The Next Time Will be Worse: Cross-Reactivity of Fluoroquinolones

On every single warning label for each fluoroquinolone it says that if a person has experienced an adverse reaction to a quinolone, they should not be exposed to quinolones again.

The Cipro/ciprofloxacin warning label says:

“Ciprofloxacin is contraindicated in persons with a history of hypersensitivity to ciprofloxacin, any member of the quinolone class of antimicrobial agents, or any of the product components.”

The Avelox/moxifloxacin warning label says:

“Contraindications: Known hypersensitivity to AVELOX or other quinolones.”

The Ciprodex ear drop warning label says:

“CIPRODEX® Otic is contraindicated in patients with a history of hypersensitivity to ciprofloxacin, to other quinolones, or to any of the components in this medication.”

Yet these warnings are disregarded regularly. I often hear from people who tell their doctor that they are allergic to Levaquin, and their doctor prescribes them Cipro. Or they tell their doctor that they are allergic to Cipro, but are still prescribed ofloxacin eye drops. There seems to be a lack of understanding of the cross-reactivity or one quinolone with all other quinolones.

The lack of knowledge and understanding is not because of lack of documentation. In an article in Current Pharmaceutical Design entitled “An Update on the Diagnosis of Allergic and Non-Allergic Drug Hypersensitivity,” it is noted that, “cross-reactivity among quinolones at both the IgE- and T-cell level is clinically well documented. Therefore, patients with hypersensitivity reactions to any quinolone should not be re-exposed to any antimicrobial agents of that class.”

Additionally, in The European Journal of Allergy and Clinical Immunology’s article, “Cross-reactivity between quinolones,” it is noted that, “We conclude that cross-reactivity between quinolone seems to be very important, and avoidance of any quinolone should be recommended to any patients who has suffered an allergic reaction to one of these drugs.”

When I told my doctors at Kaiser Permanente that I wanted fluoroquinolones to be put in my chart as a drug allergy, they couldn’t do it, because “fluoroquinolones” are a class of drugs, and they could only enter individual drugs into their system. In order to get all fluoroquinolones in my chart, I had to list every fluoroquinolone separately, because if I just said that I was allergic to Cipro, they would still give me Levaquin, or Avelox or Floxin. That’s a bit ridiculous seeing as it says ON THE WARNING LABEL that if someone has a history of hyper-sensitivity to one quinolone, they should avoid exposure to other quinolones. I’m sure that it’s easier said than done, but couldn’t there be some sort of cross-population of information that takes the “clinically well documented” cross-reactivity of quinolones into consideration? If someone has experienced a severe adverse reaction to Floxin, they shouldn’t take Levaquin—it’s not that difficult a concept. But systems are not currently in place to recognize, much less track or prevent, cross-reactivity or contraindications between drugs.


If a person experiences a severe adverse reaction to a fluoroquinolone and they feel as if a bomb has gone off in their body and mind, they know that they have had an adverse reaction to a quinolone. Going through one severe adverse reaction to a quinolone is enough for most people, and they are likely to realize that they should never take a quinolone again. However, there are many people who experience mild-to-moderate adverse reactions to quinolones who don’t realize that they have had an adverse reaction in the past.

For the people reading this who may have taken a fluoroquinolone in the past but haven’t had a severe adverse reaction, I encourage you to think about your health history. After taking Cipro/ciprofloxacin, Levaquin/levofloxacin, Avelox/moxifloxacin, or Floxin/ofloxacin, did you experience any of the following?

Loss of endurance
Muscle twitches
Tendon tears or ruptures
GI issues
Mild peripheral neuropathy

Those are all Warning Signs of fluoroquinolone toxicity. After the first time I took ciprofloxacin I had a twitchy eyelid and intermittent stomach cramping. I wish I had known that those symptoms were adverse reactions to the ciprofloxacin, and that I had known that I could no longer tolerate it. If I had known that I had experienced an adverse reaction to ciprofloxacin in the past, and if I had known that the warning labels say that people who have had a bad reaction shouldn’t take the drug again, I wouldn’t have taken it again and I would have avoided full-blown fluoroquinolone toxicity. There are a million “if only” scenarios around my adverse reaction to ciprofloxacin. I can’t turn back time and change anything though. I can only move forward and warn people. I hope that people heed my warning, and connect bizarre, seemingly innocuous symptoms like anxiety and sprained elbows, to the fluoroquinolone they took to treat an infection, and that they avoid future use of fluoroquinolones.


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42 thoughts on “The Next Time Will be Worse: Cross-Reactivity of Fluoroquinolones

  1. Debs September 22, 2015 at 9:27 am Reply

    Better than trying to remember many years back in time although that of course is a very useful in itself is keeping in mind that the symptoms can arise from just one dose, & the fact that when FQ antibiotics are prescribed, sometimes maybe a dose or two might be given & then the antibiotic is changed without even notifying the patient. I would strongly advise to also apply for copies of complete medical records including drug history. GP notes, & particularly hospital inpatient notes for example can be very revealing indeed , especially when it comes to recognising milder symptoms of FQ poisoning .

  2. Linda Livingston September 22, 2015 at 9:47 am Reply

    Yet another reason to NEVER agree to a prescription of any fluoroquinolone unless you are dying, and there are no other althernatives.

  3. Bobby Traina September 23, 2015 at 7:07 pm Reply

    Excellent post!

    • L September 23, 2015 at 9:17 pm Reply

      And I think the “allergy/hypersensivity” is a matter of degrees, I believe that everyone at some point will be affected, because of the known damage to dna, mitochondria, etc. Some of us got struck down on the first use, but I think anyone who uses these drugs is eventually headed for trouble…”the bomb going off.” It IS absurd they wouldn’t let you put down FLQ as a group. They are the same drug basically, by different manufacturers. And I always find the warning so disingenuous when it says “if you experience any of these…….contact your healthcare provider.” Well, by that time it is too late! The damage is already done.

  4. Daniel Hsieh September 25, 2015 at 10:26 am Reply

    well, whatever you broadcast this FQ toxicity , most people wouldn’t believe it especially on the notion of “delayed reaction even months/years after the last dose of FQ”. No one would believe it until they take the pills on their own…

    • L September 25, 2015 at 11:54 am Reply

      “no ne would believe it…until they take the pills on their own” You are so right. I was just talking to someone today about how miraculous it is I am even alive. My side effects were so torturous and so hideous, especially the breathing part, that I thought for sure I was going to die for a couple months. Looking back on it now, and I still have bad side effects—it’s hard for me to even believe what I went through! There truly are no words strong enough to convey the effects of this poison.

      • Lucy Sky November 18, 2015 at 2:11 am Reply

        Yes poison is the only way to describe these horrific group of drugs. How can any intelligent person possibly deny the damage these drugs do in the face of so much overwhelming evidence .

        I do not blame Linda for losing trust and confidence in the pulmonary doctor.

    • Bunny Jean January 22, 2019 at 12:49 pm Reply

      This is SO true! No one wants to think this could happen to them.

      • L January 22, 2019 at 1:48 pm Reply

        Whenever I hear someone say “well I took cipro (Levaquin, etc) before and nothing happened to me! I always tell them that I also took both before with seemingly no injuries (although who knows, they may have already been working their black magic) and my life was then devastated by 4 pills. I explain that the effects are cumulative, and by taking them again in the future they are just playing Russian Roulette.

  5. Daniel Hsieh September 25, 2015 at 10:31 am Reply

    Unfortunately and ironically, to make the public believe FQ toxicity syndrome is to make more people join the club, not prevent them from this.

  6. Cindy November 11, 2015 at 10:37 am Reply

    I wonder if Doctor’s give FQ to their family members ???? My PulmonaryDoctor denied that Levaquin caused my Heel Tendon damage…I do not trust him anymore…I am so glad Lisa started this FB Page..I do not feel so alone anymore…and my symptoms are not as bad as most of the people on this site…I feel so sorry for those of you that have had to endure years of Pain & Torture because of these horrible drugs…I have a piece of paper in my wallet that has all the Meds I take and Highlighted at the top it says NO FQ with the names of all of them for when I have to go back into the Hospital….I will refuge any of them unless I am dying…….God Bless & Heal All of You…in Jesus Name Amen…

    • Lucy Sky November 18, 2015 at 2:13 am Reply

      Should have written that I do not blame Cindy for losing trust in the pulmonary dr. How could anyone deny the damage that fluoroquinolonrs do to tendons etc when there is so much evidence to show that they cause muscle and connective tissue damage and disease!

  7. Lucy Sky November 18, 2015 at 2:07 am Reply

    I agree wholeheartedly.
    Why are these drugs still on the market? Why? Another nasty drug is perampanel and Lyrica.

  8. Andrea December 2, 2015 at 11:23 am Reply

    Lisa this is very well put. I am working on this topic here in the Boston area. I currently feel so unprotected, knowing that I cannot ever be challenged with a FQ again. If I was to be in an accident and unconscious how would I be protected in the hospital environment? I am working with medical professionals to address this critical issue. All medical professionals need to be aware of what antibiotics are included in the FQ class.

