Expert: Eric Brandt - 4/24/2007

Question
Eric,
Have been checking online regarding side effects to Levaquin. It's late at night  
and I think I'm having some sort of reaction.

Having very complicated uti's, and sensitivies to multiple antibiotics varying
from joint pains to rashes etc...in desperation, doc prescribed cipro...(before
hypersensitivity responses had been able to take it)  Believe I only took 1 or 2
pills on 1 day....didn't connect pressure in chest to antibiotic since bad air
day. Took inhalers and sudafed.  

By evening kept questioning if I could be having a heart attack. Decided the
sudafed etc...just needed to get out of my system. Took approx 48 hours!
Thank God I felt so much better.  

4 days later, UTI started totally acting up, found a 4 yr old prescription of
Levaquin in the cabinet....in desperation on a weekend started taking it....just
a little pressure in chest for 2 days.....lots of prayer.. it actually started
working.

On it for 4 days, went back to doc...he told me about the possible atrial
fibrillation response to Cipro. Since antibiotic issue was so dificult also said
that the Levaquin didn't have as much of the same heart side effects. Decided
to try it and see if it would kick this thing....

Well...kept taking the old prescription till I could get the new RX back, had a
2nd newer  only 3 yr old....bottle of leftover levaquin.... which I continued
with today. Started having chest heaviness this afternoon...again....still
thought it was the air or allergies....and ignored it.

Tonight took the 2nd dose of Levaquin...seemed to get a little stuck (also
have gerd probs with problems sometimes with pills going down) Went to
bed, tried to sleep...couldn't....heart started wierd pounding, a little labored
breathing, couldn't rest....had to get up and see if these could be all related
to taking levaquin!

Ok...so 1st question is....is there actually a known distinction in the heart side
effects between cipro and levaquin?

And 2....if one does have an adverse heart type of problem with it....do you
know what ratio it is for any actual heart damage? (The prescribing info from
their website didn't elaborate on long term probs)

And 3.....Have you had any experience with "expired" antibiotics working but
with less side effects?

I really do appreciate any insight you might be able to give.

Answer
Hi Lora,
Cardiovascular effects with Levaqun are reported to have occured in less than 0.3% of people taking the drug. The Cipro monograph lists the adverse effect but does not give the frequency of occurance so I can not varify that they occur less frequently with one drug compared to the other.
As you saw yourself in the monograph there is no inform ation regarding these effects causing permanent damage. Once the effect is noticed and the medication is stopped I expect things to return to normal.
I have no experience with expired antibiotics. You can expect expired antibiotics to cause fewer adverse effects because the drug is now less potent.
Thank you for using Allexperts
Sincerely,
Eric Brandt, B.Sc. Pharm