What Is Rhabomyolysis, and Should You Worry About It?

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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When you hear the phrase “a rare but serious side effect,” what comes to mind? With so many pharmaceutical commercials on television these days you may be be used to hearing that phrase.

Statins like Lipitor (atorvastatin), Zocor (simvastatin), and Crestor (rosuvastatin), are some of the most popular cholesterol medications, and they come with this “fine print” phrase. Statins can cause a rare but serious side effect called rhabdomyolysis.

What is rhabdomyolysis?

Rhabdomyolysis often characterized by muscle aches and pains is a rare but serious side effect caused by muscle injury which leads to the breakdown of muscle tissue that can cause harm to the kidneys. Rhabdomyolysis can cause kidney failure and, in rare cases, death.

What are the common signs and symptoms of rhabdomyolysis?

The common signs and symptoms of rhabdomyolysis include:

Just how rare is it?

Clinical studies have found the incidence of rhabdomyolysis as a side effect to statin use to be low—only 0.1 – 0.2 percent if you’re taking a statin alone, though it may be higher in combination with other medications. So, very rare.

Why is rhabdomyolysis a serious side effect?

Rhabdomyolysis can can lead to complications like kidney failure or death. Kidney failure occurs when the filtering systems of the body (the kidneys) are unable to remove waste products and urine. If waste products build up in the body they can become toxic.

Should I discontinue my statin if I experience muscle aches or pains?

Always talk to your doctor before making any changes to your prescription regimen. Muscle aches or pains may be a result of many things, but it’s important to bring any side effects you experience to the attention of your doctor.

Keep in mind that rhabdomyolysis is not a subtle ache or pain, and it is a rare reaction—but contact your doctor immediately if you think you may be experiencing it.

Your doctor may have you discontinue your medication for two weeks to see if the symptoms resolve, or perform a blood test that can confirm a diagnosis of rhabdomyolysis.

Can any other medications cause rhabdomyolysis?

Yes. Some antipsychotics, HIV medications (like Retrovir), gout meds, and antidepressants (SSRIs like Zoloft or Paxil) also have rhabdomyolysis as a potential side effect.

Are there any causes of rhabdomyolysis that are unrelated to medications?

Yes. Among several other things, the breakdown of muslce tissue can be also be caused by muscle strain, alcohol and illegal drugs, muscle compression, injury, or immobilization, electric shock or lightning strike, diseases of the muscle, and metabolic disorders like diabetic ketoacidosis.

I feel fine—do I still need to take my cholesterol medication?

Yes. High cholesterol, like high blood pressure, usually can’t be felt. Your doctor can help you determine your cholesterol level with a blood test.

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