Which medication would INCREASE the risk of an Achilles tendon rupture?

• A. Amiodarone
• B. Ciprofloxacin
• C. Simvastatin
• D. Digoxin

Answer: (B)

Fluoroquinolone antibiotics significantly raise the risk of Achilles tendon rupture. These drugs can damage tendons by altering collagen synthesis and tenocyte function, likely through oxidative stress and disruption of the extracellular matrix. The risk is higher in older adults, those with kidney disease, and individuals on corticosteroids. Clinically, if tendon pain, swelling, or rupture symptoms appear while on a fluoroquinolone, discontinue the medication and choose an alternative if possible. The other listed medications do not have a notable association with tendon rupture.