The blanket term tendinopathy covers various painful types of tendon inflammation (tendonitis etc.). The causes are not well understood but tendinopathy is often associated with over-use of the tendon. Some drug groups are known to expose patients to tendinopathy, which is generally reversible, but sometimes has debilitating after-effects. Tendinopathy often affects the Achilles tendon, sometimes even leading to rupture.

All fluoroquinolone antibiotics expose patients to tendinopathy, including single-dose treatments and ear drop medication.

In the cases reported in France, tendinopathy linked to statins (cholesterol-lowering drugs) occurred within an average of 8 months after starting the drug. Corticosteroids expose patients to tendinopathy, in whatever form they are administered, but especially oral or intra-articular injection.

Other drugs risk causing tendinopathy to a lesser degree: some oral retinoids (acne or psoriasis treatment), aromatase inhibitors (such as anastrozole).

Anabolic steroid abuse to boost muscle mass is sometimes a contributory factor in tendinopathy.

Patients are even more exposed to drug-related tendinopathy when other factors are present: old age, posture anomalies, rheumatic disease, gout, practising a sport, a history of tendinopathy or the combination of several drugs linked to tendinopathy. These risk factors should be taken into account when prescribing a drug known to expose patients to tendinopathy.

©Prescrire 1 September 2016

"Drug-induced tendon damage" Prescrire Int 2016; 25 (174): 212-213. (Pdf, subscribers only).