T Nation

Cipro Safe to Use?


Not quite sure if this is the right section for this. Just got prescribed Cipro for a little growth I have on my back that is infected. From what I can tell, it is a pretty widely prescribed anti-biotic, but one warning I was given was the slight possibility of tendon rupture. I do have a bit of tendonitis here and there to begin with. I love to lift heavy. Anyone know anything about this med or have any experience with it? When you google the side effects on the thing for tendon rupture, sounds like a nightmare. I can't take pennicilin due to being allergic. Any thoughts?


No one has ever taken it?


I have had athletes of mine take it when prescribed by a physician. They gave them the warning that long term usage of it has shown to increase risk of tendon issues, so there is a risk associated that will vary from person to person depending on your body, training history, or injury history. I think it would be best to bring this concern up with your doctor and see if there is an alternative medication to be taken. Or just take a deload time frame off while on the meds.


Well, I am now being told that it shouldn't be a huge concern. I probably won't be attempting any new 1-rep maxes, but maybe will take some extra joint support just in case. It is not for long-term, I think 10 days or so. Just frustrating because I have started to make some decent gains and would hate to deload now. Did any of your athletes' adjust their training in any way?


You're asking relative strangers for advice on how to make lifestyle changes around a prescription medication. Don't take this as a personal attack, but I really think you should consult your doctor about this one. Pretty simple: just call him/her up, ask the exam same question you asked us, and get actual medical advice on the matter.


Not looking for lifestyle change advice, just opinions and any one else's experience. No different than googling and seeing what's out there, only difference we have weight training as a common interest.


Not trying to fear monger, and I'm not ruling out that it could just be coincidence.... BUT I went to a training course where a guy tore his achilles tendon running a sprint. He said he had no pain at all in his achilles, no swelling, no symptoms, whatsoever. Post op, I talked to him, and he said the docs told him that his achilles tore because he had been on cipro for 2 weeks. So... ever since then, I have refused to take cipro any time that it's been prescribed to me. Why don't you discuss it with your doctor and see if you can use bactrim or doxycycline?


I've already gotten pushback for questioning this prescription. My regular doc referrd me to a dermatologist who is the one that prescribed it. The regular doc (who happens to work with mostly weightlifters) is deferring to the other one on this one. The dermatologist says this is the only one that will work, other than another one which he said has more side effects. Maybe I just need a second opinion.


Are you serious right now? What does the sig say and what was the quantity despensed for your prescription? You are worrying way to much. If you are to worried just stay away from one max lifts. This isn't rocket science.

EDIT: Just read in my 2008 Compendium of Pharmaceuticals and Specialties (CPS) that joint problems were reported less that 1% of people in the trails. Also noted that the tendon that would predominatly partially or complete reputre was the achillies tendon.

DOUBLE EDIT: Just read two posts up about the sprinter. Kinda creepy what I found in my book.

* Fluoroquinolones, including ciprofloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. Risk further increases with age over 60 years, concomitant steroid therapy, and kidney, heart, or lung transplants. Fluoroquinolones, including ciprofloxacin, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid in patients with known history of myasthenia gravis [19].

It is rare , but it does happen..in older people. Cipro is so widely prescribed and the rate of this happening is so low why worry? Spending 10 days(?) to get rid of your infection so that you don't turn septic seems a lot more important than the 1% chance you get a tendon rupture.


Would you mind explaining this growth? A lot of dermatological problems can be treated using creams or ointments. If the growth you're referring to is a furuncle(boil) or carbuncle it is quite possibly infected with staphylococcus aureus in which case a topical cream containing mupirocin and gentamicin should be sufficient. Such growths may also require incision to be drained prior to antibiotic application. If you received this medication from you GP you should consider asking for a dermatological referral as oral cipro is not a wise first line therapy for a hopefully minor skin infection. A topical approach should be considered. Without further detail I'm afraid I can't give you anymore advice. All I know is many GPs can be very hard-headed and asking them for a second opinion can be difficult. Hope that helps.


i simply dont have the studies to back my claims but if it worth anything...

I was on cipro for 8 days, it was to be a 2 week course, i had to stop due to very noticeable depression, quivering hamstrings, and incredible muscle soreness particularly in my rotator cuff (i was and am boxing).

When i told another md who practices functional/alternative medicine he was furious that they did not tell me to look for these signs, good thing i contacted him before i tore something, it took a little over a week for the soreness to subside.

He also throughout there that the number of cases with young athletes tearing tendons on cipro is very under reported, and more common than most think.

The likelihood of rupturing a tendon according to the packet that comes with the script says that this increased risk lasts for many weeks after discontinuing the med.

*I would recommend asking for a different antibiotic, or keeping a good eye on symptoms. like the above poster said, some tear tendons before they have time to notice side effects.


Just some advice from a pharmacy student....

Since your allergic to PCN that may be the best option for the infection that you have. Tendon ruptures are actually more common in people <18 years old, so fluoroquinolones aren't used in that population. Just FYI the way they first learned of this side effect was giving the drug to Beagle puppies who subsequently had increased tendon ruptures.

