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How Can I Avoid Levaquin-associated Tendonitis?

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Posted on Thu, 3 May 2012
Question: I am currently taking 500 mg Levaquin once per day and after my morning dose today, I noticed tightness in my achilles tendons while walking down stairs. Now I am anxious about Levaquin-associated tendonitis/rupture. It is too late to vomit-up my last dose....is there a means, other than stopping use of Levaquin, by which I can take extra precautions to avoid this (such as taking a hot bath)? I have already taken 1000 mg magnesium, as Levaquin binds to it but probably too late to interrupt my earlier Levaquin dose (3 hours apart)....Perhaps I am overly anxious but what has me worried is online reports that Levaquin-associated tendon rupture can have a very abrupt onset, with little warning. At the moment, my tendon pain is only mild but I want to keep it that way. Thank you.
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Answered by Dr. Kiran Kumar (6 hours later)
Hi,

Thanks for the query.

Levaquin (Leofloxacin) is known to cause Tendinopathy and Tendon Rupture. It usually occurs about 2 weeks after the levaquin use. However, there have been cases which have occurred within hours of taking the medication.

There is very little which you can do for the medicine you have already taken. Its usually absorbed completely within couple of hours. Taking magnesium has not proven to prevent or reduce the severity of tenon damage.

Your symptoms of tightness of achilles tendon is a mild symptom. However, you should not take any chances. You should do the following.

1. I suggest you to stop taking Levaquin (Levofloxacin) immediately. It's recommended that you should not take any Fluoroquinolones (Levofloxacin, Ciprofloxacin etc) in future.

2. Get any MRI scan of the ankle to confirm the presence of tendinitis. This will tell you the presence of any tendon rupture. Also it will help in knowing the severity of involvement.

3. Take rest. Avoid excess weight bearing. In severe cases, casts are put to prevent stretching of achilles.

So to as of now be reassured. Take rest.
Stop taking your levaquin. Taking hot bath or magnesium will not help you prevent developing tendon injury.

Consult your physician for examination at the earliest. You could get the MRI scans done through his guidance.

Hope this answers your query. Please get back if you need any further information.

Regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Kiran Kumar

Internal Medicine Specialist

Practicing since :2007

Answered : 362 Questions

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How Can I Avoid Levaquin-associated Tendonitis?

Hi,

Thanks for the query.

Levaquin (Leofloxacin) is known to cause Tendinopathy and Tendon Rupture. It usually occurs about 2 weeks after the levaquin use. However, there have been cases which have occurred within hours of taking the medication.

There is very little which you can do for the medicine you have already taken. Its usually absorbed completely within couple of hours. Taking magnesium has not proven to prevent or reduce the severity of tenon damage.

Your symptoms of tightness of achilles tendon is a mild symptom. However, you should not take any chances. You should do the following.

1. I suggest you to stop taking Levaquin (Levofloxacin) immediately. It's recommended that you should not take any Fluoroquinolones (Levofloxacin, Ciprofloxacin etc) in future.

2. Get any MRI scan of the ankle to confirm the presence of tendinitis. This will tell you the presence of any tendon rupture. Also it will help in knowing the severity of involvement.

3. Take rest. Avoid excess weight bearing. In severe cases, casts are put to prevent stretching of achilles.

So to as of now be reassured. Take rest.
Stop taking your levaquin. Taking hot bath or magnesium will not help you prevent developing tendon injury.

Consult your physician for examination at the earliest. You could get the MRI scans done through his guidance.

Hope this answers your query. Please get back if you need any further information.

Regards