Has Anyone Had Levaquin?

[HighStrung]

One dose of Levaquin and my tinnitus noise increased considerably. I didn't think to check the PDR. It's listed as causing tinnitus. I've never had this before, but my sister who also has tinnitus has taken it with no problems. If this spike is caused by the Levaquin, will it calm back down once the drug is out of my system (30-40 hours, I understand)? I sure don't want to take the whole ten day course now! I'm trying to find something strong to take that's in the Amoxicillin group.

I should mention that my fever is also a little higher than it's been, and my ears a little more clogged and painful. Not much, buy maybe enough to account for the spike, rather than the Levaquin?

Thanks for any help!

 

[linearb]

I'd be super, super, super careful with fluoroquinolone antibiotics (levaquin, cipro, etc) -- in fact my doctor, who I basically like, was so adamant about giving them to me for a run-of-the-mill infection that I basically went doctor shopping until I found someone who would pursue a different treatment.

Personally, I would never take any drug in that class again unless I thought my life was actually in danger; in general the horror stories are from people who took them for a period of time, but they are GABA antagonists and I've seen conjecture that relatively short durations of use can cause various kinds of neurotoxicity (including tinnitus).

If you think your tinnitus is increasing from a single dose, I would think long and hard about how badly you need to be on the drug. There are plenty of specific cases where fluoroquinolones are indicated: severe infections known to be resistant to all other kinds of treatment, life-threatening staph which is known from a culture test to be susceptible to quinolones and not other kinds of ABx, etc... but those probably represent a small minority of prescriptions written.

The question of whether or not your tinnitus will remain worsened after discontinuing the drug is something which no one can tell you with any certainty, but in general, the duration of adverse effects from drugs gets worse the longer you take them.

 

[HighStrung]

Yeah, I won't be taking anymore of this crap. I thought I'd done due diligence about researching it, but evidently not. Some of my family have tinnitus and never had a problem with it.

Of course I started Googling again and this time found a lot of anecdotal accounts claiming it created/worsened tinnitus, as well as the PDR listing. I really hope the spike subsides when it's out of my system

 

[linearb]

My total guess is that it will get better. Taking some magnesium might not be a bad idea.

 

[HighStrung]

Sorry for the late reply, I don't get here often.

It turns out I'm allergic to fluoroquinolones. My feet went numb and swelled up so big I couldn't put shoes on. That was from one dose. I never took a second dose. The tinnitus spike subsided after a day, but months later my feet are still somewhat numb. My neurologist thinks that may be permanent.

 

[linearb]

Ugh, sorry to hear that, and thanks for the follow-up.

 

[AdamH]

With most drugs, the rule of thumb in the presence of normal renal or hepatic function (depending upon how drug is excreted), is that "therapeutic" concentrations are reached after 5 half-lives have passed.

If I take a first dose of a drug with a 24 hour half life, then half the dose is left after 24 hours (the other half has been excreted). If I then take a second dose at 24 hours, only a quarter of the first dose and half of the second dose is present after 48 hours. If I continue to take a dose every 24 hours, then the amount "in my system" is:

• 24 hours: 1/2 dose
• 48 hours: 1/4 dose + 1/2 dose = 3/4 dose
• 72 hours: 1/8 + 1/4 + 1/2 = 7/8 dose
• 96 hours: 1/16 + 1/8 + 1/4 + 1/2 = 15/16
• 120 hours (5 days) = 31/32 dose

So, it takes 5 days in this case to get to a "therapeutic" concentration. So, unless there is an unexpected immune response (drug allergy), it's unlikely the patient will exhibit serious side effects before 5 half lives have passed. This is not the case for people with kidney or liver dysfunction, depending upon how the drug is cleared. It might also not be the case should drug or food interactions be present, eg grapefruit and statins.

BTW, the same process happens in reverse once the drug is stopped. It takes 5 half lives of time to completely clear the drug from the system.