Just take the Cipro, lay off the heavy lifting for a week or two (I didnt see where you said how long the course is but it shouldn't be more than 10-14 days) and make sure that the infection gets taken care of. I know you'll be giving up balls to the wall training for a couple weeks but it's much better than risking the minor infection getting any worse and causing more problems. Or at the very least, just do some upper-body work and then light lower work since it really is the Achilles Tendon that you'll be worried about. Also, be sure to drink plenty of water (which you prolly already do if you're a lifter). These drugs are extremely well tolerated with a very good side effect profile for the most part. Good luck

Another thing, I've taken Cipro and Levaquin several times (for UTI/Kidney stone) and have lifted (light) while on them both and never had a problem. I just pay attention to the amount of stress I'm putting on the ankle joint and be reasonable...


Wouldn't you agree, however, that a topical solution should be sought out? Especially if the infection isn't severe. A lot of GPs aren't exactly that informed when it comes down to skin infections. I'm speaking from personal experience. As a teen (16-17 i think) I went to see my GP for a dermatological problem I had on my arms. She first said it was acne, went on treatment for a month, nothing happened. Went back. Apparently she didn't say it was acne, but that it was folliculitis(even though I had Rx's for the acne meds). Anyways, got a topical antibiotic for the folliculitis... guess what? Nothing happened. Went to see her again and she insisted I continue with the meds... I didnt. Even as a teenager i realized being on antbiotic cream for a 2 weeks + 2 weeks was ridiculous. It wasn't until my 5th year of med school during dermatology that I realized how obvious it was that I had keratosis pilaris, the derms agreed.

My point is: don't be to afraid to insist on a referral and/or second opinion. A referral would be better in this case since you would ideally need to see a dermatologist.



"My regular doc referrd me to a dermatologist who is the one that prescribed it"

From what I understand the Dermatologist is the one that prescribed it...
But I definitely agree that a 2nd and sometimes 3rd opinion can't hurt and is usually a good idea..
If you're an MD then you know more about it then I would but, without seeing the actual problem I'd almost never advise someone against a treatment that both their GP and Derm (that have seen 1st hand the problem and know the pt) have concurred on. Especially when the treatment is an appropriate one for the described problem.

That's why my initial req is to just take the prescribed Tx (which is very reasonable) and take into account the possible side effects, take it easy on the heavy weights and get the skin infection taken care of in a week or two.

As you know, most skin infections are pretty inocuous but depending on the organism causing it they can become a serious problem. Also, like I said, fluoros are a pretty well tolerated group compared to others. The topical solution might work but apparently the Derm that saw it thinks he needs systemic Tx.. I'm not willing to recommend against that.


Geez, I can't believe I missed that line. That changes everything. If the derm knows what it is and still agrees with cipro then do it. A third opinion probably wont change your treatment.

As for cipro and all drugs (I could use some advice from you blakjak here), yes, it has been shown that fluoroquinolones increase the risk of developing tendonitis and tendon rupture (most commonly the achilles tendon) but you would need to see what the incidence is. Quite a few drugs cause extremely rare side effects and drug companies have to make sure the patients are aware to cover their own asses. For example, statins (cholesterol lowering drugs) have been shown to cause rhabdomyolosis in extremely rare cases. Millions of people world wide still take this drug everyday though and although some have muscle aches and pains, very very few develop rhabdomyolosis. Even corticosteroid creams warn users of possible Cushing's symptoms... the risk is ridiculously low.

Anyways, if your derm agreed with your GP then take the pills and don't lift so heavy for the next few weeks.



No prob. And the incidence is <1%... but like you said, since it's a serious ADE then they are required to inform people about it. Another thing I didn't see in the OP's posts is how old he is... that could make a difference if he's <18-19 yo... but I would hope the Derm would know better.


I appreciate all the info and insight on this. I have been on the med now for almost 5 days with 5 more to go. Notihg majorly negative to report so far, although I have just had one workout in the last few days for arms. I will say though that I think you have to be very careful what kind of supplements get used while on this med. I have always been kind of a pre-workout stimulant enthusiast. Even though I did not take the med and the supplements clse together at all, I think maybe there is not a good interaction. I felt pretty crappy for a while afterwards. No very noticeable tendon trouble yet, although my elbow tendonitis is a bit more noticeable. Nothing majorly bad.

After getting over the initial fear of getting the report on possible tendon damage, I do agree it is more important to get the infection cleared. It is basically just a disgusting looking little lump on my lower back which has been shrinking the last couple days, so it seems to be getting better. I just hope the med gets out of your system pretty quickly once you are done. Some of the online research says even those who took it for a short time had tendon trouble later down the road. As mentioned, that is hopefully a rare kind of case. By the way, I am 39 years old, weigh around 240ish and have bee weigfht training for many years.


I had problems with cipro that may have been allergenic.