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BEWARE of fluoroquinolone antibiotics – Cipro, Levaquin, Avelox and Floxin


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Posted (edited)
9 hours ago, DaRoadrunner said:

We are all different, some are naturally more susceptible than others. You were lucky to get away with it. However, FQ drugs have latent effects, delayed onset 5 years in my case. Lots o luck! As for age and fitness.... we are the same age.... I'll leave it to my nickname for you to guess my level of fitness. Yep, the doctors turned an athlete into an old man.

i know that your being a vegetarian means the idea of bone broth turns you off.  If made in a crock pot , adding generous amount of garlic and let simmer all day , it feels like a real health boost to me.  I separate into glass jars and heat as needed,  adding salt .... and veggies sometimes.

BTW:  the stories from many many sufferers are from younger people that were athletes or fitness oriented people.   keep fighting and ignore the negativity 

Edited by rumak
  • Like 1
Posted
56 minutes ago, oxysong said:

Do not understand why you guys just do not go and get the op  If prostate is enlarged,best thing I ever did,now after a beer or two can have decent nights sleep,after getting up 5/6 times in the night a couple of years ago.  Quite simple and cheap,no need for classy hospitals

Perhaps because of negative side effects?

Quote

The major possible side effects of radicalprostatectomy are urinary incontinence (being unable to control urine) and erectile dysfunction (impotence; problems getting or keeping erections).

I had prostate removed at same time as bladder due cancer so incontinence was not a factor.  Erections did return (but second urethra cancer operation has removed that factor).  Bladder/prostate operation was done by below doctor (who now works at Bumrungrad) and found him easy to talk with.

https://www.bumrungrad.com/doctors/Charuspong-Dissaranan

 

Posted
11 minutes ago, oxysong said:

Its pointless keeping on popping pills,it stops nothing,but it keeps on growing.  I have had no side effects,none,but admit I do not produce a bucketful of cum,now just nice and calm,not chasing after every piece of skirt that happens my way,can say no,when all I could say previously was yes

Neighbour of mine had the operation (TURP) done at McCormick hospital in Chiang Mai 4-5 years back.

His doctor tells him he needs to keep taking Finasteride 5mg every day for the rest of his life or he'll need the operation again when it grows back. So it looks like we're popping pills forever, operation or not.

Posted
1 minute ago, BritManToo said:

Neighbour of mine had the operation (TURP) done at McCormick hospital in Chiang Mai 4-5 years back.

His doctor tells him he needs to keep taking Finasteride 5mg every day for the rest of his life or he'll need the operation again when it grows back. So it looks like we're popping pills forever, operation or not.

Surgeon who did mine (two of them) had audience of at least 25 doctors/surgeons looking on large screen ,as (as they stated) largest one ever operated on,that it was cut back in such a fashion that it will not interfere with me again,but if it does,get it done again

Posted

Now that we are back on the subject of  PROSTATE  i refer all to an excellent post by tracyb in the CM forum  :  /forum.thaivisa.com/topic/1098566-has-anyone-had-laser-prostate-surgery/page/12/#comments

Here different solutions are offered by various members.   

All can of course comment here but by reading that post will gain some insights/ideas

 

I just reiterate my opinion:   do not do any floxins unless absolutely necessary.   I believe there is a big risk involved which I did not fully research because nobody had yet posted some of the info that I later (too late in my case) came upon.  

 

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Posted

Well,  I feel like i have completed my duty to report on my experience with floxins.   I wish all who are suffering a recovery,  and understand what you go through.   Anyone can still PM me if something positive to discuss.   

And for the few that take pleasure (for whatever their reasons) in my temporary setback I would like you

to take the time for a very short lesson on how to properly articulate your feelings:

//www.youtube.com/watch?v=O5tQEMzDlyI

from the mountains to the valleys :   peace and love 

Posted
3 hours ago, oxysong said:

Do not understand why you guys just do not go and get the op  If prostate is enlarged,best thing I ever did,now after a beer or two can have decent nights sleep,after getting up 5/6 times in the night a couple of years ago.  Quite simple and cheap,no need for classy hospitals

Best thing I ever did was take Levofloxacin for 2 months. After years of getting up 2-4 times each night to pee for years, I rarely ever miss any sleep now. I would say that I only get up once or twice in an entire week now. I still take the Alfuzosin every day because if I don't, I find it much more difficult to urinate.

