Myalgia Side Effect

Myalgia (muscle pain or aching) is characterised by diffuse muscle pain, tenderness and cramps.

Common drugs which most frequently induce myalgia are fluoroquinilones, corticosteroids, statins, fibrates, antimalarials, diuretics3, corticosteroids, drugs causing hypokalaemia, immunosuppressants. Certain combinations of drugs (e.g. cyclosporin and colchicine) can induce severe muscle diseases5, 6.

Statins are among the most well-recognized myotoxic drugs. Muscle aches, cramps and weakness can occur in up to 25% of patients taking statins1, 2. Statin-induced muscle adverse effects may be exacerbated by exercise. A possible mechanism of statin induced myopathy is a decrease in coenzyme Q10, a product of the mevalonate pathway.

Drugs, that have been reported to cause muscle pain:

Drug Incidence
Abelcet
Abilify > 2%
Accolate 1.6%
Accupril 1.5%
Accuretic 2.4%
Aceon 0.3% to 1.1%
Aciphex
Actimmune 6%
Actiq < 1%
Activella
Actonel 4.6% to 6.6%
Actos 5.4%
Adalat < 1%
Advicor 3%
Aggrenox 1.2%
Agrylin 1% to 5%
Aldara 1% to 1.4%
Aldoclor
Aldoril
Alferon N < 45%
Alinia < 1%
Altace < 1%
Altoprev 3%
AmBisome 2% to 10%
Ambien 1% to 7%
Amevive > 2%
Amiodarone (Cordarone®)5
Anaprox < 1%
Aranesp 8% to 21%
Arava 1% to 3%
Aredia 26%
Arimidex 2% to 5%
Asacol 3%
Astelin 1.5%
Atacand > 0.5%
Augmentin
Avalide
Avapro > 1%
Avelox 0.11% to 3%
Avonex 29%
Axert Infrequent
Axid 1.7%
Azasan
Azmacort Inhalation Aerosol 1% to 3%
Beconase
Benicar > 0.5%
Betaseron for SC 27%
Bextra 1.9% to 2%
Biltricide
Brimonidine Tartrate 3% to 9%
Busulfex I.V. 16%
Caduet 0.1% to 5.6%
Calcijex
Calcium Disodium Varsenate
Campath 11%
Campral < 10%
Cancidas < 3.1%
Captopril
Carbatrol
Casodex 5%
Catapres < 0.6%
Celebrex 0.1% to 1.9%
Celexa 2%
CellCept 3% to < 20%
Cenestin 3.8% to 28%
Cialis 1% to 4%
Clarinex 3%
Clinoril < 1%
Clomid
Clorpres 0.6%
Clozapine 1%
Clozaril 1%
Colazal 1%
Combivir 8%
Copaxone > 2%
Copegus 40%
Cosmegen
Coumadin
Cozaar > 1%
Crestor 2.8%
Crinone 8%
Cubicin < 1%
Cymbalta 1% to 4%
Cytovene
DTIC-Dome Infrequent
Dantrium
Demadex 1.6%
Depacon 1% to 5%
Depakene 1% to 5%
Depakote 1% to 5%
Desferal Vials
DiaBeta
Diovan
Diprivan Injectable Emulsion < 1%
Dolobid < 1%
Dostinex 2%
Doxil 1% to 5%
Dyazide
EC-Naprosyn < 1%
Effexor
Eligard 2.2%
Eloxatin 2% to 5%
Emend > 0.5%
Emtriva 4% to 6%
Engerix-B < 1%
Epivir-HBV 14%
Epivir 8%
Epogen Rare
Evista 7.7%
Evoxac 1% to 3%
Exelon Frequent
Factive < 0.1%
Faslodex < 1%
FazaClo 1%
Ferrlecit > 1%
Flexeril Rare
Flolan 3% to 44%
Flovent 1% to 3%
Floxin < 1%
Fludara 4% to 16%
Flumist 5% to 16.7%
Fortovase < 2%
Fosamax 0.4% to 6%
Furosemide
Fuzeon 5%
Gabitril 1% to 5%
Gamimune N
Gastrocrom 3.4%
Gengraf 1% to 3%
Genotropin Lyophilized Powder
Geodon 1%
Gleevec 0.2% to 38.6%
Glucotrol < 3%
HIVID 0.4%
Havrix Vaccine < 1%
Hectorol,
Humatrope Vials and Cartridges 9.1% to 24.3%
Hytrin > 1%
Hyzaar
Imitrex 1.8%
InFeD
Infergen 51% to 58%
