tdtid
Frequent Contributor (1K+ posts)
Member # 10276
posted
I have been on Cipro for six weeks now. For the most part, I have loved this drug for bartonella since it's able to give me a few hours every now and then that I think I have hope.
The downside is that I've been struggling with some leg pains. I saw the LLMD yesterday and by my discription, he wasn't convinced that I'm discussing "tendonitis", vs just more of the herxing.
He said the classic textbook would have me having these pains in more than just behind my knees and in my right foot and ankle, BUT just in case, he told me to stop the cipro effective immediately and call him on Friday.
He is looking to see if this pain has eased up or if it is still there. But it was so confusing in my mind since he was saying if it continues, we know it wasn't from the med, but then on the other hand, he was talking that if it stops is could have been a herx....or else I had too much brain fog to understand.
The brain fog is the most likely scenario. All I know is I call on Friday and report and then either I will continue the med or else start something new for the bart.
The best way I can explain where the worst inflamation is, is behind the knee. There is no sign of swelling and visually, I see nothing wrong with it.
I did have symptoms similar to this even before taking Cipro, so perhaps it's a herx. It causes me to limp, but considering I wasn't even walking for awhile, I shouldn't complain about this minor inconvenience.
At the same time, I don't want to be taking something that is causing more issues, although seriously, just in this six months, I've had some really horrid days, but I've had peeks of sunshine, so I don't want to go off this needlessly.
Any imput from anyone that has suffered tendonitis?
Cathy
-------------------- "To Dream The Impossible Dream" Man of La Mancha Posts: 2638 | From New Hampshire | Registered: Oct 2006
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Lyme can cause tendon and tendonitis all by itself.I tore my first tendon while not on abx's of any kind before treatment.But since its in the quinolone family I would stop too because the other two tendons I tore were on levaquin.
Heres a copy of cipro info:
Cipro may also be prescribed for children with a urinary tract infection or kidney infection when other antibiotics are not effective.
Because Cipro is effective only for certain types of bacterial infections, before beginning treatment your doctor may perform tests to identify the specific organisms causing your infection.
Cipro is available as a tablet and an oral suspension (liquid). Cipro HC Otic is a suspension (ear drops) that also contains the anti-inflammatory drug hydrocortisone it's used externally to treat ear infections.
Cipro XR, an extended-release form of the drug, is used to treat cystitis, urinary tract infection, and kidney infection.
Generations
The quinolones are divided into generations based on their antibacterial spectrum. The earlier generation agents are generally more narrow spectrum than the later ones.
Ciprofloxacin (Cipro, Ciproxin) Ciprofloxacin can cause photosensitivity reactions and can elevate plasma theophylline levels to toxic values. It can also cause constipation and sensitivity to caffeine. Ciprofloxacin is also known to cause swelling of certain joints and cartilage.
Quercetin, a flavonoid occasionally used as a dietary supplement may interact with fluroquinolones, as quercetin competitively binds to bacterial DNA gyrase. Some foods such as garlic and apples contain high levels of quercetin. Whether this inhibits or enhances the effect of fluoroquinolones is not entirely clear.
Contraindications
Metalcations such as aluminium, magnesium, calcium, ferrous sulfate, and zinc are thought to form chelation complexes with fluoroquinolone antibiotics and prevent the drugs from being absorbed. Because of this, avoid taking ciprofloxacin with antacids which contain aluminium, magnesium or calcium. Sucralfate, which has a high aluminium content, also reduces the bioavailability of ciprofloxacin to approximately 4%.
Ciprofloxacin may be taken with meals or on an empty stomach. Ciprofloxacin should not be taken with dairy products or calcium-fortified juices alone, but may be taken with a meal that contains these products.
Heavy exercise is discouraged, as achilles tendon rupture has been reported in patients taking ciprofloxacin. Achilles tendon rupture due to ciprofloxacin use is typically associated with renal failure.
The toxicity of drugs that are metabolised by the cytochrome P450 system is enhanced by concomitant use of some quinolones. They may also interact with the GABA A receptor and cause neurological symptoms; this is further augmented by certain non-steroidal anti-inflammatory drugs Fluoroquinolones are increasingly contraindicated for patients who have been to S.E. Asia due to the growing prevalence of antibiotic resistance to the class of antibiotics in that region.
