Antibiotics: Fluoroquinolones. Advice for patients and carers

Why have I been given this information?

You have been a prescribed an antibiotic called a fluoroquinolone which can cause serious side effects. This leaflet will tell you about this risk and what to do if they happen.

What are fluoroquinolones?

• Fluroquinolones are a group of antibiotics which treat many types of serious and life-threatening infections.
• Names for fluroquinolones include ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin, and delafloxacin. They can be taken by mouth, inhaled or with an injection.

They are very good antibiotics and may be best ones to treat your infection, but they can give you serious side effects. The doctors will have considered this before giving you this antibiotic.

What are the side effects?

• Fluoroquinolones can cause serious side effects involving tendons, muscles, joints, and the nerves.   
• They can also cause mental health side effects including confusion, disorientation, depression, anxiety, memory problems and suicidal thoughts.

You may not be aware of these mood changes if they happen to you. It is important to tell your family or friends about them when you start your antibiotic course so that they can spot them if they do happen.

• There is an increased risk of seizures (fits), even in people without a history of seizures. If you take anti-inflammatory medicine such as ibuprofen, this risk is increased. Do not take these while you are taking your antibiotic course. 
• Fluoroquinolones also cause a small increased risk of aortic aneurysm or dissection and heart valve regurgitation. Go to the hospital if you develop sudden, severe pain in the abdomen, chest or lower back.

In a small proportion of people, these side effects can be long lasting or cause a permanent disability.

When are these side effects likely to happen?

These may happen within two days of starting treatment or up to six months after stopping treatment.

How likely are these side effects?

We do not currently have the data to calculate how frequently these side effects occur. However, these side effects are rare and only affect between 1 and 10 people in every 10,000 of people treated with a fluroquinolone.

Who should I tell if have any of these side effects?

If you experience any of these side effects, stop taking this medication and contact your medical team or GP immediately. If you cannot contact your medical team or GP, or your symptoms are severe call 111.

• Tendon pain or swelling (especially ankle or calf).
• Joint pain or swelling in shoulder, arms or legs, or if you have worse pain or a change in pain in your surgery site or related to your infection.
• Sudden, severe pain in the abdomen, chest or lower back. 
• Strange or unusual pain or feelings in your body. For example, tingling, numbness, or burning, weakness in your body, or difficulty walking.   
• Severe tiredness, depressed mood, anxiety, panic attacks, confusion, problems with your memory, or severe problems sleeping.
• Distressing thoughts or feelings about self-harm or suicide.   
• Changes in your vision, taste, smell, or hearing.  
• Severe, prolonged or bloody diarrhoea (loose or runny poo). 
• Seizures (fits).

After seeking medical attention, please report any side effects to the Medicines and Healthcare Regulatory Agency (MHRA) via the yellow card scheme. Reports are confidential and help to improve the safety of medicines.  

Report side effects on the website (visit https://yellowcard.mhra.gov.uk/ or search for Yellow Card scheme), and on the Yellow Card App on the Apple App Store or Google Play Store.

Where can I find more information or advice?

Please visit the MHRA website at www.gov.uk/drug-safety-update and search ‘fluoroquinolones’.

If you need any help or advice, please contact the ward that you were staying on. You will find their contact details on your discharge paperwork. If you are under the care of a clinic, please contact the clinic directly for advice.