 

I would never have surgery (especially TURP) - what 5-7 days recovery in the hospital with a bag of bloody urine? when I had fantastic results with the Levofloxacin. My PSA also dropped by about 40%! And for a procedure like that you would want the best hospital you could get. Everyone I know who had this procedure said it was uncomfortable/painful as hell and recovery was long and slow. Surgery - no thanks.

Posted

We seem to be mixing up different things. The thread is about a class of drugs known as quinolones: Cipro. levofloxacin, ofloxacin etc.

 

The drugs referred to are often prescribed  for prostatitis

 

They have no application whatsoever in management of BPH or prostate cancer.

 

And prostatitis is not treated by surgery.

 

Aside from prostatitis, this class of drugs (quinlones) are also prescribed in management of other conditions. Some are comparatively minor and likely to resolve without drugs or using alternative drugs; some are serious and do not  respond well  to  other classes of drugs.

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Posted
27 minutes ago, Sheryl said:

We seem to be mixing up different things. The thread is about a class of drugs known as quinolones: Cipro. levofloxacin, ofloxacin etc.

 

The drugs referred to are often prescribed  for prostatitis

 

They have no application whatsoever in management of BPH or prostate cancer.

 

And prostatitis is not treated by surgery.

 

Aside from prostatitis, this class of drugs (quinlones) are also prescribed in management of other conditions. Some are comparatively minor and likely to resolve without drugs or using alternative drugs; some are serious and do not  respond well  to  other classes of drugs.

Understood, Sheryl. In my case I was being treated for years for BPH. Turned out that the root of most of my problems (after my own research) was prostatitis. After the treatment for prostatitis all of the symptoms of BPH have disappeared. Yes my prostate is large and I do have BPH. But now my situation is manageable.

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Posted (edited)

i found this article very informative concerning the surgeries available for enlarged prostate.  had to click and wade through the ads.... but finally read the whole thing.

/www.webmd.com/men/prostate-enlargement-bph/enlarged-prostate-time-prostate-surgery#1

 

India sounds like an option .   trouble is many of us hate going to a hospital even 20 minutes away.   either way, good of oxysong to post his experience.  

Edited by rumak
Posted
3 hours ago, oxysong said:

As this thread dies,all I can say is that I suffered probably more than anyone with enlarged prostate,never mind the pills,life was not worth living with the grief it caused. for a few days of unpleasantness I'm now cured,I can piss for Great Britain if Olympic sport Nice semi private room there,regular visits from doctors (all 17 of them) that are in house surgeons,loads of visits from the nurses,only one tho I would have climbed out of bed for whilst there,all went smoothly.

  Heres an idea ,if going there,go over few days before op,get all your heart,bowel ,stomach ,skin,echo,whatever ,drugs too, test arranged,come to some 100,000 here in Thailand at wrong hospital,over there around 2000baht

Can you remember what anitbiotics they gave after surgery ?   my guess would be levifloxin

Posted
6 hours ago, rumak said:

Can you remember what anitbiotics they gave after surgery ?   my guess would be levifloxin

No they were not the ones,forget the name now,but nothing I could buy from any pharmacy here. Had to go govt,hospital to buy them.

  • 2 weeks later...
Posted

Yes, this thread only touches home with those who have already been affected.  Such is life.  Here is something from website for sufferers ( floxiehope,com)  :

 

  1. I get furious when I hear doctors say this is rare. Dr Charles Bennett (U of So carolina) estimated a couple years ago (and I am guessing these figures are very low) that 300,000 have died and millions more been injured by fluoroquinolones.

    I see it says on your site you are still a registered pharmacist. How do you square this now knowing that so MANY medications do not actually heal, but rather mask symptoms?

    • 49c083f226bad4b3f6f442fd1154c0fd?s=132&d
      wellnesswithsujata October 20, 2017 at 7:00 am Reply

      L, I share in your feelings about this. It is absolutely unbelievable that doctors are still saying this is rare. Knowing that Cipro was released in 1987 and then criteria for fibromyalgia emerged in 1990, it is alarming how many people have probably been misdiagnosed and hence mistreated….as for the numbers you cited being a low estimate….let’s not forget the military soldiers deployed and forced to take these poisons….and then returning with debilitating, “unexplainable” symptoms. You are right – the estimates cited don’t even come close.

