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Avelox – Aortic Aneurysm & Dissection

Avelox is a fluoroquinolone-type antibiotic which may cause serious cardiac and other severe side effects. Because of these risks, its is only recommended for use in serious infections in adult patients.

Avelox (moxifloxacin)

Avelox (moxifloxacin) is an antibiotic that is made by pharmaceutical giant, Bayer. It is classified as a fluoroquinolone or “floxin” and was introduced as a treatment for a wide range of infections. Serious concerns about Avelox and other fluoroquinolones have prompted the U.S. Food and Drug Administration to limit its use to adults with serious infections or infections which cannot be treated with other medications.

Manufacturing information

Brand NameAvelox
Generic Namemoxifloxacin
Classification Fluoroquinolone antibiotic
ManufacturerBayer
Dosage form(s)400mg tablet400mg/250ml solution for IV infusion
Normal dosage400mg daily

Avelox FDA Warnings

The FDA requires that Avelox and related “floxin” or fluoroquinolones include black box or boxed statement warnings about risks of the antibiotics. The black box warning is the most serious safety notice that is given by the FDA.

Avelox’s boxed statement or black box warns that it may increase the risk for:

  • Tendinitis and tendon rupture
  • Peripheral neuropathy
  • Central nervous system damage
  • Worsening of muscle conditions like myasthenia gravis

The black box warning also recommends that Avelox be reserved for serious infections and infections which are not treatable with other medications. Avelox should not be used in children or in adults who are at risk for collagen disorder or those who are at risk for aortic injuries such as the elderly or those with high blood pressure. Avelox use has been linked to an increased risk of aortic aneurysm or aortic dissection which can lead to hemorrhage and death.

How Does Avelox Work?

Avelox works to treat bacterial infections by blocking enzymes used for DNA synthesis. Blocking these enzymes will prevent bacteria from reproducing or repairing cell membranes and surfaces and leading to bacterial cell death.

Avelox was once used for a wide range of infections but is now limited to more serious conditions including:

  • Complicated skin and structure infections
  • Uncomplicated skin and structure infections caused by MRSA
  • Nosocomial or community-acquired pneumonia
  • Complicated Intra-abdominal infections
  • Plague

Avelox may also be used in patients who have no other treatment options in:

  • Acute bacterial exacerbation of chronic bronchitis
  • Acute bacterial sinusitis

Avelox Side effects

All medications cause side effects. Most Avelox side effects are mild to moderate and will go away with time or are tolerable. Other Avelox side effects may be more severe or even life-threatening and warrant medical attention.

Common Avelox side effects:

  • Nausea and vomiting
  • Headache
  • Dizziness
  • Diarrhea or constipation
  • Itching

Severe Avelox side effects:

  • Tendon rupture or damage
  • Central nervous system effects
  • Peripheral nerve damage
  • Severe allergic reaction or anaphylaxis
  • Aortic aneurysm or dissection

Symptoms of severe Avelox complications should be reported to a healthcare professional immediately. Symptoms such as chest or abdominal pain, changes in consciousness, sudden pain in arms, legs or muscles or difficulty breathing should be treated as a medical emergency.

Avelox Aortic Aneurysm and Aortic Dissection

Fluoroquinolones like Avelox can disrupt the formation and structure of collagen which is the largest portion of what makes cartilage. Disruption of collagen is how Avelox may cause tendinitis and tendon rupture, but it may have a more serious consequence on the aorta.

The aorta is the largest blood vessel in the body and carries blood from the heart to the rest of the body. It is a rigid vessel which gets its structure from collagen. When Avelox disrupts collagen structure, it may weaken the wall of the aorta. Once weakened, it may bulge and form an aneurysm. In other cases, the collagen weakening may allow the layers of the aorta to separate. In either case, the vessel may tear and result in massive uncontrolled bleeding or hemorrhage and quickly result in death.

Though it is not currently part of the black box warning for Avelox, the FDA issued a December 20108 safety alert which warns that fluoroquinolones may increase the chance for potentially fatal aortic injuries. The increased risk can begin as soon as medications are started and last up to 60 days after Avelox is discontinued. The safety alert recommends that Avelox use be restricted in patients who have high blood pressure, are elderly or have a history of collagen disorder as they may be at greater risk for aortic injury.

Some fluoroquinolone antibiotics have been withdrawn or discontinued from the market due to toxicity. Levaquin’s maker has opted to discontinue manufacturing the medication and once existing Levaquin supplies are exhausted, Avelox and sister medication, Cipro will be the only remaining fluoroquinolones still in use for oral treatment.

Avelox Lawsuits

Bayer, Avelox’s manufacturer, is facing a number of Avelox lawsuits and lawsuits for its other fluoroquinolone, Cipro. Federal Avelox and Cipro lawsuits have been consolidated into multidistrict litigation (mdl) but other cases have been filed in many state and local courts. People or loved ones of those who experienced complications or died because of Avelox use should seek legal advice.

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