Frågedatum: 1993-09-14
RELIS database 1993; id.nr. 9638, DRUGLINE
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Sexual disturbances in connection with quinolone antibiotics./nA 40-year-old man has been treated



Fråga: "Sexual disturbances in connection with quinolone antibiotics. A 40-year-old man has been treated for two months with Ciproxin (ciprofloxacin) and Tarivid (ofloxacin) in "normal dosages" because of prostatitis, epididymitis and urinary tract infection. The patient stopped the treatment during the last week of 1992. In December and in January the ability to achieve and maintain an erection was decreased. (What about the duration of psychiatric side-effects after withdrawal of the drug?)"

Sammanfattning: Sexual dysfunction such as a failure to achieve erection have been associated with norfloxacin and ofloxacin in three cases. Rare side-effects such as psychiatric disturbances can persist for a few days.

Svar: A thorough literature search covering pharmacological handbooks and the databases Drugline, Medline, Swedis and Embase has been performed concerning sexual disorders in connection with any quinolone derivative.

One case report describing impotence after the use of norfloxacin was found in SADRAC (1). In this case the patient was treated with norfloxacin 200 mg a day because of urinary tract infection. After a couple of months of treatment, constipation, a decrease in potency and facial pimples occurred. The symptoms disappeared after withdrawal of the drug but reappeared upon reinstitution.

Another two cases of impotence in connection with ofloxacin were mentioned as adverse drug events in an overview of postmarketing experience in Germany (2). Nine hundred eighty five spontaneous reports received between June 1985 and December 1987 were reviewed.

Rare adverse events such as hallucinations and psychotic reactions were reported in 26 cases. The mean duration of these psychiatric symptoms was three days (3 hours - 9 days) (2). It cannot be excluded that the symptom in the present case has been caused by the drug. If so it will disappear upon withdrawal and we then suggest that this case be reported to SADRAC.

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