has been recently identified: tendinitis, and worse: tendon rupture. Having gone through the agony of Achilles tendon rupture during a marathon race, and surgery for a ruptured biceps tendon, her warning put the fear of God in me. Indeed, when I got the cipro bottle the first thing that tumbled out was a warning about tendon problems.  I decided to investigate.

Fluoroquinolones -great drugs.

Cipro belongs to fluoroquinolones family of antibiotics. They are one of the most commomly prescribed classes of antibiotics. The reason for their popularity with physicians and patients alike is their broad-spectrum anti-bacterial activity, and their high tissue distribution. These drugs are generally well-tolerated, and adverse reactions are pretty uncommon; nontheless, if the do occur, they are pretty unpleasant.

Fluoroquinolones were reported to cause dysglycemias (hyper and hypo-glycymia) cardiac arrhythmias, neuropsychiatric events, corneal perforation (topical application only, and by another fluorofloxacin, not cipro), andmost important to exercise fanatics: tendinitis, and tendon rupture. The most common tendon to be affected is Achilles tendon, but other tendons are fair game as well.

Did Paris kill Achilles with a well-aimed arrow, or with a cipro pill?

Why tendons?

It is still largely unknown, but a good guess is that since tendons are almost purely collagen, cipro must either interfere with the production of collagen, or cause its destruction. To find out which it is, we can actually play a bit of a biochemical detective game.

Collagen’s half-life, meaning its turnover rate, is extremely long; it takes months to completely replace collagen molecules with newly-synthesized ones. As a matter of fact, collagen has the longest half-life of all the tissues. So if tendon rupture was caused by interference with its synthesis it would have taken weeks or months to occur. In fact, tendon problems can surface within days, or even within hours of taking the drug.

The altenative possibility, destruction of existing collagen, is consistent with the acute occurrence of tendon problems. Although we don’t have in vivo evidence, there are suggestive in vitro experiments. If macrophages are incubated in the presence of fluoroquinolone drugs they secrete enzymes called metaloproteinases that have an interesting activity: they break down collagen molecules. admittedly, this has been shown in petri dishes, and we are far more complex than laboratory dishes. Still, the report on corneal perforation says that it happened when a fluoroquinolone was applied topically to the cornea-quite similar to the petri dish experiment. And yes, cornea is made mostly of  collagen.

Why only tendons (and possibly cornea)?

Indeed why? collagen is the most ubiquitous molecule in the body. It makes up the skin, the dermis that underlies the skin, it anchors all the internal organs, it forms tendons and ligaments. And that’s only a partial list. What makes tendons so special?

I couldn’t come up with a good answer to that question. Other collagen disorders, such as structural mutations, result in widespread and debilitating effects. Why not the fluoroquinolones?

I think that it is a matter of awareness. The realization that these antibiotics can affect collagen is relatively recent. Adverse effects of these antibiotics will be treated now with a much higher index of suspicion. This week we were treated to an article in JAMA titled “Oral Fluoroquinolones and the Risk of Retinal Detachment”. The exact mechanism is unknown, but the retina is attached to the cortical vitreous by a complex matrix of collagen fibers.

Anatomy of the eye

Should you take fluoroquinolones?

The answer is a resounding YES. The drugs are extremely effective, and very safe. These adverse effects sound scary, but they are rare. If you exercise -be aware of your body; stop when you experience the first signs of joint, muscle or tendon pain. And as always, talk to your doctor.

TAGGED:antibioticsCipropharmaceuticals
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

engineer fitting prosthetic arm
How Social Security Disability Shapes Access to Care and Everyday Health
Health care
August 20, 2025
a woman explaining the document
How a DUI Lawyer Can Help When Your Future Health Feels Uncertain
Public Health
August 20, 2025
physiotherapist at work
How One Fall Can Lead to a Long Road of Medical Complications
Health care
August 20, 2025
Common Healthcare Accreditation Programs
7 Most Common Healthcare Accreditation Programs: Which Should You Use?
Health News
August 20, 2025

You Might also Like

use sclerotherapy to treat varicose veins
News

The Key Advantages of Foam Sclerotherapy Treatment

July 13, 2022
malpractice
BusinessPolicy & LawPublic Health

Are Doctors Sued Enough for Medical Malpractice?

May 10, 2014

Why Doctors Should Have Their Own Website

March 26, 2012
Health carePublic Health

6 Questions To Ask When Choosing The ‘Right’ Kind Of Care For Seniors

August 21, 2018
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?