Veterinary use
The quinolones have been widely used in agriculture and several agents exist which have veterinary but not human use. � danofloxacin (Advocin, Advocid)(*Veterinary use*) . difloxacin (Dicural, Vetequinon) � enrofloxacin (Baytril) � marbofloxacin (Marbocyl, Zenequin(*Veterinary use*) � orbifloxacin (Orbax, Victas)(*Veterinary use*) � sarafloxacin (Floxasol, Saraflox, Sarafin)(*Veterinary use*)
Why should this drug not be prescribed? If you are sensitive to or have ever had an allergic reaction to Cipro or certain other antibiotics of this type such as Floxin, Noroxin and Trovan, you should not take this medication. Make sure that your doctor is aware of any drug reactions that you have experienced. Cipro HC Otic suspension should not be used on anyone whose eardrum is perforated or who has a viral infection of the ear.
Special warnings about this medication Cipro may cause you to become dizzy or light-headed; therefore, you should not drive a car, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you know how the drug affects you. Continued or prolonged use of this drug may result in a growth of bacteria that do not respond to this medication and can cause a secondary infection. Therefore, it is important that your doctor monitor your condition on a regular basis. Cipro can cause increased pressure within the brain. Convulsions have been reported in people receiving the drug. If you experience a seizure or convulsion, notify your doctor immediately. This medication may stimulate the central nervous system, which may lead to tremors, restlessness, light-headedness, confusion, depression, and hallucinations. If these reactions occur, consult your doctor at once. Other central nervous system reactions include nervousness, agitation, insomnia, anxiety, nightmares, and paranoia. If you have a known or suspected central nervous system disorder such as epilepsy or hardening of the arteries in the brain, make sure your doctor knows about it when prescribing Cipro. Remember to stop taking Cipro and see your doctor at the first hint of an allergic reaction (see "Most important fact about this drug"). Also call your doctor if you develop diarrhea. Antibiotics such as Cipro occasionally trigger a form of diarrhea that needs a doctor's attention. Rare cases of peripheral neuropathy (changes or disturbances of the nervous system) have been reported with this type of antibiotic. Contact your doctor if you experience muscle weakness, paralysis, pain or numbness, a burning sensation, or a "pins and needles" sensation. You may become more sensitive to light while taking this drug. Try to stay out of the sun as much as possible. People taking Cipro have been known to suffer torn tendons. If you feel any pain or inflammation in a tendon area, stop taking the drug and call your doctor; you should rest and avoid exercise. You may need surgery to repair the tendon. If you must take Cipro for an extended period of time, your doctor will probably order blood tests and tests for urine, kidney, and liver function. If you are taking Cipro to treat gonorrhea, the doctor should test you for syphilis after 3 months.
Possible food and drug interactions when taking this medication Serious and fatal reactions have occurred when Cipro was taken in combination with theophylline (Theo-Dur). These reactions have included cardiac arrest, seizures, status epilepticus (continuous attacks of epilepsy with no periods of consciousness), and respiratory failure. The following can interfere with the absorption of Cipro and should be taken no less than 6 hours before or 2 hours after a dose:
Antacids containing magnesium and aluminum Carafate Supplements and other products containing calcium, iron, or zinc Videx chewable tablets and pediatric powder You should also avoid taking Cipro with milk or yogurt alone, though calcium taken as part of a full meal has no significant effect on the drug. Cipro may increase the effects of caffeine. If Cipro is taken with certain other drugs, the effects of either could be increased, decreased, or altered. These drugs include:
Cyclophosphamide (Cytoxan) Cyclosporine (Sandimmune, Neoral) Glyburide (DiaBeta, Glynase, Micronase) Methotrexate (Rheumatrex) Metoclopramide (Reglan) Metoprolol (Lopressor) Phenytoin (Dilantin) Probenecid Warfarin (Coumadin) Certain nonsteroidal anti-inflammatory drugs (NSAIDs), with the exception of aspirin, could cause convulsions when combined with high doses of this type of antibiotic.
Special information if you are pregnant or breastfeeding Although there's reason to believe that Cipro poses little danger during pregnancy, its effects have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. Cipro does appear in breast milk when it's taken internally, and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
Jill E.
Frequent Contributor (1K+ posts)
Member # 9121
posted
Hi,
I know how confusing this is, because when I was on quinolones, I was told to watch out for any tendon pain.