Intal Inhaler Rare
Intron A 3% to 75%
Invirase 0.3% to 2%
Isotretinoin (Accutane®)3
Jantoven
Kaletra < 2%
Klonopin 1%
Lamictal > 1%
Lamisil
Lariam 1% to 10%
Lescol 3.8% to 5%
Leukine 18%
Leustatin 7%
Levaquin 0.1% to 1%
Levitra < 2%
Lexapro
Lipitor < 5.6%
Lofibra
Lotensin < 1%
Lotrel
Lotronex Rare
Lupron 5% to 8.2%
M-M-R II
Marinol < 1%
Matulane
Mavik 4.7%
Maxalt < 1%
Maxzide
Meridia 1.9%
Meruvax II
Mevacor 1.8% to 2.4%
Miacalcin 1% to 3%
Micardis 1%
Mirapex > 1%
Monurol Sachet < 1%
Myfortic 3% to 20%
Mylotarg 3% to 11%
Nabi-HB 10%
Naprosyn < 1%
Naropin < 1%
Nasonex > 2%
Navelbine < 12%
Neoral 1% to 3%
Neulasta 15% to 72%
Neumega > 10%
Niaspan
Nimotop < 1.4%
Nipent 11% to 19%
Norditropin Cartridges
Noroxin
Norvasc 0.1% to 1%
Norvir 1.7% to 2.4%
Oncaspar 1% to 5%
Ontak Vials 17%
OptiPranolol Metipranolol
Orap 2.7%
Orthoclone OKT3 < 1%
PEG-Intron 54%
Paxil 2%
Pegasys 37%
Pentasa < 1%
Pepcid Infrequent
Periostat 1%
Permax 1.1%
Persantine Rare
Pletal 2% to 3%
Pneumovax 23
Pravachol 0.6% to 2.7%
Premarin 5% to 9%
Premphase 4% to 5%
Prempro 4% to 5%
Prevacid < 1%
Prevpac 1% to 3%
Prilosec < 1%
Prinivil 0.3% to 1%
Prinzide 0.3% to 1%
ProSom Infrequent
Prochieve
Procrit Rare
Prograf 3% to 15%
Proleukin 6%
Prometrium < 5%
Protonix I.V. < 1%
Protonix < 1%
Protopic < 3%
Provigil > 1%
Prozac
Pulmicort 1% to 3%
Rabies Vaccine RebAvert 53%
Rapamune 3% to 20%
Raptiva 8%
ReFacto Vials
Rebetol 32% to 64%
Rebetron 61% to 64%
Rebif 25%
Recombivax < 1%
Relenza Rotadisk < 1.5%
Relpax Infrequent
Remicade for I.V.
ReoPro Vials 0.3%
Requip > 1%
Rescriptor
Retrovir 8%
Reyataz < 3%
RhoGAM Ultra-Filtered
Ribavirin 50% to 64%
Rifater
Risperdal < 5%
Rituxan 7%
Rocaltrol
Roferon-A 51% to 73%
Rythmol
Salagen 1% to 2%
Sandimmune < 2%
Sandostatin < 18%
Sensipar 15%
Septra
Serevent Diskus 1% to 3%
Simulect 3% to 10%
Sonata > 1%
Soriatane 1% to 10%
Spectracef 0.1% to 1%
Spiriva HandiHaler 4%
Sporanox 1% to 3%
Strattera 3%
Stromectol 0.4%
Sular < 1%
Suprane < 1%
Sustiva < 2%
Synercid I.V. < 1%
Synvisc
Tagamet Rare
Tambocor < 1%
Targretin
Tarka > 0.3%
Tasmar 1% to 10%
Taxotere 1% to 21.1%
Tegretol
Temodar 5%
Tequin < 0.1%
Teveten > 1%
Thalomid
Tiazac 2%
Timentin
Timolide < 1%
Tindamax
Topamax 2%
Toprol-XL
Toradol
Tricor
Trisenox 25%
Trizivir 8%
Truvada
Twinrix < 1%
Uniretic < 1%
Univasc 1.3%
VFEND < 1%
Vantin < 1%
Vaqta 1.9%
Varivax > 1%
Vaseretic
Vasotec I.V. 0.5% to 1%
Velcade 14%
Vesanoid 14%
Viagra < 2%
Vicoprofen < 1%
Videx EC
Voriconazole (Vfend®)7
Viracept < 2%
Viramune
Viread 3% to 4%
Vivelle
Vytorin 3.5%
Welchol 2%
WinRho
Xalatan 1% to 2%
Xanax 1.5%
Xeloda 5% to 9%
Xenical 4.2%
Xifaxan < 2%
Xopenex 1.5%
YF-Vax 10% to 30%
Zantac Rare
Zegerid < 1%
Zelnorm 1%
Zemaira 0.2% to 0.4%
Zenapax for 2% to 5%
Zerit 32%
Zetia 5%
Zevalin 7%
Ziagen
Zocor
Zofran 10%
Zoladex 3%
Zoloft 1% to 10%
Zometa 23%
Zomig 1% to 2%
Zonegran Infrequent
Zosyn < 1%
Zovirax
Zyban 2% to 4%
Zyprexa
Zyrtec < 2%

