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
- Viral myositis
- Inclusion body myositis
- Alcohol use disorder
- Amyotrophic lateral sclerosis (ALS)
- Critical illness neuropathy
- Chronic inflammatory demyelinating polyneuropathy (CIDP)
- Inherited muscular dystrophies (Duchenne, limb-girdle, Becker, oculopharyngeal, myotonic dystrophy)
- Glycogen storage disease type 2
- Glycogen storage disease type 5
- Cushing syndrome
- Radiation dermatitis
- Heart failure
- Myasthenia gravis
- Infections (human immunodeficiency virus [HIV], syphilis, tuberculosis, cytomegalovirus, Epstein-Barr, adenovirus)
- Polymyalgia rheumatica
- Drug-induced arthralgia
- Systemic lupus erythematosus
- Muscle injury or sprain