Fluoroquinolones associated “Tendinopathy”:

 Dr.Naina Mohamed Pakkir Maideen

ª  Fluoroquinolones may cause tendinopathies such as tendinitis and tendon rupture of Achilles tendon and also other tendons like rotator cuff (the shoulder), the hand, the biceps, and the thumb.

ª  According to FDA, patients should stop taking fluoroquinolone at the first sign of tendon pain, swelling, or inflammation.

ª  Due to the chelating properties, Fluoroquinolones may form complex with several metal ions (e.g., calcium, magnesium, aluminum) and cause direct toxicity to type 1 collagen synthesis which leads to collagen degradation.

ª  Fluoroquinolones may also interact with regulating proteins of tenocytes because of their Chelating properties to damage the tendon structure.

ª  By Chelating with magnesium in joint cartilage, Fluoroquinolones may induce irreversible cartilage lesions.

ª  Fluoroquinolones associated Tendinopathy could be managed by taking rest, decreasing the physical load on the tendon and initiating physical therapy.

ª  Most Fluoroquinolones are contraindicated in children and during pregnancy and lactation, due to possible damage to juvenile weight-bearing joints by FQs.

ª  Fluoroquinolones associated Tendon rupture could be prevented or reduced by appropriate use of a fluoroquinolone, patient selection, and careful monitoring.