I'm 15 and a week ago I was prescribed Ciprofloxacin as a first line medication for an uncomplicated Uti. I was told by my physician (which seems to be rather irresponsible for giving me this medicine) to take a 500mg pill every 12 hours. I started taking it on Wednesday night. Friday morning I started to read about the drug and found out it was pretty dangerous, how it shouldn't be used as first line antibiotics, caused tendon damage etc. So I called my physician and told him I was a bit concerned. I had already taken 3 tablets at the time (following the every 12 hours recommendation) and it was approximately time to take the 4th tablet. He then told me to take this 4th tablet and then stop the medicine. I did as he said.
Upon some research I became aware that Cipro (as others fluoroquinolones) has a few fluoride atoms. Seeing as fluoride plays a big role in its composition, and tablets receive as big as 750mg, couldn't that cause a severe skeletal fluorosis or something of the sort?
Oh, anyways, I didn't receive any major side effects from the medicine (at least so far). Apart from I've been experiencing some pain in my left arm (this one started just a few hours ago) and had some pain in the legs during the past few days. I've been off it since Friday and took those 4 tablets only. I got my urine tested today to see whether I still had the bacteria (or had it become even worse) and it seems that my urine is now normal. I plan on never seeing that urologist again. Is it possible to litigate him for misuse of antibiotics?
Also, I don't live in the U.S so Cipro has no Black Box Warning here. That's partly why it took me so long to find out approximately all the risks involved.
Okay.. wow.
First, fluoroquinolones are frequently used as first choice antibiotics against Utis, particularly when there is reason to suspect some antibiotic resistance, or an atypical infective organism. Antibiotic selection can receive a little complicated depending on the age, gender, medical history of the patient - notably how frequently they have Utis. Cipro's ability to penetrate into the bladder intact, and extremely broad spectrum of antibiotic action make it a good selection.
Fluoroquinolone tendon damage is problematic primarily in athletes, or otherwise very physically active people, usually those who indulge in very high impact fitness training who do not discontinue their training while taking the medication for a longer period of time. It is practically unheard of to see tendon damage in your average member of the population, particularly for a short course of therapy. If you are running marathons on a steady basis, this would be something to worry about.
Fluoride is the ion. Fluorine is the atom. In Cipro, the Fluorine is attached to a benzene ring central to the molecule's constitution, to which it is covalently bonded. Removing that strong an electrophilic atom from a benzene ring... let's put it this way. This is not going to happen under physiological conditions. So no, it could not cause skeletal fluorosis, as there is no way to liberate fluoride ions from the chemical compound for them to be incorporated into bone.
I do not know about your locale, but in the Us you could not litigate. You have no cause of action, and endured to harm. There is no malpractice, as prescribing Cipro is well within the clinical guidelines of every reputable medical society, major review and insurance company policy of note.
Just because fluorine is attached to something doesn't really intend anything - after all, you don't receive sick from the 2 hydrogens attached to all of the water you alcohol - the fluorine atom is part of the molecule, and isn't randomly going to fall off. Fluorine plays a big role because it modifies the properties of the compound as a whole, giving the drug the characteristics that make it an effective antibiotic - not because there is a bunch of fluorine just sitting in there (it's one unmarried atom, on a enormous honking molecule).
Without knowing your particular situation, I can't say if Cipro was the right selection or not - it might not be ideal, but it likely isn't an absolutely wrong selection either. There are a lot of factors that must be considered when choosing an antibiotic to treat any infection - like with any medication, there are potential side effects, which is why you only use a medication when the potential increase exceeds the potential harm. In your case, I doubt that your 4 pills of cipro has anything to do with your hurting. For the major side effects you mention, I'll use the most infamous example, tendon damage. The risk of any sort of tendon injury is between 0.1 and 0.4 and occurred on average after 13 days. The risk of the worst case scenario, tendon rupture, was 0.08 or about 2x the chance of just any random person on the street having a tendon rupture for any reason. These are exceedingly small numbers - the potential benefit from using the drug when it is needed far, far outweighs the risks, which is why it is used so widely. So, no, you probably don't have any case for a lawsuit, and no, you probably don't have any injuries from the drug, so for now, just relax and enjoy not having a Uti.