      Thank you for asking about my registered pharmacist status. I became a pharmacist 24 years ago. I continue to keep my license because it is part of my credentialing that allows me to consult with patients and offer solutions to these devastating conditions. Without the license, I am not as legally able to do what I do.

      I quit practicing pharmacy in the traditional sense because I simply could not stomach dispensing another poison. Yes, some drugs help save lives. But I fear the majority of them are unnecessary. You are right – they mask symptoms instead of actually heal. The way we approach health and well being in this country is alarming. A pill for every ill is not the way. I could go o for days about this.

      I can assure you I will never dispense another pharmaceutical drug in this lifetime!

  2. 1c6bc709363dff92e82a4bfad6e182d1?s=132&d
    Donna McElvany October 19, 2017 at 12:14 pm Reply
Posted

Thank you, Rumak for the interesting update. People who suffered from all these ailments created by fluroquinolones can relate to this data, but not only. 

I feel loads of sympathy to all sufferers, it could be anyone, it could be me, certainly!

Those that are well versed into nutrition and holistic therapies are more likely to be informed about quinolones and the damages.

This TV forum is very racist and very misogenist, please disregard the trolls. 

I first heard about quinolones in Andreas Moritz website. Later in Dr Mercola site. Then a young cousin of mine got all symptoms after being medicated with Floxies in a tour around Europe.

I found a health alert from Dr Gaby:

 

Posted
7 hours ago, snowballthecat said:

hank you, Rumak for the interesting update. People who suffered from all these ailments created by fluroquinolones can relate to this data, but not only. 

I feel loads of sympathy to all sufferers, it could be anyone,

And thank you for posting as well.  I was most surprised that 3 other members saw the thread and were good enough to share their (bad) experiences with floroquinolones.   The side effects are really hard to believe so I felt I had to tell of my shock of waking up on day 5 with tightness in my legs that made it painful to walk.  Yes, there were the usual dismissals from those that have not been affected..... but I did not want to be quiet about this VERY LARGE problem.  if just one or two people are made aware from my post of the dangers then I have been successful.  EVERY drug has tons of warnings as to side effects, so it is natural to disregard them.   With floxins this can be very life changing !    

I was fortunate to read the information after I got bad side effects and took immediate action with a natural protocol in the form of an ebook.   Anyone can go to the site  floxiehope,com and will find an ad for it.

I am 3 weeks in and now 75% better.   Nutrition and natural remedies are the real force behind healing...

but the trolls, as you say, will always take their shots .  

  • Like 1
Posted
On 6/30/2019 at 4:43 PM, rumak said:

And thank you for posting as well.  I was most surprised that 3 other members saw the thread and were good enough to share their (bad) experiences with floroquinolones.   The side effects are really hard to believe so I felt I had to tell of my shock of waking up on day 5 with tightness in my legs that made it painful to walk.  Yes, there were the usual dismissals from those that have not been affected..... but I did not want to be quiet about this VERY LARGE problem.  if just one or two people are made aware from my post of the dangers then I have been successful.  EVERY drug has tons of warnings as to side effects, so it is natural to disregard them.   With floxins this can be very life changing !    

I was fortunate to read the information after I got bad side effects and took immediate action with a natural protocol in the form of an ebook.   Anyone can go to the site  floxiehope,com and will find an ad for it.

I am 3 weeks in and now 75% better.   Nutrition and natural remedies are the real force behind healing...

but the trolls, as you say, will always take their shots .  

Rumak, very glad you are improving....keep going on the diet that works for you. When you get to know about naturopath and  natural remedies, there is no way back for us. Everything in the just measure, I believe. The "Middle Way" of the Buddha. When an antibiotic is needed, it is needed. 

 

Keeping the mind open, that is the key. 

Posted
1 hour ago, snowballthecat said:

Rumak, very glad you are improving....keep going on the diet that works for you. When you get to know about naturopath and  natural remedies, there is no way back for us. Everything in the just measure, I believe. The "Middle Way" of the Buddha. When an antibiotic is needed, it is needed. 

 

Keeping the mind open, that is the key. 

I agree that sometimes an antibiotic or other pharmaceutical is a blessing.  The curse is that almost everyone takes the easy way out and turns to drugs when a natural way to cure is possible, but takes more effort.   The advantages of strengthening or curing one's body without drugs are many , but the people dedicated to that philosophy few.   Happy to see that you also have "seen the light" .  

