The class of antibiotics known as quinolones — including ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin, norfloxacin, and ofloxacin — are mostly safe but carry the risk of liver damage.

According to RightDiagnosis.com, symptoms of antibiotic-induced liver damage can range from non-existent to mild to severe depending on the degree of exposure.

Mild liver toxicity from taking quinolone antibiotics may not produce any symptoms in the patient, while severe liver damage can cause a plethora of painful manifestations such as:

• Nausea
• Vomiting
• Abdominal pain
• Loss of appetite
• Diarrhea
• Tiredness
• Weakness
• Jaundice
• Yellow eyes
• Yellow skin
• Enlarged liver
• Abnormal liver function test results
• Swelling in feet
• Weight increase due to water retention

Quinolones have an antibacterial effect by preventing bacterial DNA from unwinding and duplicating. Oral quinolone antibiotics are commonly used to treat mild-to-moderate urinary, respiratory tract infections, infectious diarrhea, typhoid fever, uncomplicated gonorrhea, a form of meningitis and as a prophylaxis for the deadly anthrax virus.

Patients experiencing acute liver damage from hepatoxicity often require hospitalization in the intensive care unit, where the patient’s airway can be protected and fluid and electrolytes can be managed.

The medical journal Gastroenterology published a study that found that antibiotics — more than any other prescription medications — are most likely to cause liver damage. Risk factors include the preexisting hepatotoxic reaction to a specific antibiotic, being female, increasing age and the presence of another disease, such as diabetes.

The quinolones most frequently linked to liver damage are ciprofloxacin (Cipro) and levofloxacin (Levaquin), according to the National Institutes of Health, though the agency notes that those are the two most widely prescribed quinolones.

One in 100,000 people suffer adverse reactions as hepatoxicity (chemical-driven liver damage) from quinolones. Since it is the liver’s job to clear chemicals ingested in the body, the liver is highly susceptible to toxicity.

“Factors such as age, race, gender, overall health and underlying liver problems may also influence a person’s risk of developing liver problems and the severity of the symptoms,” according to RightDiagnosis.

Treatment for quinolone liver damage includes discontinuing the medication, monitoring and reviewing a patient’s liver function, abstaining from alcohol and avoiding medication that may contribute to further liver damage.

Liver damage caused by quinolones typically begins within one to four weeks of starting the drug. As a precaution to prevent liver damage, it is advised that patients taking quinolones should not misuse or overuse the antibiotics and follow the doctor’s dosing instructions.

It is a good idea to keep a written record each time an antibiotic is taken, including the name, strength and time the drug was taken. Notify your doctor of any side effects.