    • Bunny Jean January 22, 2019 at 1:01 pm Reply

      A tattoo across your forehead ?!?!

      I was told (at the hospital) that they only use the drugs they have on hand and we can not always “pick and choose”!!! They NEVER say that about penicillin!

  9. Debs January 18, 2016 at 10:34 am Reply

    Andrea I would suggest setting up an advance directive / statement or whatever it is called where you reside. stating you refuse as treatment in the future ALL drugs from the fluoroquinolone class including ALL modes of administration, listing them by name if you have to.
    An advance directive is a legal document, & to my knowledge, with an advance directive in place, ( & this applies even if we have been ‘ sectioned ‘ held under psychiatric care because they think we are of unsound mind, ) a FQ because it is a drug for our physical health can never be forced on us just like that, our wishes re this, can only be overridden via court, & they have to prove us of unsound mind first. Whilst nothing is 100% foolproof nothing surprises me in this strange world we inhabit, I have seen far too many people have MED ID ignored & medical records stating severe allergy to FQs ignored. An advance directive is our last safety net, & I would recommend that everyone look into this .

  10. Shelly bean January 20, 2016 at 12:17 pm Reply

    I would never take another fluoriquinolone even if it was life or death because this toxicity has stolen my life.

    • Linda January 20, 2016 at 12:51 pm Reply

      Nor would I Shelly. I would seriously rather die than go through the nightmare I have been through. In fact I hope not to ever take ANY antibiotic again since they mess up your gut an immune system.

  11. Karen April 30, 2016 at 8:58 am Reply

    Does anyone have a complete list of all fluoroquinolones? I have a card in my wallet that states “No Fluoroqinolones” and bracelet that states the same thing but, from what I am reading here, that isn’t sufficient to prevent being given a fluoroquinolone in an emergency situation where I am unable to speak for myself.

    • Linda April 30, 2016 at 10:04 am Reply

      The most commonly used are: Ciprofloxacin (cipro), Gemifloxacin
      Levofloxacin (levaquin) Moxifloxacin Norfloxacin Ofloxacin
      But take a look at this list. obscene. And I read they are coming out with a new one. It’s just a shell game to the manufacturers. And if you just put “fluoroquinolones” most medical personnel would not even know what that included.

  12. Cindy Schmidt April 30, 2016 at 10:08 am Reply

    I to would like to know do I have to do something legal to be sure that I am NEVER given any FQ again….I was lucky ..I still have some problems but nothing like some of you…I may not be so lucky next time…..I have a paper in my wallet with a list of all my meds I take & a list of all the FQ names not to give me…..just wondering….Thanks again Lisa this group has helped me bet the vitamins & minerals back into my body to help with my recovery…

  13. Jana Wiley September 22, 2016 at 3:14 pm Reply

    Group Health in WA State has Cipro as my allergy on my records. Yet, if someone prescribes another FQ the system will block the order as they recognize the FQs are related. Craziness if other healthcare groups do not follow suit. I actually made my doctor prescribe Levaquin just to see what would happen. Other places can do this too.

    • L September 22, 2016 at 3:37 pm Reply

      That’s good because most doctors don’t even realize that avelox, cipro, levaquin, etc are even in the same family!!!

  14. Ali April 12, 2017 at 3:41 pm Reply

    I had pneumonia over Christmas and moxifloxacin was prescribed. On day three, I took another dose at supper time with food and within a half hour, I was sweating, short of breath, had a racing heart, and basically was in full on panic mode. I knew what the symptoms of a panic attack, but I didn’t believe I was having a panic attack. I debated about going to the hospital, but after an hour, symptoms started to subside. I also started getting some hives later and the next day. I did go to emerg the next day and got a different drug. I still had reactions and benedryl took care of it each time. But, the hives didn’t disappear (got itchy and was covered head to toe on day 3 of second drug) until I got the third drug and things were fine after that.

    I saw an allergist yesterday (after insisting on getting test with my regular doctor as I thought it was prudent) and the allergist didn’t bother challenging the drug. She listened to my symptoms and just said to get a medical alert bracelet with fluoroquinolones antibiotics listed. Thanks, Linda, for the comment about the list of drugs. I’ll print that and put it in my wallet. A good druggist should know before filling anything if the docs make a mistake. I don’t blame the docs too much because they have to know so much and there are so many drugs to know about and what reacts with what etc. I don’t know how they can do that all!

    However, if they don’t listen to the patient, then that I have a problem with.

    The quote: “If a person experiences a severe adverse reaction to a fluoroquinolone and they feel as if a bomb has gone off in their body and mind…” resonated big time. That’s a good way of describing what I felt.