Whenever I want to make an exit I just start talking about natural remedies and people quickly lose interest

5555   

  • Haha 1
Posted
On 6/30/2019 at 4:43 PM, rumak said:

I was most surprised that 3 other members saw the thread and were good enough to share their (bad) experiences with floroquinolones. 

I didn't realise this thread was going, although I had posted on another thread about my experience with ciprofloxacin/fluoroquinolones and the experience was not good at all – – torn tendons and much pain and the first time round, many years ago, I thought it was just me because I was a keen sportsman, then not more than about a year ago I was prescribed ciprofloxacin here by a particularly useless urologist and the same thing happened again in my right leg.

 

Looking back I do believe that in almost all of the occasions when I have been given a fluoroquinolone, I have had some muscle/tendon problems in one form or another, and it is certainly a drug I will no longer consider and I have put it on the list of drugs to which I am allergic, at my local hospital.

 

Onto the other subject of a TURP, well I had one 11 years ago in Melbourne and it was to allow me to empty my bladder fully, because I was continually getting UTIs due to retained urine and there were a few setbacks after the operation, but at least I could pee properly again.

 

A couple of years ago even that reduced somewhat and it was determined that I needed an incision on my bladder neck due to previous scar tissue, and I had that done here, and there have been some side-effects (retrograde ejaculation) but I have learned to live with them.

 

One poster mentioned that his doctor told him he would need to be on finasteride forever after a TURP, and that is not usually the case, however it is known that in a few individuals the prostate tissue can grow back again, usually after approx a 10 year period, and I think I'm heading that way again.

 

As Sheryl has said, taking antibiotics for BPH is not going to do any good unless there is an infection present which is causing a problem.

 

If I do get this operation done again rather than go for a full TURP I will investigate where I can get the Rezum procedure (Rezūm is a treatment for BPH that can be performed in a clinic or out-patient setting) carried out, and from what I can see it can be done on the Gold Coast, near where a friend has an apartment, so that would be easy for me to undertake if necessary.

 

So I have options in that regard, but back to the fluoroquinolone argument, although the initial medical literature supplied with this drug indicated that this type of side effect was very rare, there are lawsuits in the USA taking the manufacturers to task because there are many more side-effects and they are/can be dangerous, much more so than was indicated initially by the drug company.

 

Furthermore there are many other drugs out there which can do exactly the same job, with fewer side effects.
 

  • Like 2
Posted
6 minutes ago, xylophone said:

So I have options in that regard, but back to the fluoroquinolone argument, although the initial medical literature supplied with this drug indicated that this type of side effect was very rare, there are lawsuits in the USA taking the manufacturers to task because there are many more side-effects and they are/can be dangerous, much more so than was indicated initially by the drug company.

thank you for posting.  you are now example number 5 on this very small forum that has related your very bad side effects from flouroquinolones.  Those of us that have suffered know full well the dangers !  Maybe too late in our cases , but like i have said I had to post to at least warn others.  You have pointed out how large a problem it really is.... some readers will take heed, others not.    AND btw,  i think most of us affected were very fit, contrary to one comment.   It is a crap shoot.   Now as the industry finally is forced to admit:  use in life threatening cases only

 

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Posted
On 7/2/2019 at 6:46 PM, rumak said:

thank you for posting.  you are now example number 5 on this very small forum that has related your very bad side effects from flouroquinolones.  Those of us that have suffered know full well the dangers !  Maybe too late in our cases , but like i have said I had to post to at least warn others.  You have pointed out how large a problem it really is.... some readers will take heed, others not.    AND btw,  i think most of us affected were very fit, contrary to one comment.   It is a crap shoot.   Now as the industry finally is forced to admit:  use in life threatening cases only

 

 

It does affect healthy, athletic types, for some reason.

it is explained in the video....collagen type and changes. Please keep going with the natural diet, it does work. 

This medicine is a pain,  agree: use only in life- threatening situation. Ask your doctor to find a substitute. I usually say that "I have had bad reactions to this one in the past", but better idea to say one is allergic, thanks @Xylophon!

Better than saying "this medicine has a bad press", it doesn't work. 

 

  • Like 1
Posted (edited)
38 minutes ago, snowballthecat said:

 

It does affect healthy, athletic types, for some reason.

it is explained in the video....collagen type and changes. Please keep going with the natural diet, it does work. 

