Cipro and other widely-prescribed antibiotics may put certain people at increased risk for a potentially deadly aortic aneurysm, the FDA now warns. Even if you’re not currently taking one of these antibiotics, you might be prescribed one in the future. Reading this could save your life…
Cipro is one of a class of antibiotics called fluoroquinolones. You’ve probably taken a fluoroquinolone—which also includes Avelox, Floxin and Levaquin—at least once, since they’ve been around for more than 30 years. These are broad-spectrum drugs, meaning that they can treat a wide range of bacterial infections—including infections of the lungs, skin and urinary tract.
Now case reports and four studies show that for people at risk for aortic aneurysm (AA), taking a fluoroquinolone doubles their risk. AA is a bulge in a weak spot in the wall of the large artery that carries blood from the heart down through the chest and belly to the rest of the body. An AA can lead to dissection—the layers of the artery separate, allowing blood to leak between the layers—and possibly to rupture, which is a medical emergency that is usually fatal without immediate surgery.
The US Food and Drug Administration (FDA) issued a warning in December 2018 that applies to all fluoroquinolone antibiotics that are taken as pills or injections. The FDA says these antibiotics should not be used unless there are no other antibiotic options for people at risk for AA. Risk factors include…
- Being elderly (some studies found increased risk in people over age 65 while other studies found risk increased over age 70).
- Having a history of aneurysm in any artery of the body.
- Having a history of “hardening of the arteries” (atherosclerosis).
- Having high blood pressure.
- Having a genetic condition that weakens arteries (such as the genetic connective-tissue disorders Marfan syndrome and Ehlers-Danlos syndrome).
- Being male and a current or former smoker.
Overall risk for AA is still relatively small, even for people at increased risk. Per every 100,000 people, there are about 300 cases of AA per year among those at highest risk, compared with about nine cases among the general population. But because AA is potentially deadly and can happen quickly, a doubled risk needs to be taken seriously.
The FDA advises patients to let their doctors know if they have any risk factors for AA before taking a fluoroquinolone, and to discuss whether a safer antibiotic can be prescribed instead. If a fluoroquinolone is still the best—or only—option, patients and doctors need to be aware that the increased risk for AA continues for 30 days after taking the drug.
Important: Get to an emergency room or call 911 immediately if you have severe, sudden and steady pain—which may feel like throbbing and/or feel deep—in your chest, belly or back. You also may have trouble breathing or swallowing.
And if you are a man age 65 to 75 and have ever smoked, the US Preventive Services Task Force recommends that you have a onetime ultrasound screen for AA. Screening can discover an AA early, when it can be corrected surgically to prevent rupture.
The current warning is the latest among several issued recently for fluoroquinolones. Earlier in 2018, the FDA warned of a risk for low blood sugar and mental health changes that can include insomnia, anxiety and paranoia. There also was a previous warning of higher risk for nerve damage and tendon ruptures.
