The FDA recently issued a warning that use of antibiotics like Levaquin may lead to aortic aneurysm injuries, including rupture of the main artery carrying blood from the heart muscle.

Levaquin is one of a class of antibiotics known as fluoroquinolones, which have been implicated in an elevated risk of serious damage to the aorta.

With over 20 million prescriptions written for these common antibiotics every year, it is possible that a significant number of people are at risk for Levaquin aortic aneurysm injuries.

The FDA’s warning regarding fluoroquinolones and the danger of aortic aneurysm injuries was originally published in May 2017, and updated on Dec. 20, 2018. Since the warning was published, the FDA has required a black box warning regarding the risk of aortic tears.

A Brief History of Fluoroquinolone Antibiotics

Fluoroquinolones are broad spectrum antibiotics used for both human patients and animals in veterinary medicines.

The predecessor of these medications, nalidixic acid, was first introduced in the early 1960s and used to treat infections of the urinary tract. Since that time, over 10,000 similar compounds have been developed, but very few are used today.

Fluoroquinolones represent the fourth generation of the quinolone family of medications. For many years, it was the first line treatment for many common infections, including those of the sinuses and respiratory system.

However, problems became apparent in the early part of the century. In July, 2008, the FDA added a Black Box warning about the elevated risks of tendon inflammation and rupture.

In early 2011, another warning was issued to patients suffering from a muscular disorder known as myasthenia gravis. Only two years later, a third warning was added, advising patients of potential nerve damage risk in the extremities (peripheral neuropathy).

In July, 2018, the FDA announced that fluoroquinolone drugs had been associated with severe hypoglycemia (dangerous drops in blood sugar levels) and may also have an impact on mental health.

Fluoroquinolones and Levaquin Aortic Aneurysm

Current concerns about Levaquin aortic aneurysm were raised after the FDA received adverse event reports of patients who had experienced a rupture, or tear in the primary artery that supplies blood from the heart to the rest of the body.

Although it is not yet understood why this happens, the FDA has estimated that as many as three out of 1,000 patients could be at risk for aortic aneurysm.

The FDA advises that patients with a previous history of aneurysm as well as those who may be suffering from atherosclerosis (hardening of the arteries), hypertension, Marfan Syndrome or Ehlers-Danlos syndrome avoid taking fluoroquinolones.

Other Fluoroquinolone Drugs

In addition to Levaquin, members of the fluoroquinolone class of antibiotics include:

• Avelox
• Cipro
• Factive
• Floxin
• Noroxin

Any or all of these could result in injuries similar to Levaquin aortic aneurysm. While these drugs do pose risks, patients who have been prescribed a fluoroquinolone should consult with their doctor before they stop taking the medication.