The TGA is putting stricter warnings on fluoroquinolones over rare but “potentially irreversible” reactions, including toxic psychosis, seizures and tendon ruptures.

All oral and injectable fluoroquinolones, including ciprofloxacin, will get boxed warnings about potential CNS, psychiatric and musculoskeletal effects, the TGA announced last week.

The reactions “can occur in patients of any age without pre-existing risk factors and have been reported simultaneously in the same patient”, the TGA said.

The warnings do not apply to fluoroquinolone eye or ear drops.