New safety information for fluoroquinolone antibiotics

June 26, 2019

Fluoroquinolones are antibiotics with names ending in “-oxacin”. Ciprofloxacin, levofloxacin, moxifloxacin and ofloxacin are available in the UK. These antibiotics are used to treat serious and life-threatening infections. However, they may affect the muscles, joints, tendons and nerves. These side-effects have led to long-lasting or permanent disability in a very small number of patients.

The MHRA (the agency in the UK responsible for the safety of medicines) has therefore issued new safety information, so that any side-effects are identified quickly and the right action is taken.

When deciding whether to give fluoroquinolone antibiotics to your child, it is important to consider the benefit of fluoroquinolones in treating serious infections against the very low risk of a serious side-effect. If you have concerns, discuss these with your doctor.

This advice only applies to tablets and liquid medicine. It does not apply to ear drops, as the dose of antibiotic is much lower, and it does not get into the body.

Keep a close eye on your child while they are taking any fluoroquinolone. Contact your doctor straight away if you notice any of the following:

Pain or swelling in the tendons, often starting in the ankle or calf (rest the painful area until you have seen your doctor)
Pain in the joints Swelling in the shoulder, arms or legs Pain or unusual feelings, such as pins and needles, tingling, tickling, numbness or burning
Weakness in the body, especially in the arms or legs, or difficulty walking
Severe tiredness, low mood, seeming anxious, problems with memory, difficulty sleeping
Changes to sight, taste, smell or hearing.

More information can be found in the Medicines for Children leaflet about ciprofloxacin. The advice from the MHRA can be read here.

Tell your doctor if your child takes, or is likely to take, corticosteroids such as prednisolone and hydrocortisone, which are widely used to treat inflammatory conditions. Corticosteroids can increase the risk of tendon problems with fluoroquinolones. You can report any side-effects to the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk