EMA Warnings

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European Medicines Agency’s (EMA) Fluoroquinolone Press Release 2019:

https://www.ema.europa.eu/en/documents/referral/quinolone-Fluoroquinolone-article-31-referral-disabling-potentially-permanent-side-effects-lead_en.pdf

European Medicines Agency’s (EMA) Fluoroquinolone Public Hearing 2018:

https://www.ema.europa.eu/en/documents/other/public-hearing-quinolone-Fluoroquinolone-written-interventions_en.pdf

Pharmacovigilance Risk Assessment Committee (PRAC) Assessment report 2018:

https://www.ema.europa.eu/en/documents/referral/quinolone-Fluoroquinolone-article-31-referral-assessment-report_en.pdf

Tendon disorders

• Oxidative stress (ROS overproduction)
• Mitochondrial damage
• Inhibition of tenocytes proliferation 
• Inhibition of tenocytes migration
• Enhanced expression of matrixmetalloproteinases (MMPs)
• Induced apoptosis
• Chelation of metal ions by quinolones
• Ischemia and contribution of poor vascularization in tendon tissue

Neurotoxicity

Neuropathies

Phototoxicity

Vasculitis