This medicine is a pain,  agree: use only in life- threatening situation. Ask your doctor to find a substitute. I usually say that "I have had bad reactions to this one in the past", but better idea to say one is allergic, thanks @Xylophon!

Better than saying "this medicine has a bad press", it doesn't work. 

 

I have been frantically searching for an article which I downloaded a while ago, because whilst it was labelled an article on pathogens in the urinary tract and associated areas, it did deal with the UTIs and prostatitis and why they were so hard to eradicate, or more importantly why they kept recurring despite the use of various antibiotics.

 

The key word is "biofilm" and it appears that this is quite common where bacteria are concerned, because colonisation can take place and this biofilm takes the form of a type of shield, through which most antibiotics cannot penetrate, or indeed that some do, but to a minor extent, not being able to fully eradicate the bacteria beneath it, hence the recurring infections.

 

As regards the antibiotics that are most effective in penetrating the shield, read the following..........

 

Macrolides (erythromycin, clarithromycin, and azithromycin) are the first-choice antibiotics having “in vitro” and “in vivo” high antibiofilm activity [62]. Clinicians should attempt to make an accurate diagnosis of UTIs, as this will be crucial in the choice of the appropriate narrow-spectrum antibiotics [63] and thus in the prevention of antibiotic resistance emergence [64].


So it appears that the quinolones, although they may have some effect if there is no such thing as the biofilm, are not considered to be the drug of choice for the likes of prostatitis or recurring UTIs.

 

Another article has suggested that a twin antibiotic approach (along with a biofilm disruptor) should be tried if the pathogen cannot be isolated.

 

Anyway it appears that there are good reasons for not taking any one of the quinolones for prostatitis, and for those interested, because it is very interesting and in-depth study, I will include the full attachment if I can. 

pathogens-05-00065-v2.pdf

Edited by xylophone
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Posted
On 7/2/2019 at 6:46 PM, rumak said:

thank you for posting.  you are now example number 5 on this very small forum that has related your very bad side effects from flouroquinolones.  Those of us that have suffered know full well the dangers !  Maybe too late in our cases , but like i have said I had to post to at least warn others.  You have pointed out how large a problem it really is.... some readers will take heed, others not.    AND btw,  i think most of us affected were very fit, contrary to one comment.   It is a crap shoot.   Now as the industry finally is forced to admit:  use in life threatening cases only

 

More on this............and worrying for me because I have been prescribed quinolones on many occasions, and suffered tendon problems, and have now been diagnosed with an aortic aneurysm, which will need careful watching and could prove fatal if it increases in size.

 

The Antibiotic You Should (Almost) Always Avoid (Medscape)

 

The Many Perils of Quinolones........The US Food and Drug Administration (FDA) has issued a raft of warnings about this drug class over the past decade, making levofloxacin my choice for the drug to not use in this case (cough, chest infection).

 

Tendinopathy. The first of these, issued in July 2008, warned about the risk for tendonitis and tendon rupture. The most common site is the Achilles tendon, though shoulder tendons are also frequently involved. Highest risk is found in patients taking steroids along with a fluoroquinolone as well as in older adults. While this adverse event has been documented in a number of studies, there continue to be lawsuits alleging that affected patients were not informed of this risk.

 

Peripheral neuropathy. In August 2013, a second warning, this time about the risk for peripheral neuropathy, was issued. This serious adverse effect can be permanent, even in patients taking a fluoroquinolone for as few as 4-5 days.

Long term neurologic risk. In July 2016, the FDA issued a more comprehensive alert, warning that fluoroquinolones should not be prescribed if other alternatives are available for patients with:

 

  • Acute sinusitis
  • Cystitis
  • Acute bacterial exacerbations of chronic bronchitis

 

The risks with use of this class of medications outweigh the benefits in patients with these common, relatively mild infections.

 

Hypoglycemia. Another alert was issued in July 2018, this time regarding the risk for hypoglycemia associated with fluoroquinolones. This is particularly a concern when a fluoroquinolone is prescribed for a patient who is on multiple diabetes medicines.

