I know this has come up before where I believe you ,PMRpro , warned about the use of these antibiotics whilst still on pred. If I remember correctly I remember you saying that taking these antibiotics could increase the risk of Achilles tendinitis and tendon rupture
My sister in law has been prescribed ciprofloxacin for a very difficult UTI that has been going on for sometime. Although cultures have been taken and other antibiotics prescribed nothing appears to be working and she has been prescribed a hefty dose of this antibiotic at 750 mg twice a day. Up to this point she has been on sepsis alert at her local hospital. She is at present on 10 mg of pred , she is also receiving infusions for RA and is recovering from breast cancer.
I did want to encourage her to look into this but checking the NICE website for interactions nothing is mentioned at all and I feel I have very little firm evidence to present to her without her feeling that she has been worried by me unnecessarily.
I felt too that perhaps this subject should be raised again just in case others will be prescribed this while they were on pred and might experience problems.
Written by
Jackoh
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It comes with a risk of tendinitis all on its own without interactions. See this from NICE. I was crippled for 18 months after having repeated 10 day courses over 6 months during chemo. My sister got the same after only 3 weeks. Pred can weaken tendons so it is a double whammy. The link below shows caution in their use generally and corticosteroids in the interactions list.
I can only quote our family experience - I developed achilles tendinitis when I was given cipro while on methyl pred (which increases the risk) and was on crutches for months. I had realised I had soreness so went immediately to the GP and she sent me to the ED - got a boot and crutches and a stern warning of the risk of rupturing the achilles tendon bu a simple trip or stumble. Some years later, OH was given cipro and within 2 days had signs of achilles tendinitis and he wasn't on steroids at all. It is a risk with quinolones and also with steroids, both together it is higher.
These days a ruptured achilles tendon is less of a problem as there is a complex surgery to repair it - but it is a bit of a performance. jinasc on the forum spent a long time in a wheelchair after hers in the procedure's early days in the UK.
I think it has to be the "watch out for ANY pain at the back of your ankle" approach. She may well escape but it is something to bear in mind in the future as it is the history that is also important. But as soon as there is any ankle pain she needs to take great care and a protective boot is very helpful. When it is inflamed it is very delicate and can easily snap so prevention is key.
hi Jackoh, I had two shoulder surgeries within 8 weeks of each other (Sep. to November 22). I had an infection after the first surgery and was prescribed Ciprofloxacin 750mg x2. Within a week of taking it I had pain and swelling of my right Achilles tendon. My consultant changed my prescription and put me on Flucloxicillin (500mg x4 daily). My ankle continued to be painful but improved as soon as I stopped the Ciprofloxacin. After the second surgery I had healing issues and was again prescribed Ciprofloxacin and Flucloxicillin (1000 mg x 4 daily). I was reluctant to take the Ciprofloxacin but did as I was told. Again after only 3 days my Achilles tendon was swollen and painful and this time I also had pain and swelling in my right wrist. I stopped the Ciprofloxacin and things started improving. For me there was a definite link between Ciprofloxacin and Achilles tendon problems. I hope you soon find something that helps 🌸
Cipro has been linked to more than just an Achilles tendon problem - and given the other problems you SIL has, she might (wisely, I believe) want to avoid it. Oddly enough, I've heard about other women having problems recently with intractable UTIs - without any apparent satisfaction from the usual courses of drugs. Best of luck with talking to her - or her doctor?
Thank you for this ShadyLady. I did know that it had a black box warning in USA but her own personal experiences detailed in this article were so devastating.
It is a very unpleasant antibiotic and there have been repeated instructions issued it should only be used when all else has failed, And NOT be used for banal UTIs.
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