  15. AnnMarie Rojas June 22, 2017 at 5:24 am Reply

    Hello, I’m a 39 year old woman who use to be very motivated and healthy. That was until they prescribed both Ciprofloxacin and Levofloxacin to me. Before being hospitalized, I was given Ciprofloxacin at the urgent Care. I took it, and went home to sleep. Instead I felt extremely cold and could not stop shaking. Let me remind you that outside was around 90° here in the Coachella Valley. I also had a fever of 102.3, so I couldn’t get under the blankets.
    I decided to bring my dog in so she could keep me warm. But I got worse, I was so cold that I couldn’t control my shaking and I peed myself. All of a sudden everything went black. When I woke up, I was already showered, and all the bed sheets and comforter were changed as well. My husband had already come home from work, and so I asked him if he had bathed me, but he said, “no, when I got home you were already like that”.
    I became very scared and asked him to take me to the hospital. At the hospital, I told the nurses about what had happened to me, but they acted like nothing was wrong and blamed it on my fever. They hospitalized me, and while there I began to experience hallucinations of the nurses hovering over me and screaming in my ear saying, “WAKE UP”! I got insomnia, had extremely scary nightmares, and became very sensitive to any light. When they discharged me 2/3 days later from the hospital, I felt worse even if my kidney infection was almost completely gone. I became very weak, dizzy, unbalanced while walking or standing, extremely depressed so much that I quit my morning job. My personality changed from being a very out going and social butterfly to not wanting to leave my room at home.
    Then just like that, 2 days after I finished taking the Levofloxacin(what they prescribed for me after I was discharged)I began noticing that I was feeling better. I became more motivated, not as depressed, body didn’t ache as much, I began to smile and just be me.
    Only now I began noticing that my memory was shot. I would use a word in a sentence and forget the word by the next sentence. Well it’s been 1 1/2 months and my memory is still not 100%.
    These meds are very dangerous, I have another appointment coming up and I hope there’s no permanent damage. I hope this story can help back up your article.

  16. Amy March 8, 2018 at 9:45 am Reply

    I took my daughter to the ER for high fever and back pain. Yup! Kidney infection….. Almost was admitted. However since she was well hydrated she was sent home with a script for Levoquin.

    What pisses me off is that we adamantly and frequently stated that she was highly allergic to Ciprofloxacin! We purchased the prescription and she took it on the way home.

    We live in a remote area. If we had not recognized the initial signs of a reaction (itching and tingling of her eyes) and continued on our course home (I turned the car around) she could have died!! By the time we got to the pharmacy to purchase benadryl before heading to the ER…. Her face looked as if she had been repeatedly punched. Her eyes were swollen to the point that they were shut and had purple bruising!!!!

    While at the pharmacy I asked if Levoquin was related to cipro… Guess what I discovered!

    When we returned to the ER I am not proud of my behavior… At all. I showed my booty (metaphorically speaking)! All they had to say for themselves… “Just because a patient has a reaction to one does not mean she will be allergic to the other”. Really? Isn’t that a bit like saying “getting ran over by a truck will kill you… But that doesn’t mean getting hit by a car will kill you”? Just saying.

    • L March 8, 2018 at 10:41 am Reply

      That is pure insanity. These are basically the same drug by different manufacturers. AND I am guessing that they did not even know they are both fluoroquinolones and were just trying to save face. I would try to find somewhere else to go for medical care.

  17. L March 23, 2018 at 10:41 pm Reply

    There are way more indicators of an adverse reaction than these. And I think it somehow minimizes the breadth of people injured by referring to it as an allergic reaction

  18. Meredith April 29, 2018 at 1:48 pm Reply

    Absolutely right. Cipro made me unable to pick up a cup. So they give me eye drops which caused me to be unable to walk.
    I’m getting a bracelet but not sure what it should say. I told my husband’s doctor he could nit take cipro so they gave him levaquin.
    Scary world out there.

    • L April 29, 2018 at 1:56 pm Reply

      omg…the ignorance. The problem is there are SO MANY fluoroquinolones. You have to list them or when a doctor suggests something, look it up right there and make sure it’s not in the family.

      I was going to get a bracelet but decided that “no, I am not going to mark myself and carry it on me like that.” Personal choice of course. What I did do though, is took my drivers’ license out of the license “window” in my wallet, and put in it’s place a card that says: “No fluoroquinolones; No Cipro, Levaquin, Avelox; no sulfa drugs; no steroids; No fluoride containing RX.” I avoid regular doctors, prescriptions drugs and hospitals like the plague. the only way I would end up in one is a bad accident.

