patient that developed Sweet's Syndrome very soon after starting levaquin.

[Guest guest]

This is EMPOWERMENT INFORMATION.....be well informed with any medications.

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A patient that developed Sweet's Syndrome very soon after starting levaquin.

Sweet syndrome is a rare skin disorder characterized by fever,

inflammation of the joints (arthritis), and the sudden onset of a rash.

The rash consists of bluish-red, tender papules that usually occur on

the arms, legs, face or neck, most often on one side of the body

(asymmetric). In approximately 80 percent of cases, Sweet syndrome

occurs by itself for no known reason (idiopathic). In 10 to 20 percent

of cases, the disorder is associated with an underlying malignancy,

usually a hematologic malignancy such as certain types of leukemia. The

exact cause of Sweet syndrome is unknown.

Resources

NIH/National Arthritis and Musculoskeletal and Skin Diseases

Information Clearinghouse

1 AMS Circle

Bethesda, MD 20892-3675

USA

Tel: 3014954484

Fax: 3017186366

Tel: 8772264267

<snip>

" Other Special Senses Disorders

Parosmia, taste perversion

Platelet, Bleeding and Hematoma, epistaxis, prothrombin Clotting Disorders

decreased, pulmonary embolism, purpura, thrombocytopenia ........... "

LEVAQUIN - Side Effects & Drug Interactions

[Levofloxacin]

infarction

Neoplasms

Carcinoma, thrombocythemia

Other Special Senses Disorders

Parosmia, taste perversion

Platelet, Bleeding and Hematoma, epistaxis, prothrombin Clotting Disorders

decreased, pulmonary embolism, purpura, thrombocytopenia

Psychiatric Disorders

Abnormal dreaming, agitation, anorexia, confusion, depression, hallucination,

impotence, nervousness, paroniria, sleep disorder, somnolence

Red Blood Cell Disorders

Anemia

Reproductive Disorders

Dysmenorrhea, leukorrhea

Resistance Mechanism Disorders

Abscess, bacterial infection, fungal infection, herpes simplex, moniliasis,

otitis media, sepsis, viral infection

Respiratory System Disorders

_______________________________

Reactions to Cipro, Levaquin, and Other Fluoroquinolone Antibiotics

Since the December, 2001, publication of my article in the ls of

Pharmacotherapy,1 I've received hundreds of e-mails from people suffering

from

devastating, long-lasting side effects associated with Cipro, Levaquin,

Floxin,

and other fluoroquinolone antibiotics. Most of these people are young and had

been healthy and active.

These antibiotics have legitimate uses in treating infectious diseases,

but they are overused for minor conditions such as sinusitis, prostatitis,

and

bladder infections. My stance is that Cipro, Levaquin, and similar

antibiotics should be used only when other, safer drugs are ineffective, or

for

organisms that are only sensitive to fluoroquinolones.

As I said on National Public Radio in October 2001, I strongly believe

that all people placed on these antibiotics should be warned about infrequent

yet serious reactions that may cause joint, muscle, or tendon pain or

rupture,

nerve pain (burning, electrical sensations, tingling), muscle weakness,

thinking or memory problems, heart palpitations, rapid heart rate, gastric

problems,

skin rash, or many other unusual physical or psychological symptoms. These

reactions can occur quickly and suddenly, and patients should alert their

doctors immediately.

Doctors, for their part, must recognize that these symptoms can lead to

severe, long-term pain or dysfunction, and should stop the antibiotics

immediately if at all possible. Because adverse reactions may increase in

severity

and duration with each exposure, patients with these reactions should not

receive fluoroquinolones again. I'd hoped that my article would accomplish

this,

just as it prompted the U.S. Centers for Disease Control to alter their

guidelines for treating anthrax. But it hasn't had the same impact on the

medical

system.

" These adverse reactions can occur quickly and severely.

Doctors must be better informed. "

Most people do fine with these antibiotics. For those who don't, the

effects can often be minimized with proper warning and prompt response.

Unfortunately, few patients were given any warnings. Again, their rights of

informed

consent are violated.

On the hopeful side, I have spoken to the FDA about this issue. They are

taking a very serious look at the problem. But although the FDA has already

received thousands of reports, action is slow. And even if the FDA requires

new

warnings in package inserts and the PDR, most doctors will never notice them,

and because of the unrelenting influence of the drug industry, most doctors

will continue to overprescribe these drugs when other, safer, cheaper drugs

would do.

So you'd better be informed. Preventing fluoroquinolone reactions is

much, much better than trying to treat them, because there is no known,

specific

treatment. Below is the information that I have sent to people seeking help.

I

don't know if any of these suggestions is highly effective, but having

experienced a severe, long-term disability myself in the mid-1990s and now

having

improved considerably, I encourage people to keep asking questions and trying

things. You can also connect with others enduring similar experiences with

fluoroquinolones at the following websites: ***

INFORMATION FOR PEOPLE WITH FLUOROQUINOLONE-RELATED REACTIONS

I have sent this information to hundreds of people who have contacted me

about their reactions following the publication of my paper. I wrote the

paper so that people having these types of problems might get accurately

diagnosed, because most physicians have no idea how severe some of these

fluoroquinolone-related reactions can be.

First, I should explain I am not an expert on Cipro, Levaquin, or other

fluoroquinolone antibiotics. I am a researcher (I do not see patients), and

my

major area of expertise is medication reactions, which you can read about in

my medical journal articles and my recent book, Over Dose: The Case Against

The Drug Companies (Tarcher/Putnam, info & reviews at amazon.com). I wrote

the

article about fluoroquinolones because of the reports I received and because

no

one was paying attention to this serious problem. My knowledge about

fluoroquinolones in particular and antibiotics in general is limited to what

is

contained in the article. I have not conducted any new research on

fluoroquinolones

since writing my article in the ls of Pharmacotherapy in December, 2001,

so you need to check the medical literature and others sources for updated

information.

