Fluoroquinolone antibiotics (ciprofloxacin, delafloxacin, levofloxacin, moxifloxacin, and ofloxacin)

You have been prescribed Fluoroquinolone antibiotics. The following leaflet explains:

• what these antibiotics are;

• why you have been prescribed them;

• what side effects you need to watch out for;

• who is at higher risk of developing these side effects; and

• what to do if you experience any of them.

If you have any questions after reading this leaflet, please speak to the clinician who prescribed your antibiotics.

What are Fluoroquinolones?

Fluoroquinolones are a family type of antibiotics that fight against serious bacterial infections when other antibiotics are not suitable for you. They should be used for the shortest effective time to treat your infection.

Why have I been prescribed these antibiotics?

You have been prescribed Fluoroquinolone, as you are either:

• allergic to the alternative antibiotics, or

• Fluoroquinolone antibiotics are the best available treatment for your infection.

What are the side effects?

As with most medications, Fluoroquinolones also have side effects. A small number of patients (between 1 and 10 people in every 10,000) may have serious side effects that can cause long-lasting problems.

Your prescribing doctor has decided that the seriousness of your condition outweighs the risks of the side effects.

• Joint and movement disorders may include tendon pain or weakness (especially in the shoulder, ankle or legs), swelling, burning, tingling, numbness or weakness of the tendons. This is sometimes referred to as tendonitis.

Tendon swelling and injury may occur within 48 hours of starting treatment with a Fluoroquinolone, but may occur several months after stopping treatment. 

Other side effects that you may need to be aware of

• Changes in your vision, taste, smell, or hearing.

• Mood changes can also occur, as well as changes in memory or sleep.

• Gastro-intestinal symptoms can include diarrhoea. This can become severe, and you may have persistent blood or mucous in your stools.

• Increased seizure activity can occur in patients with a history of seizures or epilepsy. If you have a history of seizures, please discuss with your doctor before you start treatment.

• Cardiac symptoms may develop in elderly patients. Symptoms can include chest pain, difficulty breathing, deep stomach pain, pulsating or discomfort, or changes to your voice.

Stop taking your Fluoroquinolone antibiotics and contact your prescribing doctor immediately if you have any of the above side effects.

If you have any questions or concerns about these side effects, please speak to your prescribing doctor.

Who is at most risk?

You are more at risk if:

• you are aged over 60 years

• your kidneys do not work well

• you have had an organ transplant, or

• you are taking oral steroid medications (such as hydrocortisone or prednisolone).

What will happen if I stop taking my antibiotics?

You must tell the doctor who first prescribed them. They will need to look for alternatives to treat the infection you were diagnosed with.

What can I do if I think I am having a side effect?

If you have tendon or muscle problems or are feeling particularly unwell (aside from your infection), this may be caused by events other than your medicines. It is important for your symptoms to be investigated. The best person to talk to is your prescribing doctor or another prescriber from the same team. If you are unable to see your doctor, you can call 111 for advice. Do not delay in talking to your doctor if you think something is wrong.

Further information

For more information on tendonitis, please go to the Tendonitis page on the NHS web site.