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Drug-induced myopathies
Other Resources UpToDate PubMed

Drug-induced myopathies

Contributors: Erin Keenan MLIS, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Drug-induced myopathies occur when a drug causes a toxic effect that results in myalgia, muscle damage, and/or muscle breakdown. Most drug-induced myopathies are reversible upon drug discontinuation if recognized early. They commonly include acute mild to severe myalgia and/or muscle weakness, sometimes accompanied by serum creatine kinase (CK) elevations.

More severe drug-induced myopathies can include chronic myopathy, myositis (dermatomyositis, polymyositis), myonecrosis, or rhabdomyolysis with the potential for life-threatening complications of myoglobinuria, hyperkalemia, and acute renal failure.

Other signs and symptoms include muscle soreness, tenderness, swelling, stiffness, spasms, cramps, diminished tendon reflexes, dyspnea, dysphagia, weight loss, oliguria, discolored urine, and/or exercise intolerance. A patient may also present with fatigue and generalized, symmetrical weakness, typically proximal. Pain is not always present. Sometimes patients are asymptomatic.

Statins are a known cause of myopathy, and the risk and severity of muscle toxicity increases with dose. Patients with statin-induced myopathy may present with flu-like symptoms along with muscle complaints. Other associated medications include fibrates (gemfibrozil), corticosteroids (prednisone), cyclosporine, daptomycin, cimetidine, penicillamine, levodopa, interferon-a, gemcitabine, procainamide, laxatives, diuretics, zidovudine, chloroquine, hydroxychloroquine, emetine, vincristine, isotretinoin, colchicine, excessive antacids, antipsychotic drugs, tumor necrosis factor (TNF) inhibitors, heroin, cocaine, and amphetamine. Alcohol can also induce myopathy. Alcohol-induced myopathy typically presents hours after a binge-drinking episode in patients with a history of chronic alcohol use.

Related topics: Immune-mediated necrotizing myopathy, Mitochondrial myopathy, Drug-induced muscle spasm


G72.0 – Drug-induced myopathy

240101000 – Drug-induced myopathy

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Viral myositis
  • Inclusion body myositis
  • Alcohol use disorder
  • Amyotrophic lateral sclerosis (ALS)
  • Critical illness neuropathy
  • Chronic inflammatory demyelinating polyneuropathy (CIDP)
  • Inherited muscular dystrophies (Duchenne muscular dystrophy, Limb-girdle muscular dystrophy, Becker muscular dystrophy, Oculopharyngeal muscular dystrophy, Myotonic dystrophy)
  • Glycogen storage disease type 2
  • Glycogen storage disease type 5
  • Cushing syndrome
  • Radiation dermatitis
  • Heart failure
  • Hypothyroidism
  • Myasthenia gravis
  • Infections (Human immunodeficiency virus primary infection [HIV], Secondary syphilis, Tuberculosis, Cytomegalovirus infection, Epstein-Barr virus infection, Adenovirus infection)
  • Polymyalgia rheumatica
  • Fibromyalgia
  • Arthritis
  • Drug-induced arthralgia
  • Sarcoidosis
  • Systemic lupus erythematosus
  • Muscle injury or sprain

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:04/03/2018
Last Updated:04/03/2018
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Drug-induced myopathies
A medical illustration showing key findings of Drug-induced myopathies : Muscle weakness, Creatine kinase elevated, Myalgia
Copyright © 2024 VisualDx®. All rights reserved.