- Marc L Miller, MD
Marc L Miller, MD
- Clinical Assistant Professor of Medicine
- Tufts University School of Medicine
- Section Editors
- Ira N Targoff, MD
Ira N Targoff, MD
- Section Editor — Muscle Disease
- Professor of Medicine, Section of Rheumatology
- University of Oklahoma Health Sciences Center
- Jeremy M Shefner, MD, PhD
Jeremy M Shefner, MD, PhD
- Section Editor — Neuromuscular Disease
- Professor and Chair of Neurology, Barrow Neurological Institute
- Professor of Neurology, University of Arizona, Phoenix
- Clinical Professor of Neurology, Creighton University
Although the precise incidence is unknown, drug-induced myopathy is among the most common causes of muscle disease. Drug-induced myopathy ranges from mild myalgias with or without mild weakness to chronic myopathy with severe weakness and to massive rhabdomyolysis with acute renal failure [1,2]. Over 150 agents have been associated with rhabdomyolysis . This topic will review drug-induced myopathies. Rhabdomyolysis and statin myopathy are discussed in detail separately. (See "Causes of rhabdomyolysis" and "Clinical manifestations and diagnosis of rhabdomyolysis" and "Statin myopathy".)
Drug-induced myopathy may result from several different mechanisms [4,5]:
●Direct myotoxicity – Examples include alcohol, cocaine, glucocorticoids, lipid-lowering drugs, antimalarials (which are associated with vacuolar myopathies), colchicine (which is associated with vacuolar myopathies), and zidovudine (which causes a mitochondrial myopathy).
●Immunologically induced inflammatory myopathy – The myopathy associated with D-penicillamine is an example of this mechanism.
●Indirect muscle damage – This problem can occur by a variety of mechanisms including drug-induced coma with subsequent ischemic muscle compression, drug-induced hypokalemia (eg, diuretics), drug-induced hyperkinetic states (eg, delirium tremens or seizures secondary to alcohol), dystonic states associated with phenothiazines, hyperthermia related to cocaine use, and the neuroleptic malignant syndrome.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- DRUGS CAUSING DIRECT MYOTOXICITY
- - Acute myopathy
- - Chronic myopathy
- Lipid-lowering drugs
- Antimalarial drugs
- Antipsychotic drugs
- Antiretroviral drugs
- Chemotherapeutic agents
- DRUGS CAUSING AN IMMUNOLOGICALLY MEDIATED MYOPATHY
- Tumor necrosis factor inhibitors
- Interferon alfa