The Food and Drug Administration (FDA) is strengthening the current warnings in the prescribing information that fluoroquinolone antibiotics may cause significant decreases in blood sugar and FDAcertain mental health side effects. The low blood sugar levels can result in serious problems, including coma, particularly in older people and patients with diabetes who are taking medicines to reduce blood sugar. The FDA is making these changes because a recent review found reports of life-threatening low blood sugar side effects and reports of additional mental health side effects.

The FDA is requiring these updates in the drug labels and to the patient Medication Guides for the entire class of fluoroquinolones. This affects only the fluoroquinolone formulations taken by mouth or given by injection. Blood sugar disturbances, including high blood sugar and low blood sugar, are already included as a warning in most fluoroquinolone drug labels; however, we are adding that low blood sugar levels, also called hypoglycemia, can lead to coma.

Across the fluoroquinolone antibiotic class, a range of mental health side effects are already described under Central Nervous System Effects in the Warnings and Precautions section of the drug label, which differed by individual drug. The new label changes will make the mental health side effects more prominent and more consistent across the systemic fluoroquinolone drug class. The mental health side effects to be added to or updated across all the fluoroquinolones are disturbances in attention, disorientation, agitation, nervousness, memory impairment, and serious disturbances in mental abilities called delirium.

For more information, please visit: Fluoroquinolones.

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