Yet Lyme has given me four years of continuous aching in my legs, so how would I know?
Just before I went off Levaquin, I developed pain in both heels, but it was right where the leg meets the sole - not in the Achilles Tendons. So the doctors didn't think it was tendonitis.
I had to go off Levaquin due to a rash. But I did end up developing Achilles Tendonitis in both legs, even after I went off the drug. I've been trying to recover for nearly a year.
I wouldn't take any chances, go off and see if it improves and discuss it with your LLMD about whether to go back on.
Take care, Jill
-------------------- If laughter is the best medicine, why hasn't stand-up comedy cured me? Posts: 1773 | From San Diego | Registered: Apr 2006
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tdtid
Frequent Contributor (1K+ posts)
Member # 10276
posted
Treepatrol and Jill,
Thank you for your insight and experience on this issue. Obviously I'm waiting this out til Friday when I call the doctor and not taking ANY abx at this moment, so for a couple days, it's "wait and see".
So I guess when looking at it from your experiences, if I were to swap out of the cipro and levequin category for bart, what would be another good choice of med with the fewest side effects that still may continue where the cipro left off?
Also, keep in mind that before I was complaining about my legs, my LLMD was going to have me adding in 100 mg a day of Minocycline which has been called into the pharmacy but not picked up.
I'm also doing Zhang with this combo, but hate to give up on the Bart with my cipro without a good back up. Any solutions that worked for you and even more....what did you do for the "tendonitis" pain, if that is indeed what this could be? Ice, heat, suggestions?
Cathy
-------------------- "To Dream The Impossible Dream" Man of La Mancha Posts: 2638 | From New Hampshire | Registered: Oct 2006
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Jill E.
Frequent Contributor (1K+ posts)
Member # 9121
posted
Hi Cathy,
I'm on Rifampin now for Bartonella because I ran out of other options. But it's taken me a month to ramp up and I'm only at half a dose. And I have to get my liver enzymes checked every week because Rifampin can be hard on the liver and I had liver problems from Ketek.
Another Lyme pal and I, who each developed tendonitis from quinolones, found that icing the area every day, sometimes several times a day, gave us the most relief.
I also took Advil for a couple of weeks with my LLMDs OK, then tried some more natural anti-inflammatories. I also used some homeopathic creams such as Traumeel and Topricin.
My pain and weakness became so bad in the Achilles Tendons that I couldn't drive for quite a while, had to often use a cane to walk, couldn't walk up and down hills and could not walk barefoot in my house. I've been using orthotics and wearing athletic shoes for months, although I've graduated to wearing flat casual shoes.
My pal with the tendonitis went to physical therapy for awhile and felt it helped. She sure recovered faster than I have. I do have a prescription for physical therapy but just haven't been able to fit it into my schedule, but hopefully can if I need to.
Jill
-------------------- If laughter is the best medicine, why hasn't stand-up comedy cured me? Posts: 1773 | From San Diego | Registered: Apr 2006
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tdtid
Frequent Contributor (1K+ posts)
Member # 10276
posted
Jill,
Again, thank you so much for the advice. I'm on my laptop in bed and on ice in hopes that it will atleast settle this down a bit.
I'm still struggling since I honesty feel the cipro was "working" and having an effect on the bart but at the same time, you don't want to rupture tendons just to get bart treatment.
You mentioned Ketek and Rifampin, both of which I've heard mentioned a lot here. If you had it to do again, and had problems with your levequin, would you have still tried the ketek first or would you have gone straight for the Rifampin?
Since they both seem horrid on the liver, is there any other bart treatment that doesn't cause havoc on the liver. I know my LLMD will have his views, but if I'm going to be changed, he also is very open minded about various things I want to try, which is why I'm doing a cram course.
I imagine that if I'm having this problem with cipro, I'd have it with levequin too, correct? Or would it take maybe another six weeks to catch up? Just weighting out all my options.
Thank you for your patience and time.
Cathy
-------------------- "To Dream The Impossible Dream" Man of La Mancha Posts: 2638 | From New Hampshire | Registered: Oct 2006
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Jill E.
Frequent Contributor (1K+ posts)
Member # 9121
posted
Cathy,
I'm not the best person to ask about Ketek given that I'm one of the people that was nearly in liver failure from it and the hepatologist predicted I would need a liver transplant. I did not but it was touch and go.
