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
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 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
    Cash Transfers: Good for HIV/AIDS Too
    August 9, 2012
    unnecessary medical tests
    Eagerly Awaiting the Death of Defensive Medicine
    September 5, 2013
    Image
    Mobile Health Around the Globe – mHealth Fighting Malnutrition in India
    December 17, 2012
    Latest News
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 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

Siemens and Stand Up To Cancer
Passing Hope in the Form of a Baton
Abstinence-only education has failed; let’s embrace what works instead
10 Ways You Can Promote Good Community Healthcare
Can You Hear Me Now? Another Health Market that Really Works
Making The Decision To Outsource And Choosing The Right IRO Partner

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

9 Lifestyle Tweaks That Can Add Years to Your Life
9 Healthcare Lifestyle Tweaks That can Add Years to Your Life
lifestyle
July 11, 2025
car accident lawsuit
Let Your Lawyer Handle the Work Before You Pay Medical Costs
Policy & Law
July 6, 2025
women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025

You Might also Like

Aetna and CVS Brand a Prescription Drug Plan

October 4, 2011
male menopause
News

Is Male Menopause a Real Thing? Yes, It Unfortunately Is

July 18, 2021

Lessons on Healthcare and Risks from the Passing of Joan Rivers

September 7, 2014

End-of-Life Care? Maybe

September 10, 2014
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?