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Dr. Peter Gott - Can drug cause tendons to rupture?

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DEAR DR. GOTT: I recently heard a statement on television made by an attorney with regard to Levaquin, causing tendon rupture and asking anyone who suffered with the problem to call a toll-free telephone number. What on earth is this all about? Has an enterprising law office simply devised another get-rich-quick scheme? Or is there validity to the issue? I've had family members prescribed this drug by their physicians but haven't heard of any associated problems.

DEAR READER: Levaquin is a synthetic, broad-spectrum antibiotic used to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. The drug is prescribed to people 18 years of age and older for infections such as acute bacterial sinusitis, chronic bronchitis, some urinary-tract infections and more. Because the safety and efficacy in young children, adolescents under 18, and pregnant and nursing women has not been established, the drug is not recommended for those people.

Now, on to your question. It would be my guess that an attorney is attempting to help people who have experienced adverse effects from the drug. I quite doubt he is acting on behalf of the pharmaceutical companies involved with the manufacture of fluoroquinolone, the class of drugs that Levaquin and others inhabit.

From 2001 to 2004, the Food and Drug Administration (FDA) included warning information on the packaging of Levaquin, Cipro, Avelox, Noroxin and Floxin and updated the information in 2008. Now, according to CNN, the FDA has ordered the manufacturers of these drugs to add a black-box warning for consumers that the drugs can cause possible tendon ruptures and tendonitis. The companies involved with the manufacture will be required to submit label safety changes within 30 days of receipt of the request. If the order is not complied with, each must submit the reasons why it did not believe such changes are necessary. Tendon rupture and tendonitis occur in about one in 100,000 people. Fluoroquinolones increase that risk by up to four times, according to the FDA. Of note is the elevation of risk in people over 60, those on concomitant steroid therapy and those with kidney, heart and lung transplants.

Bayer holds the licenses for Cipro and Avelox and has agreed to make the changes as outlined by the FDA; however, Bayer has gone on record as indicating both drugs are effective and well tolerated. Ortho-McNeil-Janssen, marketer of Levaquin in the United States, and Merck, the manufacturer of Noroxin, have both agreed to abide by the request. Oscient, the manufacturer of Floxin, did not respond to news requests for comment.

I sound like a broken record when I indicate all medications can carry side effects, no matter how slim. Speak with your physician if he or she places you on one of the drugs mentioned.

DEAR DR. GOTT: Two years ago, my doctor and a gastroenterologist diagnosed me with acid reflux. I was given a prescription for it but soon stopped taking it because I decided to try apple-cider vinegar. I took 1 tablespoon per day, and it seemed to work for a while, but I stopped taking it.

Six months ago, I started craving mustard and noticed that if I ate it before 10 a.m., I wouldn't have reflux that day. My friends think it's all in my head. Is this crazy or what?

DEAR READER: Acid reflux is a common condition marked by heartburn and increased stomach acidity. If your favorable experience with mustard continues, I would have to assume that the reaction has something to do with its abilities to neutralize the excess acid in your stomach. In fact, one of the primary ingredients in most types of mustard is some variety of vinegar.

I don't believe the mustard's positive effect on your reflux is in your head; I think it is in your stomach. Frankly, it does sound a little crazy, but I can't argue with your success.