 

Aortic aneurysm. The most recent alert was released in December 2018, warning of a rare but potentially fatal aortic aneurysm rupture. This warning followed a number of studies that documented increased risk for collagen-associated effects. A 2015 population-based longitudinal cohort study involving 1.7 million adults 65 years and older tracked those who received a fluoroquinolone prescription.[1] 

 

Compared with use of amoxicillin, current use of a fluoroquinolone was associated with a hazard ratio (HR) for tendon ruptures of 3.13; HR for aortic aneurysm was 2.72. Two subsequent studies confirmed this higher risk. A cohort study[2] conducted in Sweden investigated outcomes in almost 400,000 treatment episodes with fluoroquinolones and an equal number of episodes of amoxicillin use.

 

 Fluoroquinolone use was associated with an HR of 1.66 for aortic aneurysm or dissection.

 

A case-crossover study in Taiwan of 1200 patients hospitalized for aortic aneurysm and dissection compared risk during the period in which the patient was exposed to a fluoroquinolone versus a period without that exposure.[3]After controlling for multiple confounders as well as duration of time exposed to a fluoroquinolone, the investigators found that use of a fluoroquinolone within 60 days was associated with the highest risk for aneurysm, with risk increasing with longer durations of exposure.

 

Patients taking a fluoroquinolone for more than 14 days experienced a 2.8-fold increase in risk.

 

Posted
1 hour ago, xylophone said:

More on this............and worrying for me because I have been prescribed quinolones on many occasions, and suffered tendon problems, and have now been diagnosed with an aortic aneurysm, which will need careful watching and could prove fatal if it increases in size.

Really sorry to hear that you have this new development.   As the OP i receive notifications if anyone posts, but I think this thread is now pretty well forgotten.  I am just beginning my second month of recovery and doing fairly well,  eating and taking supplements to overcome the tendon issues.  

I get very upset at what I see as a total disregard by most of the medical and pharmaceutical industry to seriously care for the people .   This is a broad statement but I stand by it.  Of course that makes me an easy target for many ....... 

I hope you can overcome your issues.  You, me, and tens of thousands of others must now do the best we

can to take control of our lives and think carefully of who we can trust.   Its a cliche, but keep fighting and don't let the bad days destroy you.   Rumak

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Posted
14 hours ago, rumak said:

Really sorry to hear that you have this new development.   As the OP i receive notifications if anyone posts, but I think this thread is now pretty well forgotten.  I am just beginning my second month of recovery and doing fairly well,  eating and taking supplements to overcome the tendon issues.  

I get very upset at what I see as a total disregard by most of the medical and pharmaceutical industry to seriously care for the people .   This is a broad statement but I stand by it.  Of course that makes me an easy target for many ....... 

I hope you can overcome your issues.  You, me, and tens of thousands of others must now do the best we

can to take control of our lives and think carefully of who we can trust.   Its a cliche, but keep fighting and don't let the bad days destroy you.   Rumak

Agree and now we know about this antibiotic we should refuse to take it as there are others that will do the same job.

 

What I have is a dilated aorta which is of some concern esp if it increases in size, so 6 monthly electrocardiograms are on the cards to plot its course.

 

Of course these can occur through other factors but the main one, plaque/calcium build up in the arteries, is not a factor for me because my calcium score reading is zero!

 

So quinolones could well be a factor, rare but still a consideration. 

 

Everyone should be made aware that this class of drugs is dangerous, so great that you posted on it.

  • Thanks 1
Posted
4 hours ago, xylophone said:

Agree and now we know about this antibiotic we should refuse to take it as there are others that will do the same job....

 

 

I think you meant to say "IF there are others"...

 

Not always the case. Often yes, but always, no.

  • Like 1
Posted
4 hours ago, xylophone said:

Agree and now we know about this antibiotic we should refuse to take it as there are others that will do the same job.

I had no adverse reactions at all to a month of Vocin 500 (levofloxacin).

Back to walking 7Km-10Km/day.

Posted
26 minutes ago, BritManToo said:

I had no adverse reactions at all to a month of Vocin 500 (levofloxacin).

Back to walking 7Km-10Km/day.

But you risked having possible severe consequences........

 

Boxed warnings

In 2016, the U.S. FDA stated that serious side effects generally outweighed the benefits for people with acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections when there are other treatment options.[11] In 2008 the FDA added black box warning on all fluoroquinolones, advising of the increased risk of tendon damage.[12] In 2016 the FDA found that when used systemically (by mouth or injectable) "disabling and potentially permanent serious side effects" can involve the tendons, muscles, joints, nerves, and central nervous system.[11] Concerns regarding low blood sugar and mental health problems were added in 2018.[13]

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