Advertisement


Many medications can cause toxicity in muscle tissue, leading to significant muscle pain and sometimes morbidity. Myotoxic drugs can affect muscles through a variety of mechanisms by directly affecting muscle mitochondria, lysosomes, and myofibrillar proteins; altering muscle antigens and triggering an immunologic or inflammatory reaction; or by impairing the electrolyte or nutritional balance.

References
  • 1. Parker BA, Thompson PD. Effect of statins on skeletal muscle: exercise, myopathy, and muscle outcomes. Exerc Sport Sci Rev. 2012 Oct;40(4):188-94. PubMed
  • 2. Phillips PS, Haas RH, Bannykh S, Hathaway S, Gray NL, Kimura BJ, Vladutiu GD, England JD. Statin-associated myopathy with normal creatine kinase levels. Ann Intern Med. 2002;137(7):581–5.
  • 3. Chroni E, Monastirli A, Tsambaos D. Neuromuscular adverse effects associated with systemic retinoid dermatotherapy. Drug Saf. 2010 Jan 1;33(1):25-34. PubMed
  • 4. Greenberg A. Diuretic complications. Am J Med Sci. 2000 Jan;319(1):10-24. PubMed
  • 5. Le Quintrec JS, Le Quintrec JL. Drug-induced myopathies. Baillieres Clin Rheumatol. 1991 Apr;5(1):21-38.
  • 6. Finsterer J1. Medically induced myopathia. Nervenarzt. 2006 Jun;77(6):682-6, 688-93. PubMed
  • 7. Wise SM, Wilson MA. A case of periostitis secondary to voriconazole therapy in a heart transplant recipient. PubMed

Published: September 07, 2016
Last updated: September 08, 2016

Advertisement

Home | Contact Us | Cookies Policy

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here



Copyright 2007-2018 eMedExpert.com. All rights reserved.
All information is for educational purposes only.