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Medical Forum / General / General / June 2005

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What drug has the side effect of bilateral Achilles tendonitis?

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George - 12 Jun 2005 00:51 GMT
A friend in good physical shape and a regular exerciser, following
his normal routine, suddenly develops severe tendonitis in both
Achilles tendons, and can barely walk.

He's on nine medications (I don't know which ones) for a variety of
things.

Is there a drug class, or perhaps an interaction, that is known for
producing this kind of adverse reaction?  It seems to be an almost
bizarre effect.
Emma Chase VanCott - 12 Jun 2005 01:40 GMT
: A friend in good physical shape and a regular exerciser, following
: his normal routine, suddenly develops severe tendonitis in both
: Achilles tendons, and can barely walk.

: He's on nine medications (I don't know which ones) for a variety of
: things.

Guess it would help if you knew, before asking this question. Noone here
is going to do that legwork for you, likely.

Emma
:)
Jim Chinnis - 12 Jun 2005 02:23 GMT
George <gh424NO824SPAM@cox.net> wrote in part:

>A friend in good physical shape and a regular exerciser, following
>his normal routine, suddenly develops severe tendonitis in both
[quoted text clipped - 6 lines]
>producing this kind of adverse reaction?  It seems to be an almost
>bizarre effect.

This can result from a seemingly minor change in an exercise
routine, particularly if it is lengthy. An example: increasing the
angle on a treadmill.

No one has any idea what the interactions among nine drugs might
be.
--
Jim Chinnis   Warrenton, Virginia, USA
J - 12 Jun 2005 03:47 GMT
> A friend in good physical shape and a regular exerciser, following
> his normal routine, suddenly develops severe tendonitis in both
[quoted text clipped - 6 lines]
> producing this kind of adverse reaction?  It seems to be an almost
> bizarre effect.

There's a warning about ruptures on quinolones
http://www.rxlist.com/cgi/generic3/norfloxacin_wcp.htm
Tendon effects: Ruptures of the shoulder, hand, Achilles tendons or other
tendons that required surgical repair or resulted in prolonged disability
have been reported in patients receiving quinolones, including
norfloxacin. Post-marketing surveillance reports indicate that this risk
may be increased in patients receiving concomitant corticosteroids,
especially in the elderly. Norfloxacin should be discontinued if the
patient experiences pain, inflammation, or rupture of a tendon. Patients
should rest and refrain from exercise until the diagnosis of tendinitis or
tendon rupture has been excluded. Tendon rupture can occur during or after
therapy with quinolones, including norfloxacin.

I was more on  (than off)  that one for almost 6 months.
Nobody warned me to take it easy. I also did not rupture and the med was
necessary to get rid of a bad infection.
I only found out about the warning a few years ago, when someone else
mentioned that antibiotic and tendonitis. That person may have been on
corticosteroid. I wasn't at the time.
That was 6 years ago.
I don't know if it's coincidence or not, but I now have chronic tendonitis
in my knees, my thumbs, my elbows and my shoulders.

There's a list of other quinolones here
http://www.cdc.gov/ncidod/hip/Lab/FactSheet/quinlolones.htm

FWIW
outrider - 12 Jun 2005 07:53 GMT
STATINS, a class of drugs taken to lower cholesterol, can cause
tendinopathy, tendinitis, myopathy, myositis, joint pain,
rhabdomyolysis; gastrointestinal disorders including gall bladder
disease, pancreatitis, helicobactor pylori ulcer, acid reflux;
respiratory problems; memory problems and memory loss; loss of libido,
erectile dysfunction and many other serious side effects.

Statins: Zocor (simvastatin), Lipitor (atorvastatin), Crestor
(rosuvastatin), Mevacor (lovastatin), Pravachol (pravastatin).

http://medicine.ucsd.edu/SES/adverse_effects.htm
Statin Side Effects

http://www.impostertrial.com
(Is Myopathy Part of Statin Therapy?)

~~~~~~~~~~~~~~~

Cardiovasc Drugs Ther. 2003 Sep-Nov;17(5-6):459-65.     Related Articles,
Links
   Click here to read
   A comprehensive description of muscle symptoms associated with
lipid-lowering drugs.

   Franc S, Dejager S, Bruckert E, Chauvenet M, Giral P, Turpin G.

   Department of Endocrinology, Hopital de La Pitie-Salpetriere,
Assistance Publique-Hopitaux de Paris, 83 Bd de L'Hopital, 75013 Paris,
France. sylvia.franc@free.fr

   A spectrum of disease from myalgia to rhabdomyolysis exists as
classic side-effect of lipid-lowering treatment (LLT). While myopathy
has generated considerable interest, mild musculo-skeletal symptoms are
poorly assessed. OBJECTIVE: To report on the muscular side-effects of
LLT with a particular focus on the overlooked milder ones. METHODS:
Hyperlipidemic patients under LLT and complaining of muscle symptoms
were asked to complete a self administered questionnaire. Among the 815
adult hyperlipidemic patients under LLT and referred to the
cardiovascular prevention unit of La Pitie Hospital, 165 patients
answered that they experienced, or had experienced, muscle symptoms
which they attributed to the LLT. One hundred and thirty three of these
completed and returned a self-administered questionnaire. RESULTS: A
clear chronological link between symptoms and the LLT was revealed,
either because they appeared soon after drug initiation or because of
an improvement after drug withdrawal. While cramps and stiffness were
the most frequent symptoms, tendonitis-associated pain was surprisingly
common, reported in almost half the cases. Pain was often diffuse with
a focus on a given location, mainly lower limbs. 39% of patients had
used analgesics for pain relief. Unpredictably, a majority of patients
reported pain during rest and the lying position. In a number of cases,
a family history of pain under LLT was revealed. CONCLUSION: The impact
of these mild symptoms on daily activities might not be negligible in a
subset of patients. The role and importance of a genetic background
predisposing to low-grade myopathy deserves further investigation.

   PMID: 15107601 [PubMed - indexed for MEDLINE]

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

> A friend in good physical shape and a regular exerciser, following
> his normal routine, suddenly develops severe tendonitis in both
[quoted text clipped - 6 lines]
> producing this kind of adverse reaction?  It seems to be an almost
> bizarre effect.
George - 12 Jun 2005 16:31 GMT
>A friend in good physical shape and a regular exerciser, following
>his normal routine, suddenly develops severe tendonitis in both
[quoted text clipped - 6 lines]
>producing this kind of adverse reaction?  It seems to be an almost
>bizarre effect.

I appreciate the responses.  Sorry I didn't have the details on what
he was taking.  I still don't know everything, but confirmed
that recent additions (i.e. - within the last six months) include
both Lipitor (statin) and Cipro (flurorquinolone).

I took the opportunity to play doctor on TV, and told him that as
side effects go, this is a pretty serious one, and that he needed to
talk to his doctor right away (which he hadn't done).

Thanks for the information.
 
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