Black-Box Avelox Warnings: Use of drugs in the fluoroquinalone class including Avelox may be associated with an increased risk of tendinitis and tendon rupture in patients of all ages, but the risk in patients over age 60 is increased further than in younger patients, as well as in patients taking corticosteroids or who have organ transplants like kidney, heart or lung transplants. Avelox is also known to cause exacerbations of muscle weakness in patients with myasthenia gravis, and should be avoided in patients with this diagnosis.
Common Avelox Side Effects: Few Avelox side effects are considered common and the brief list includes nausea, dizziness and diarrhea.
Serious Avelox Side Effects: Unfortunately although the list of common Avelox side effects is short, the list or potential serious Avelox side effects is unusually long. In addition to the tendon rupture issues listed in the Black Box Warning section above, serious Avelox side effects include potentially life threatening cardiac rhythm disturbances of prolonged QT and torsades de pointes. Allergic Avelox side effects can include anaphylaxis, photo toxicity, and hypersensitivity reactions. Neuropsychologic Avelox side effects may include an increase in intracranial pressure, seizures, toxic psychosis, depression, suicidal ideation and peripheral neuropathy. Dermatologic Avelox side effects can present as severe skin reactions. Like most of the drugs in its class Avelox is a common cause of pseudomembranous colitis. Serious hematologic Avelox side effects include various blood dyscrasias and myelosupression. Super infection with resistant bacteria or fungi like yeast can be a serious Avelox side effect. Nephrotoxicity, potentially fatal hepatotoxicity, serum sickness, and possibly arthropathy are also listed as possible serious Avelox side effects. See the manufacturer’s prescriber guidelines for a complete list of possible Avelox side effects.
Cautions and Drug Interactions: Caution with Avelox use is advised with age over 60 years, prolonged QT syndrome, hypokalemia, organ transplant, seizure disorder or other significant central nervous system disorders, dehydration, advanced kidney or liver disease, or any conditions that may be considered to increase the chances of a cardiac arrhythmia. Avelox use is considered contraindicated with Class 1A and Class 3 anti-arrhythmic medications, with the phenothiazines, with cisapride (no longer available in the U.S.), and with dronedarone, primozide, and ziprasidone. The list of medications where caution is advised is extensive and readers should refer to the manufacturer’s prescriber guidelines or consult their pharmacist if they are taking other medications. The list includes but is not limited to these relatively commonly used drugs: other fluoroquinalones like ciprofloxacin and levofloxacin, haloperidol, methadone, and clarithromycin. The list of drugs where dose modification or other precautions is advised is even longer but includes many diuretics, many cardiac medications that can alter cardiac conduction, and most notably the anticoagulant warfarin.
Pregnancy and Lactation: Avelox is considered pregnancy category C, and its safety in pregnancy is unknown.
Unusual Avelox Side Effects: Tendinitis and tendon rupture is likely the most unusual Avelox side effect. Tendinitis is common enough that most physicians have seen patients with this Avelox side effect, but tendon rupture is considerably less common though devastating if it occurs.
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