Question: My doctor recently prescribed Cipro for an infection. A friend told me that it's bad for your tendons. How can a medicine hurt tendons?

Dr. Hibberd's Answer:

Your friend is quite correct. I have been prescribing Cipro and related agents for many years and have yet to see a single case of tendon rupture or damage (yet!).

This family of antibiotics (quinolones) is very potent. The drug levels in tissues are many times the levels found in the bloodstream.

The animal studies published have demonstrated the potential for significant weight-bearing joint and soft tissue injury in juvenile animals. The mechanism of tendon injury is unknown, however, reports of spontaneous shoulder, hand, and Achilles tendon rupture and tendonitis have been well documented to occur both during and after therapy. The risks of tendon injury appear more pronounced in the elderly and those on corticosteroid therapy.

Generally these agents are not intended for use in children and used with caution in those under the age of 18. These agents have extended warnings and precautions that should be heeded by professionals using them. They should generally not be used as first line agents.