As far back as 2012, researchers have called for more caution when using fluoroquinolone antibiotics.

Fluoroquinolone antibiotics are a widespread class of antibiotics with a reputation for safety. They include drugs like Levaquin and Avelox. One fluoroquinolone antibiotic, Cipro, briefly rose to “celebrity” status as the only drug approved to treat anthrax during the post-9/11 anthrax attacks.

However, several other fluoroquinolone antibiotics have since been approved to treat infection with anthracis bacteria. But despite their widespread reputation for safety, researchers have raised some safety concerns.

Medical literature contains numerous reports of liver damage associated with fluoroquinolone antibiotics. In fact, some researchers believe that the number of reports of liver damage from fluoroquinolones is on the rise. Like many drugs, the liver breaks down fluoroquinolone antibiotics, possibly exposing the organ to dangerous byproducts from the processs.

Researchers from the University of Port Harcourt had noted that a wide variety of types of liver damage, including liver failure and liver toxicity had appeared in patients taking fluoroquinolone antibiotics. This included damage to a number of parts of the liver, as well as different types ranging from subtle changes in liver function that could only be detected by blood test.

The researchers speculated that some of the byproducts from breaking down fluoroquinolone antibiotics were what they were seeing. Some of these byproducts are very reactive chemicals, which may damage both DNA and mitochondria, which can kill cell. Widespread death of liver cells can cause liver damage and even liver failure.

Symptoms of liver damage vary with the severity and type of liver damage. Some minor, subtle forms of liver damage can only be detected by blood tests, but may escalate over time. However, many cases of liver damage include nausea, fatigue, diarrhea, jaundice, and bleeding and bruising easily. More serious cases can cause coma, and even death.

But the exact physiology of a person’s liver varies wildly from one person to another, meaning that it’s very hard to tell how a person will respond from a specific drug like fluoroquinolone antibiotics. It’s also hard to predict recovery from liver damage.

Under ideal conditions, the liver is a very resilient organ. But even then, it can take months to fully recover from a serious case of liver damage. In light of these concerns, the paper’s authors recommended liver function tests before starting a patient on fluoroquinolones.

Lawsuits have been filed against drug manufacturers over allegations that they have not done enough to protect the public against potential complications of their medications. For example, a person who suffered liver failure after using fluoroquinolone antibiotics may file a fluoroquinolone lawsuit alleging that medical companies haven’t done enough to protect the public from the risk of fluoroquinolone liver damage.