PT  - JOURNAL ARTICLE
AU  - Dalakas, M C
TI  - Toxic and drug-induced myopathies
AID  - 10.1136/jnnp.2008.168294
DP  - 2009 Aug 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 832--838
VI  - 80
IP  - 8
4099  - http://jnnp.bmj.com/content/80/8/832.short
4100  - http://jnnp.bmj.com/content/80/8/832.full
SO  - J Neurol Neurosurg Psychiatry2009 Aug 01; 80
AB  - Drugs used for therapeutic interventions either alone or in combination may sometimes cause unexpected toxicity to the muscles, resulting in a varying degree of symptomatology, from mild discomfort and inconvenience to permanent damage and disability. The clinician should suspect a toxic myopathy when a patient without a pre-existing muscle disease develops myalgia, fatigue, weakness or myoglobinuria, temporally connected to the administration of a drug or exposure to a myotoxic substance. This review provides an update on the drugs with well-documented myocytoxicity and cautions the clinicians to be alert for the potential toxicity of newly marketed drugs; highlights the clinical features and pathomechanisms of the induced muscle disease; and offers guidance on how best to treat and distinguish toxic myopathies from other acquired or hereditary muscle disorders. Practical issues regarding the diagnosis and management of statin-induced myopathies are emphasized. Myotoxicity resulting from direct insertion of transgenes to the muscle, an exciting new tool currently tested for treatment of muscular dystrophies, is also discussed.