Don't give up on Cipro without your LLMDs input, just be careful until you've had a chance to talk out all the pros and cons. As you know, Dr. B. used Levaquin, and sometimes Cipro, with great success for people with Bartonella and Bartonella-like organisms. These days, Levaquin seems to be the medication of choice for Bartonella among many LLMDs, but Cipro is closely related and used by top LLMDs too.
Did you ever see the DVD of Dr. B.'s lecture on Bartonella-like organisms?
All the quinolones can affect the tendons, although my LLMD said Factive has a slightly lower chance. It's one of the medications we were considering for Bartonella, but it's a quinolone and I'm not chancing anything while my tendons are still recovering.
I don't know if reacting to one quinolone would increase the chances of tendon problems on a different quinolone. I think the damage can happen pretty quickly in some people. One of my neighbors, a non-Lyme patient, got tendon damage from being on Cipro just a few days for a bladder infection.
Zithromax is used for some pediatric Bartonella patients and that was another one we were considering. It can be hard on the liver, too.
Please let me know what you and your LLMD decide. I'm obviously trying to learn about all the Bartonella options if Rifampin doesn't work out for me.
Keep icing!!
Jill
-------------------- If laughter is the best medicine, why hasn't stand-up comedy cured me? Posts: 1773 | From San Diego | Registered: Apr 2006
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tdtid
Frequent Contributor (1K+ posts)
Member # 10276
posted
Jill,
Your icing idea was wonderful but since it's not nearly as bothersome today, my LLMD is having me start the Cipro back up with the Minocycline but said to call if it starts getting bad again.
Hopefully it wasn't related to the cipro and since today my PCP upped my Armour Thyroid dose, my LLMD said that could have been part of the problem too. So time will tell.
Thank you for all of your support and help on this topic. I'll let you know if I do indeed need to swap off the cipro to another med for the bartonella.
Cathy
-------------------- "To Dream The Impossible Dream" Man of La Mancha Posts: 2638 | From New Hampshire | Registered: Oct 2006
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In my opinion it is extremely likely that you have already surpassed the cumulative limit of toxicity of cipro. Most doctors, and yours seems to be no exception, know little or nothing about pharmacology. If you stop taking cipro, your symptoms can decrease a little, but the damage will go on building up for a long time. Today it is extremely well documented that tendon ruptures, and many other sinister effects of cipro can take place up to 8 months after discontinuing it. So stopping the cipro for a few days will add zero information as to whether one is becoming intoxicated and risking ruining one's life.
I would bet that if you did some strenous or repetitive exercises for a few days, you would develop a very resilient tendinitis as a consequence of the toxicity of cipro.
Other symptoms of cipro toxicity are brain fog, insomnia, coffee "sensitivity", itching, numbness, fasciculations, pain in the back of the knees, pains in any joint, and a hundred more.
For instance, the information of some monographs is well manipulated by the manufacturers and states that coffee sensitivity can be developed. This euphemism, "sensitivity" is in fact a liver impairment of the P450 enzymes pathway. This means that the liver is injured and cannot metabolize properly caffeine,....and neither many other medicines as well as many foods.
and look there for symptoms, because it will help you to discern whether you are having a reaction.
Take also into account that taking a quinolone and sunbathing can cause skin cancer and irreversible eye injuries, and skin lesions. Well, describing here the real lesions that these antibiotics do cause shortly after the first symptoms arise, would take too much space.
Once a reaction has developed, it is very unlikely that one gets well before one year, and sometimes recovery takes 5 or more years. Many permanent injuries occur to those that fail to identify the early signs of a reaction to a quinolone. ------------------------------
Jill. E.
If you develop a reaction to a quinolone, like cipro you cannot be rechallenged with any other one for your whole life. Remember that many injuries are irreversible, specially brain and nerver damages, as the FDA forced recently to be stated on the package inserts.
All their known toxic effects are shared by the whole family of antibiotics, as they are all the same formulation derived from nalidixic acid, just shifting slightly the position of an atom of the molecule. The different positions of a couple of atoms within the molecule allows different manufacturers to register the compound and earn exclusivity. These different positions of atoms make slight differences in a 10% of the toxic profile, that change from bad to worse normally. All the rest is identical for all of them.
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