Cipro, Levaquin and Avelox Side Effects and FDA Warnings
Cipro, Levaquin and Avelox are fluoroquinolone antibiotics that can cause tendon injuries, nerve damage, mental health issues and other disabling side effects. Market withdrawals and FDA warnings highlight the risks of these widely used drugs.
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- Last update: September 12, 2025
- Est. Read Time: 2 min read
What Are Fluoroquinolones?
Fluoroquinolones are a class of antibiotics used to treat or prevent bacterial infections, such as pneumonia and complicated urinary tract infections (UTIs). Cipro, Levaquin and Avelox are three of the most common types of fluoroquinolone antibiotics.
Serious Side Effects of Fluoroquinolones
All fluoroquinolones can cause serious and, in some cases, life-threatening side effects. As a result, the U.S. Food and Drug Administration (FDA) has recommended that health care providers prescribe alternative antibiotics whenever possible.
- Tendinitis and tendon rupture
- Nerve damage, which may be permanent
- Central nervous system complications
- Worsening of myasthenia gravis, a chronic autoimmune condition
- Mental health issues, such as depression or suicidal thoughts
Cipro (Ciprofloxacin) Side Effects
Tendon rupture and nerve damage are frequently reported side effects among Cipro users. Despite this, Cipro is still widely prescribed, leading to ongoing risks. Some patients have permanent disabilities from Cipro.
Levaquin (Levofloxacin) Side Effects
Levaquin can also cause tendon rupture and nerve damage. After the discovery of potentially severe mental health side effects, Janssen Pharmaceuticals — a subsidiary of Johnson & Johnson — discontinued its Levaquin production in December 2017.
Avelox (Moxifloxacin) Side Effects
Avelox can lead to serious side effects, such as tendon problems, nerve damage and nervous system issues. Due to the FDA’s safety warnings about these potentially permanent complications, prescriptions for Avelox decreased by 17.7% from 2015 to 2019.
FDA Warnings and Label Changes
Throughout the years, there have been a number of FDA warnings and required label changes to address the serious risks of fluoroquinolones.
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2008:
The FDA added a black box warning — its most serious type of alert — for fluoroquinolones regarding their increased risk of tendon ruptures and tendinitis.
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2013:
The FDA issued a drug safety alert for nerve damage, such as peripheral neuropathy, that can occur at any time after someone starts taking a fluoroquinolone.
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2016:
The FDA advised health care providers to avoid prescribing fluoroquinolone drugs for people who suffer from bronchitis, sinusitis and other uncomplicated infections.
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2018:
The FDA announced that fluoroquinolone use can increase the risk of heart problems like aortic aneurysms. In addition, the FDA strengthened warnings about mental health risks.
Levaquin Market Withdrawal
In December 2017, Janssen Pharmaceuticals discontinued production of both the oral and IV versions of Levaquin. While stopping short of a recall, Janssen withdrew the drug amid mounting concerns and the wide availability of alternative treatment options.
Why Some Patients Filed Lawsuits
A number of patients allege that companies failed to warn them about tendon ruptures, nerve damage and other serious and potentially permanent side effects of fluoroquinolones. As a result, attorneys have filed numerous fluoroquinolone lawsuits.
The U.S. Judicial Panel on Multidistrict Litigation consolidated many of these lawsuits into multidistrict litigation (MDL) in a Minnesota federal court. An MDL groups similar cases together to expedite the legal system. While the MDL is still technically active, most of the cases have been settled, and drugmakers have urged the court to terminate the MDL.
Should You Stop Taking Cipro, Levaquin or Avelox?
The FDA recommends fluoroquinolones only when no safer alternatives exist. For example, doctors still often prescribe them for complex conditions like pneumonia and bone infections.
If your doctor prescribed these antibiotics for you, do not discontinue use without medical advice from a qualified provider. Also, if you’re experiencing any side effects, contact your health care provider immediately.
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