Antibiotics can cause muscle tears!
by David T. Ryan, DC

Medical Director of the Arnold Fitness Weekend and the IPA Nationals. 
He is in private practice in Columbus, Ohio
On the web at www.GotSportsDoctor.com 

Taking that antibiotic can cause your muscles to tear! If you get anything 
out of this article, realize that taking certain antibiotics has resulted in 
muscle and tendon tears. 

The most common side effects associated with Quinolones are sezures and 
dizziness.

It is very important to realize that if you are a young male athlete then you 
are the primary risk. But this is reaching the late bloomers too. A friend 
of mine Gus Shihab, Esq., a local hobbiest powerlifter in the Columbus, Ohio 
area, is 40 and he just got a torn pec, while warming up with only 135 on the 
bench press. This occurred four months after taking Cipro. My guess is that 
it effects anyone at any age and if you are active in your 40's or 50's or 
whatever, it will come after you. 

CIPRO IS A QUINOLONES (fluoroquinolones) [floor-o-qwin-o-loans] Several Quinolones exist and here is a short list of possible drug names. Norofin®, Norxacin®, Orixacin®, Oroflox®, Urinox®, Zoroxin®), 
enoxacin(Penetrex®), lomefloxacin(Maxaquin®), grepafloxacin(Raxar®), 
trovafloxacin(Trovan®), sparfloxacin(Zagam®), temafloxacin(Omniflox®), 
moxifloxacin(Avelox®), gatifloxacin(Tequin®), gemifloxacin, 
ofloxacin(Floxin®), levofloxacin(Levaquin®, Tavanic®), ciprofloxacin(Cipro®, 
Baycip®, Cetraxal®, Ciflox®, Cifran®, Ciplox®, Cyprobay®, Quintor®), 
norfloxacin(Noroxin®, Amicrobin®, Anquin®, Baccidal®, Barazan®, Biofloxin®, 
Floxenor®, Fulgram®, Janacin®, Lexinor®, 
HOW THE QUINOLONES CAUSE TENDON TEARS
Some scientist feel that the normal mechanism of sulfur bonds between 
collagen cells causes the weakness and leads to eventual problems. Now just 
for the record, the jury is still out on what actually is going wrong and is 
still anybodies guess. The most logical situation is that since the cystein 
(sulfur) bonds are being broke apart in the bacteria, this is spilling over 
to the human cells and specifically collagen sulfur bonds. I'll let you know 
if I find out.

WHAT CAN YOU DO TO HELP PREVENT TENDON AND MUSCLE DAMAGE
The first is obvious, discuss with your physician other drug options. 
Discuss staying on the medications for a short period of time, however, 
always finish all prescribed medications. Don't take the medication with 
vitamins or minerals or milk or anti-acids. Refer to Table 1

Table 1: Tips on making Ciprofloxacin safer
Take ciprofloxacin at evenly spaced intervals
Do not take antacids that contain calcium, magnesium or aluminum (e.g., Tums 
or Rolaids); the ulcer medicine sucralfate (Carafate); or vitamin or mineral 
supplements that contain calcium, iron or zinc for a minimum of 6 hours 
before or 2 hours after a dose of ciprofloxacin. Taking antacids, sucralfate, 
or vitamin or mineral supplements too close to a dose of ciprofloxacin can 
greatly decrease the effects of the antibiotic.

Avoid excessive consumption of products that contain caffeine. Ciprofloxacin 
may increase the effects of caffeine.

Drugs are quite complicated and work on a very deep level within the cells 
now. Testing can't isolate all the problems, this is a serious one that got 
thru. If you take any antibiotic, take around five grams a day of 
glucosamine sulfate and chondrotin sulfate to counter the effects.


Suggested Reading

Tendinitis associated with ciprofloxacin.
Carrasco JM, Garcia B, Andujar C, Garrote F, de Juana P, Bermejo T. Ann 
Pharmacother 1997 Jan;31(1):120

More on fluoroquinolone antibiotics and tendon rupture.
N Engl J Med 1995 Jan 19;332(3):193

What is the risk of Achilles tendon rupture with ciprofloxacin? Shinohara YT, Tasker SA, Wallace MR, Couch KE, Olson PE. J Rheumatol 1997 
Jan;24(1):238-9

Ciprofloxacin in children: is arthropathy a limitation?
Singh UK, et al. Indian J Pediatr 2000 May;67(5):386-7

Toxicity of quinolones.
Stahlmann R, Lode H. Drugs 1999;58 Suppl 2:37-42

Adverse reactions to fluoroquinolones. an overview on mechanistic aspects. De Sarro A, De Sarro G. Curr Med Chem 2001 Mar;8(4):371-84

Clinical toxicological aspects of fluoroquinolones.
Stahlmann R. Toxicol Lett 2002 Feb 28;127(1-3):269-77