Should I ask my doctor for a Cipro alternative?
December 5, 2011 8:44 PM   Subscribe

My doctor prescribed me Cipro (Ciprofloxacin) for a potential prostate infection. This is the first prescription drug I've been on in about 10 years. After reading up on the internet about potential side effects (as well as FDA black box warnings [!]) I have to admit I am rather concerned about permanent damage to weight bearing joints and possible tendon rupture (which can occur long after you stop treatment) There are a bunch of lawsuits going on about it. I do fairly heavy weight training and this makes me nervous.

Do you think it's worth it to switch to another antibiotic, and if I wanted to, how would you do that? Does one make another appointment to see the doctor or talk to the appointment scheduling person or what? I rarely go to the doctor, so I don't even know how you would contact them again about something going wrong with a drug or a little question. Is everything appointment worthy?

I am also wondering if I am making a big deal over nothing. The incidence of really bad non-reversible side effects can't possibly be that serious if they just give this drug out to people, or can it?
posted by anonymous to Health & Fitness (16 answers total)
Anytime you are concerned you should be able to talk to a nurse with your doctor's practice.
Just call the appointment people ask who you should talk to in order to leave a message for your doctor. Leave a message with your concerns and request for a new antibiotic. Leave your pharmacy info so they can call in the prescription.
posted by Librarygeek at 8:51 PM on December 5, 2011 [1 favorite]

I don't even know how you would contact them again about something going wrong with a drug or a little question.

Call their office and tell them you have a question for the doctor. Usually in my experience either they (receptionist) asks you the question and passes it on, or just makes a note for the doctor. In either case, a simple question will usually just mean a phone call from the doctor. Obviously if it becomes too complicated they may ask you to come in. But something like this can probably just be handled with a phone call, and I've definitely had followup questions for my doctor resolved this way.
posted by wildcrdj at 8:52 PM on December 5, 2011

Do you think it's worth it to switch to another antibiotic

If you want a second opinion, please seek one from another physician. People on the internet generally (a) lack the knowledge to give you worthwhile advice and always (b) lack access to your medical records, which are essential to informing that advice. Before you do anything else, though, you should speak to the prescribing physician and/or your pharmacist, as it may well be the case that they can assuage your concerns quickly.
posted by Inspector.Gadget at 8:52 PM on December 5, 2011 [1 favorite]

I don't have the answer to your specific question, you need to be able to contact your doctor, it's a problem that you can't. I will say though that I had another (unrelated to your concerns) bad reaction to Cipro years ago and I've had it in my chart since then that I can't have it, and they've always been able to find me an alternative with no issue.
posted by crabintheocean at 9:03 PM on December 5, 2011

Mark's Daily Apple recently did a series of quite informative articles on antibiotics and the tendon issue comes up several times throughout the comments. I haven't delved too deeply myself but you may find some worthwhile reading there (caveat emptor of course)...

The Problems with Antibiotics: They Kill the Good Guys and Make You Fat
The Problems with Antibiotics: More Fallout from Killing Your Flora
The Problems with Antibiotics: Possible Alternatives and Damage Control
posted by Kandarp Von Bontee at 9:03 PM on December 5, 2011 [1 favorite]

I believe the incidence of this side effect is under reported in the literature. Anecdotally, many people I know taking this class of antibiotics have experienced joint pain short of tendon rupture. I experienced severe pain in my achilles tendon which limited my ability to walk more than a few hundred feet at a time and which took nearly a year for recovery.
posted by caddis at 9:19 PM on December 5, 2011

I took cipro a couple of years ago, while training for a marathon. I'm not a regular antibiotic-taker, but in my case - kidney infection - getting the infection cleared up was clearly the main priority. It generally made me feel like crap, but I didn't get any tendon injuries, during the course of cipro or subsequently. I am fairly bullet-proof injury wise, so YMMV.

