Can Levaquin Cause Plantar Fasciitis? Understanding Fluoroquinolone Risks

October 14, 2025 •

2 min read

The Food and Drug Administration (FDA) has placed a Black Box warning on Levaquin and other fluoroquinolone antibiotics due to the increased risk of serious side effects, including tendon damage. While the Achilles tendon is the most commonly affected, reports confirm that can Levaquin cause plantar fasciitis or similar tendinopathy in the foot.

Quick Summary

Levaquin is associated with a risk of tendinitis, an inflammation of tendons, which can affect the plantar fascia and cause symptoms akin to plantar fasciitis. This adverse effect can occur during or months after treatment, particularly in higher-risk individuals like the elderly or those taking corticosteroids.

Key Points

Black Box Warning: Levaquin carries an FDA Black Box warning for serious adverse reactions, including tendinitis and tendon rupture.
Tendon Damage Connection: The antibiotic can damage the body's collagen, causing inflammation and weakening tendons, potentially leading to plantar fasciitis-like pain in the feet.
High-Risk Groups: Elderly patients (over 60), those on corticosteroids, and organ transplant recipients face the highest risk of tendon problems with Levaquin.
Delayed Onset Possible: Tendon issues can develop during treatment or up to several months after stopping the medication.
Immediate Action Required: If you experience foot or ankle pain while on Levaquin, stop taking the medication and contact your doctor immediately to prevent severe injury.
Different From Typical Plantar Fasciitis: While the symptoms are similar, Levaquin-induced tendinopathy has a specific drug-related cause and requires different management.

Levaquin and the Risk of Tendon Damage

Levaquin (levofloxacin) is a powerful fluoroquinolone antibiotic used for serious bacterial infections. It carries an FDA Black Box warning, the strongest safety warning, due to the risk of severe tendon damage.

How Can Levaquin Cause Plantar Fasciitis-like Pain?

Levaquin and similar antibiotics can cause tendinopathy, inflammation of tendons, which can manifest as pain similar to plantar fasciitis. These drugs may damage the body's collagen, weakening tendons and potentially leading to inflammation or rupture. This effect can occur in tendons throughout the body, including those in the feet, such as the plantar fascia.

Symptoms of Levaquin-Induced Tendon Pain

Symptoms can include pain, tenderness, swelling, and stiffness in the feet or ankles. A sudden pop or snap may indicate a tendon rupture, requiring immediate medical attention. Bruising can also occur with rupture.

Identifying Risk Factors

The risk of tendon problems with Levaquin is higher in certain groups:

Age: Patients over 60 have a greater risk.
Corticosteroid Use: Taking steroids concurrently significantly increases the risk.
Transplant or Kidney Disease: Those with organ transplants or kidney issues are at higher risk.
Physical Activity: Strenuous activity during treatment can increase risk.
Pre-existing Tendon Issues: Individuals with prior tendon disorders are more susceptible.

The Timing of Onset and Long-Term Effects

Tendon issues can arise quickly, sometimes within hours or days of starting Levaquin. Problems can also appear months after discontinuing the drug. In some instances, the damage can be long-lasting and potentially irreversible.

Comparison of Levaquin-Induced Tendinopathy vs. Chronic Plantar Fasciitis


Feature	Levaquin-Induced Tendinopathy	Chronic Plantar Fasciitis (Typical)
Underlying Cause	Drug-induced collagen damage.	Repetitive stress, obesity, or foot structure issues.
Onset	Often sudden, during or after drug use.	Typically develops gradually.
Location of Pain	Can affect various tendons, including plantar fascia.	Primarily heel and arch of the foot.
Risk Factors	Age > 60, corticosteroid use, transplant, kidney disease.	Age 40-60s, obesity, prolonged standing, specific activities.
Associated Symptoms	May include nerve symptoms.	Usually limited to foot pain.
Treatment	Stop drug, rest, see doctor.	Rest, stretching, orthotics, therapy.

What to Do If You Experience Pain

If you take Levaquin and develop foot or ankle pain, stop the medication and contact your doctor immediately. Rest the area and avoid exercise. Your doctor can determine if a different antibiotic is needed. Prompt action is vital to prevent severe injury.

Conclusion

Medical evidence and regulatory warnings show that Levaquin can cause tendinopathy that mimics plantar fasciitis symptoms. Given the risk of potentially permanent consequences, awareness of these dangers is crucial for patients and doctors. Discuss risks and alternatives if prescribed a fluoroquinolone, especially with risk factors. Quick action is key to minimizing damage.

For more information, see the official MedlinePlus drug information for levofloxacin.

Frequently Asked Questions

Levaquin, a fluoroquinolone antibiotic, can cause tendinopathy, or inflammation of tendons, as a serious side effect. The plantar fascia, which is a thick tendon-like tissue on the bottom of the foot, can become inflamed, leading to pain and symptoms similar to traditional plantar fasciitis.

Tendon pain and inflammation can start very quickly, sometimes within hours or days of beginning the medication. However, symptoms can also appear weeks or even months after a patient has stopped taking Levaquin.

The damage can be prolonged, disabling, and in some cases, potentially irreversible. For many, symptoms improve after discontinuing the drug, but some individuals experience persistent pain and disability.

Those at highest risk include patients over 60, individuals with a history of heart, kidney, or lung transplants, and people also taking corticosteroids like prednisone.

You should stop taking Levaquin immediately and contact your healthcare provider. Avoid exercise or putting strain on the affected area. Your doctor can assess your condition and switch you to a different antibiotic.

Yes, the risk of tendinopathy and tendon rupture is a class-wide effect of fluoroquinolone antibiotics. Ciprofloxacin (Cipro) and moxifloxacin (Avelox) also carry the same Black Box warning from the FDA.

It is not recommended to engage in strenuous physical activity or exercise while taking Levaquin, as it increases the risk of tendon injury. It's best to discuss your activity level with your doctor.