Regrettably, there are few doctors who are informed about

fluoroquinolone-related reactions. You might find information about

knowledgeable doctors at

some of the fluoroquinolone websites, where people have posted a lot of

useful information.

As far as I know, there are no specific treatments for the nerve or

tendon/joint/muscle problems associated with Cipro, Floxin, and Levaquin, and

other fluoroquinolones. Most of my information is hypothetical or anecdotal;

some

of these recommendations may help some people, but not others.

Medications such as amitriptyline or other tricyclics, or Neurontin

(gabapentin), may be helpful for neuropathic pain (tingling, burning or

electrical

sensations) or nerve pain. Muscle spasms, twitching, tremors, and seizures

may be helped with long-acting benzodiazepines such as clonazepam (Klonopin)

or

diazepam (Valium). SSRI antidepressants (Zoloft, Paxil, Effexor, Prozac,

etc.)

are occasionally helpful for depression. Because patients' nervous system are

sometimes very sensitive, these drugs should be started at very low doses and

increased, if necessary, very gradually.

Magnesium (chelated) in doses of 400-1000 mg/day may be useful for

reducing neuropathic pain or muscle spasms in some people. Doses over the

U.S.

recommended daily amount of 320 for women and 400 for men should always be

taken with a doctor's supervision. Seniors, people with kidney disorders, and

those

taking medications for heart, hypertension, or other vascular or neurological

disorders should have medical supervision even for RDA doses of magnesium.

Interestingly, another doctor has also been recommending magnesium, as

low doses of milk of magnesia (1 or 2 teaspoons twice-daily), to be taken for

several months. The theory is that because of the affinity of minerals for

these antibiotics, this might help leech some of the remaining

fluoroquinolone

molecules from the tissues. Some patients have benefited, but not all. In

discussion with this doctor, our sense is that calcium, magnesium, and

perhaps other minerals may be beneficial. With magnesium, better absorption is

important to

get the magnesium into the tissues, so chelated magnesium or a magnesium

solution might work best. As with all of these recommendations, there's

little

solid science, so it's trial and error. (For more information on magnesium,

please

go to the other magnesium sections of this website.)

B-vitamins have been reported to reduce tingling. One person wrote to me

that high doses of lecithin have helped with memory problems. GABA, an amino

acid, has some similar qualities to Valium and Klonopin and may be helpful

for

anxiety, nervousness, or insomnia.

Anti-inflammatory drugs are controversial: some people have written to

me that they have helped, especially for muscle/joint/tendon pain; others

have

written that they have worsened their conditions. If you have benefited from

anti-inflammatory drugs, you might obtain additional benefit from high doses

of

omega-3 oils (fish oils; EPA/DHA). There is considerable literature on this.

Omega-3 oils take time to work, but the ultimate result can be better than

standard anti-inflammatory drugs (NSAIDs).

Many alternative doctors are knowledgeable about magnesium, GABA,

omega-3 oils and, perhaps, about other possibilities.

Corticosteroids (cortisone, etc.) are very controversial. Doctors

sometimes prescribe steroids in the hope of reducing the reactions, but many

people

have written that steroids actually made their cases worse. Steroids should

be

used with great caution unless there is a specific indication.

Fluoroquinolone-linked reactions can be nasty, and recovery varies from

individual to individual, with some reactions resolving quickly and others

lasting years. That's why I do not advocate using fluoroquinolones as the

first

antibiotics for treating minor infections. If we are ever to change the

medical-pharmaceutical mindset about this, it will be accomplished by

patients. So

please submit a Medwatch report. It's easy to do at:

www.fda.gov/medwatch/report/consumer/consumer.htm. Or call 800-FDA-1088).

I regret that I cannot give you a more specific, well-proven remedy for

these reactions. It is tragic -- and very frustrating -- that the

medical-pharmaceutical system frequently fails to recognize these problems

and, therefore, doesn't warn patients or doctors. So doctors not only fail to

recognize the

reactions, but continue to prescribe fluoroquinolones to people who've

already

shown signs of toxicity previously. It's a terrible situation, but not unlike

I've seen and written about with other drugs.

I hope that your condition resolves soon. Sincerely, Jay S. Cohen, M.D.

1. Cohen, JS. Peripheral Neuropathy with Fluoroquinolone Antibiotics. ls

of Pharmacotherapy, Dec. 2001;35(12):1540-47.

Copyright 2003, Jay S. Cohen, M.D. Readers have my permission to copy and

disseminate all or part of this newsletter if it is clearly identified as the

work of: Jay S. Cohen, M.D., The Free MedicationSense Underground

E-Newsletter,

July-August 2003, www.MedicationSense.com.

***Websites for Fluoroquinolone-Related Reactions

Quinolone Antibiotics Adverse Reaction Forum:

http://www.geocities.com/quinolones/

Discussion Group Website of the Quinolone Forum: Case Reports, Updated

Reports, Information, Support, and More

quinolones/messages/?threaded=1

DrugVictims.Org: Information, Articles, Studies, Personal Reports of

Reactions to Quinolones

http://www.drugvictims.org/

RxList Website: Levaquin Case Reports

http://www.rxlist.com/rxboard/levaquin.pl

Medications.com: Levaquin Case Reports

http://medications.com/index.php?act=se & drug=Levaquin