In spite of this, I still had potential injury concerns and if I was prescribed it again I'd certainly seek a second opinion or follow up with my doc - as I've no medical background, reading around on the internet wasn't going to do me any good.
posted by poissonrouge at 9:44 PM on December 5, 2011

I took Cipro while recovering from pneumonia, and it was pretty awful. I didn't rupture anything, but I had terrible leg cramps every single night from it, no matter what kind of stretching I did, and no matter how hydrated I was. I was supposed to take it for 12 days and ended up skipping the last dose, as I just couldn't stand it one more night. I would really have to be convinced that it was the absolute only thing that would cure me before I'd take it again. Were I you, I'd put in a request to my doctor to have him call me, and ask if there is anything else I could take that would be as effective.
posted by clone boulevard at 10:29 PM on December 5, 2011 [1 favorite]

I have rheumatoid arthritis and regularly take Cipro for kidney and UTIs. I've never had any issue with it causing increase in injury.

But again, if you are worried, seek a second opinion.
posted by strixus at 10:46 PM on December 5, 2011

Ok here's my $.02, I have taken cuprous many times, that is because other antibiotics including ones with harsher side effects (yes they exist as much as your googling has scared you). But and here's the big but...I also know someone personally who took cipro and had a rupture.

Basically if nothing else is working use cipro, I probably would have died if that stuff wasn't around and I would gladly have whatever craziness with my tendons in order to live. But honestly you don't sound like me. If your dr hasn't done a culture To determine that your infection is resistant to most antibiotics simply call them up (leave a message if they are unavailable) and say, "hey I'm uncomfortable with the side effects of cipro, could we try something else first". They will call it into a pharmacy and you can go pick it up. (if they have done a culture though I would generally trust their judgement that you need the nuclear option)
posted by boobjob at 12:07 AM on December 6, 2011

Aw spellcheck cipro
posted by boobjob at 12:09 AM on December 6, 2011

I was prescribed Cipro a year ago, and had the same concerns that you did (especially after the pharmacist told me that it was probably going to kick my butt). I called my doc, and they had NO problem switching me to another antibiotic. Mine was for a dental infection. I think the replacement I was given was Azithromycin (z-pack). If I was in your shoes, I would definitely see if there was something a bit less scary that you could take.
posted by Happydaz at 1:00 AM on December 6, 2011

You can use the internet to scare yourself away from any drug. Or food product, for that matter. Seriously, if you read the scary stories about diet soda, jello or bananas (they're radioactive!) you might swear off all food and drink forever.

That said, there's not nothing to be said for being a little informed. The right way to use this information you have found is to detail/summarize the concerns for your doctor and ask what they think about these possible side effects. Should you worry, given your overall health and condition, and so on.

(Many doctors hate the internet because it turns every patient into a paranoid hypochondriac, but at the same time they're very accustomed to dealing with the concerns of a semi-informed patient, so don't be shy. You're the customer-client-patient, after all.)
posted by rokusan at 7:17 AM on December 6, 2011 [2 favorites]

I would call and ask to speak to the doctor's nurse (I almost never got the actual doctor and stopped trying). When you get the nurse, just say that you're concerned about possible joint problems from cipro and ask if there's another antibiotic you could take instead. The nurse will check with the doctor and call you back, probably to say that she'll call in a different prescription to the pharmacy of your choice.

I also had a bad reaction to cipro (severe insomnia and jitters). The doctor was happy to switch me, and since then I haven't had trouble getting a non-cipro alternative when cipro has been proposed.
posted by ceiba at 7:31 AM on December 6, 2011

FWIW, I have taken Cipro several times for horrible UTIs with no side effects what so ever. Obviously, YMMV. Also, I would have no problems contacting my doctor's office with concerns. I always seems to research the hell out of any prescriptions that I've been given and have never had any issues speaking with a nurse about concerns--Note I'm not crazy lady or demanding just looking for peace of mind. They get this.
posted by allnamesaretaken at 10:28 AM on December 6, 2011

I'm also a heavy weight trainer and have taken cipro many times to no ill effect, if it makes you feel any better.
posted by ch1x0r at 4:30 AM on December 7, 2011

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