  19. Krc August 20, 2018 at 9:24 am Reply

    I was in the hospital for a month for complications of pneumonia. I took Cipro along with two other drugs while in the hospital. Then I was prescribed Cipro for 3 months after my release from the hospital. I had to have surgery (empyema and decortication) to get infected fluid out of my lung cavity and peel away scar tissue to allow my long to expand. It took me six months to completely recover. I was dangerously ill and Cipro saved my life. I had no side effects from it so it is only fair to realize that individuals have different tolerances for the drug. Since that time I had a reaction to avelox — my legs looked like they had been scalded and I felt a creeping burning sensation. I took Benadryl immediately and went to the ER. My doctor told me that episode meant I would probably never be able to take that class of drugs again. A few years later I was given rocephin, which I understand is related, and tolerated it well. I am allergic to penicillin so my drug choices are limited. I know I am not alone. That is why it is important to have as many antibiotics available as possible.

    • L August 20, 2018 at 9:55 am Reply

      It is thought that the effects are cumulative, so even if you had no problem with cipro once, it doesn’t mean it won’t hurt you if you take it again. I was given both cipro and Levaquin with no APPARENT injury. Third time it went off like a bomb in my body. I won’t go into all the gory details You can find them on here a number of times, but suffice it to say, it obliterated me and I prayed for death every day for most of the first year, as I gasped for every breath, wondered if I would completely lose my eyesight and struggled through each day as a skeleton of my former self. While you may think you had no injury from that first round of Cipro I suspect it was already doing it’s damage. These are CHEMO drugs. They destroy at the cellular level, including mitochondrial DNA. I believe they should be removed completely (as does a physician who testified in front of the European equivalent of the FDA a couple months ago.) BUT if these toxins must remain on the market they should be used ONLY for life and death situations. (If I were given the choice between death or cipro, I would choose death.)

  20. NHWCenter September 4, 2018 at 8:50 am Reply

    Any vets here who can discuss how Cipro can affect an animal? Its been 2-3yrs since being treated by a vet with Cipro and now my lab has a weakness in her hind legs. I did a signifant liver detox on her after the med and even did probiotics during her treatment for an infection. I know dogs age fast (she’s 12 1/2 now) but now reading this again (I argued with vet who said animals don’t respond to antibiotics like people) I have to wonder. Any vets who are aware of animal effects please feel free to email me.

    • Bunny Jean January 22, 2019 at 1:23 pm Reply

      YES! There are some commonly given drugs (prescribed by the Vet) that can do grave harm. I do not have the list in front of me but you can look them up online. My dog took one of these drugs along with prednisone, and we all know these drugs should never be taken together.

      I’m so tired of these side effects being downplayed as simply aging, in both pets and humans!

  21. Elna Lewis March 6, 2019 at 8:07 am Reply

    Elna Lewis December 2018
    One pill – Within 10 minutes – I nearly died.
    I also took the pill before with no problem but 1 pill and my life was then devastated.

  22. Jana Wiley May 28, 2019 at 11:53 am Reply

    Note: I am a Kaiser member and Cipro is listed on my chart. The pharmacy cannot fill a FQ order as they do cross reference this as an allergy. It has been this way up here in the PNW since early 2015.

  23. […] hair loss, hyperactivity, brain fog, short term memory issues and fatigue. Additionally, I had irritability, emotional blunting, and personality changes after my son’s C-section. All of these symptoms were much more severe after my son’s delivery […]

  24. BJ January 6, 2020 at 10:28 am Reply

    Hormones Matter: I’ve read that fluoroquinolones are the drug of choice with c-section, and I’ve had two. I’m glad you brought this up as I don’t recall side effects if I was given them and women should have a choice to refuse them. It would be the prescription several years later then two years after that – I wouldn’t take this class of drugs again.

  25. […] hair loss, hyperactivity, brain fog, short-term memory issues, and fatigue. Additionally, I had irritability, emotional blunting, and personality changes after my son’s C-section. All of these symptoms were much more severe after my son’s delivery […]

  26. […] hair loss, hyperactivity, brain fog, short-term memory issues, and fatigue. Additionally, I had irritability, emotional blunting, and personality changes after my son’s C-section. All of these symptoms were much more severe after my son’s delivery […]

  27. BJ October 6, 2020 at 7:17 pm Reply

    Anyone have trouble with a numbing med at the dentist?

    • L October 6, 2020 at 7:33 pm Reply

      I actually just posted about this the other day. I had no trouble with carbocaine or septicaine, but I recall someone else did. These are the ones used most often in holistic dentistry because they are the safest. I don’t know if a “regular” western medical DDS would have them.

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