Fluoroquinolone antibiotics

This information has been written by members of the antimicrobial team. If you have any concerns or questions after reading it please speak to your doctor or pharmacist who will be happy to answer any questions.

Remember that serious complications are rare and that there are many benefits of receiving this medication.

What are Fluoroquinolones?

Fluoroquinolones belong to a family of antibiotics that are used to treat or prevent bacterial infections. These antibiotics are of great value in treating severe infections where other antibiotics are not suitable. They should be used for the shortest effective time to treat your infection.   

What are the side effects?

In a small number of patients, fluoroquinolones can cause serious side effects which are listed below.

Joint & Movement Disorders may include tendon pain or weakness (especially in the shoulder, ankle or legs), swelling, burning, tingling, numbness or weakness of the tendons.

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

Who is at most risk?

  • If you are aged over 60 years, your kidneys do not work well or if you have received organ transplantation
  • If you are taking oral steroid medications (e.g. hydrocortisone or prednisolone)

If you experience any of the above symptoms, stop your medication, rest the painful area and inform your doctor immediately.

Other side effects

  • Mood changes can also occur, as well as changes in memory or sleep.
  • Gastro-intestinal symptoms can include diarrhoea (if this becomes persistent or there is presence of blood or mucus)
  • 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 and symptoms can include chest pain, difficulty breathing, deep stomach pain,  pulsating or discomfort, or changes to the voice.

If these symptoms occur, continue to take your medication and seek further advice from your doctor or pharmacist.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, or think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

It is preferable to avoid the use of fluoroquinolones in pregnancy.

Fluoroquinolones are excreted into the breast milk and therefore should be avoided where possible whilst breast feeding. 

Food interactions 

Dairy products, such as milk or yoghurt, or drinks with added calcium may reduce the absorption of fluoroquinolones. Do not take these at the same time.

Drug interactions

Due to the increased risk of side effects, please discuss with your doctor / pharmacist before starting fluoroquinolones if you are taking any of the following;

  • Warfarin
  • Phenytoin
  • Probenecid
  • Theophylline
  • Ropinirole
  • Methotrexate
  • Tizanidine
  • Clozapine
  • Pentoxifylline

Avoid taking the following at the same time of the day as the following medicines:

  • Antacids
  • Mineral supplements
  • Sucralfate
  • Polymeric phosphate binder (e.g. Sevelemer)
  • Medicines containing calcium, aluminium, magnesium or iron

Driving and machinery 

If you experience reduced alertness, do not drive a vehicle or operate machinery. If in doubt, ask your doctor.

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