Collagen / tendon toxicity
Fluoroquinolone collagen toxicity (tendon, aorta)
- Boxed: tendinitis and tendon rupture — Achilles most often; risk highest with age, corticosteroids and transplant
- Aortic aneurysm and dissection share the mechanism — matrix-metalloproteinase activation and collagen degradation
- Also boxed: peripheral neuropathy, CNS effects, myasthenia exacerbation
- Boxed: tendinitis and tendon rupture — Achilles most often; risk highest with age, corticosteroids and transplant
- Aortic aneurysm and dissection share the mechanism — matrix-metalloproteinase activation and collagen degradation
- Also boxed: peripheral neuropathy, CNS effects, myasthenia exacerbation
Drugs with this mechanism (10)
- Ciprofloxacin — Fluoroquinolone with strong Gram-negative and anti-pseudomonal activity; tendon warnings.
- Delafloxacin — Anionic fluoroquinolone with MRSA activity, which is unusual for the class.
- Enoxacin — Fluoroquinolone antibiotic; a potent CYP1A2 inhibitor with seizure risk.
- Gatifloxacin — Ophthalmic fluoroquinolone for bacterial conjunctivitis; systemic use ended after severe dysglycemia.
- Gemifloxacin — Respiratory fluoroquinolone for pneumonia and bronchitis, notable for rash in younger women.
- Levofloxacin — Respiratory fluoroquinolone; once-daily coverage including atypical pneumonia.
- Moxifloxacin — Respiratory fluoroquinolone with anaerobic coverage; QT prolongation risk.
- Norfloxacin — Early fluoroquinolone for urinary infections, superseded by later agents in the class.
- Ofloxacin — Fluoroquinolone now mostly used as otic and ophthalmic drops.
- Sparfloxacin — Fluoroquinolone withdrawn for QT prolongation and severe phototoxicity.
All mechanisms · Open Collagen / tendon toxicity in the interactive console ↗