9 Medications That Cause Joint and Muscle Pain

Muscle pain and weakness, joint pain, and other musculoskeletal complaints are among the most common health issues. Long-lasting muscle and joint pain may be due to chronic health conditions.

But short-term soreness and pain can happen for many reasons, including recent injuries or overusing your muscles (such as during strenuous exercise). Another possible cause is the medications you take.

Below, we’ll cover nine medications that can cause muscle pain and weakness or joint pain.

1. Statins such as simvastatin

Statins are a group of cholesterol-lowering medications. They’re commonly known for causing muscle pain and joint pain. But research suggests that most muscle pain reported while taking a statin isn’t actually caused by the medication, though it is still possible. And in rare cases, statins can cause rhabdomyolysis. This is when muscles break down and leak toxic byproducts into the bloodstream, which damage the kidneys.

The risk of muscle problems from statins may be greater if you:

• Take a high statin dose

• Take a statin with a higher risk of muscle problems, such as simvastatin (Zocor, FloLipid)

• Take certain medications that interact with statins

• Are over age 75 or female

• Have certain health conditions, such as diabetes

Often, muscle pain from statins goes away soon after it appears. But if it’s bothersome or not going away, tell your prescriber. They may lower your dosage or switch you to a statin that’s less likely to cause it. Don’t change or stop your statin without talking to your prescriber first.

2. Fluoroquinolone antibiotics such as levofloxacin

Levofloxacin and ciprofloxacin (Cipro) belong to a group of antibiotics known as fluoroquinolones. Because of their risks, they’re generally reserved for certain infections when safer options aren’t available.

Fluoroquinolones can cause tendon injuries, muscle pain, and joint pain. Levofloxacin may create a higher risk of tendon rupture, while ciprofloxacin may be more likely to cause tendonitis (tendon inflammation).

Your risk of muscle and joint problems from fluoroquinolones may be higher if you:

• Are over age 60

• Take corticosteroids, such as prednisone

• Have kidney problems

• Have diabetes

• Have a history of tendon problems

These problems can develop within days of starting a fluoroquinolone or several months after. They often improve after the medication is stopped. But some tendon damage can be permanent. Contact your prescriber right away if you develop tendon, muscle, or joint pain.

Good to know: Most antibiotics besides fluoroquinolones aren’t known to cause muscle or joint pain. So if you have a bacterial infection, there may be other antibiotic options that are a better choice.

3. Fibrates such as gemfibrozil

Fibrates, such as fenofibrate (Tricor) and gemfibrozil (Lopid), treat high cholesterol. Though rare, they can cause muscle-related problems that can lead to rhabdomyolysis.

You may be more likely to experience muscle problems from fibrates if you:

• Are age 65 or older

• Have hypothyroidism (underactive thyroid) that isn’t well managed

• Have kidney problems

• Take them with certain medications, such as statins or colchicine (Colcrys, Lodoco, Mitigare)

Tell your prescriber if you experience muscle pain while taking a fibrate. Seek immediate care if you also have weakness and dark-colored urine, which can indicate rhabdomyolysis.

4. Bisphosphonates such as alendronate

Bisphosphonates, such as alendronate (Fosamax) and ibandronate, treat osteoporosis. But they can also cause muscle and joint pain, which in some rare cases can be severe.

Pain may develop soon after starting treatment or months later. Symptoms often improve after stopping the medication. But you shouldn’t stop taking a bisphosphonate without talking to your prescriber first.

Bisphosphonates help lower your overall fracture risk, but in rare cases they’ve been linked to unusual thighbone fractures. Contact your prescriber if you develop new or persistent pain in your thigh, hip, or groin.

5. Teriparatide (Forteo)

Another medication that treats osteoporosis is an injection called teriparatide (Forteo, Bonsity). Joint pain affects up to 10% of people who use it, and neck pain is also possible.

These aches may improve as your body adjusts to treatment. Tell your prescriber if the pain is severe or doesn’t go away. They can help determine whether a different osteoporosis medication would be a better option.

6. Aromatase inhibitors such as anastrozole

Anastrozole (Arimidex) and letrozole (Femara) are medications used to treat breast cancer. They belong to a group of medications known as aromatase inhibitors. People usually take these medications for several years to prevent breast cancer from returning.

Joint pain is the No. 1 reason people stop taking aromatase inhibitors. Up to 50% of people report experiencing joint pain within the first year of starting their medication.

It’s not clear whether certain risk factors make you more likely to experience joint pain from aromatase inhibitors. Younger people and those with a history of joint pain or joint-related conditions may be at greater risk.

7. Oral steroids such as prednisone

Long-term use of oral corticosteroids, such as prednisone, can cause avascular necrosis, but it’s quite rare. This serious condition occurs when reduced blood flow causes bone tissue to die. It most often affects the hip, but it can also affect other joints. The risk increases with higher doses and longer treatment.

Avascular necrosis may not cause symptoms at first. But as it progresses, persistent joint pain can develop. Tell your prescriber about new or worsening joint pain, since early treatment may help limit bone damage. Don’t change or stop taking a steroid on your own.

8. Isotretinoin (Accutane, Absorica)

Isotretinoin (Accutane, Absorica) treats severe acne. Muscle and joint pain are common side effects, but they usually improve after you stop taking the medication.

Isotretinoin is typically taken for several months. So mild aches may be manageable during treatment. Tell your prescriber if you develop pain, especially if it’s severe or interferes with daily activities. They can recommend ways to manage it or adjust your treatment, if needed.

9. Pregabalin (Lyrica)

Pregabalin (Lyrica) treats certain types of seizures and nerve pain, but it can cause joint pain as a side effect. It can also cause muscle pain and muscle spasms.

Joint and muscle pain from pregabalin are usually mild and go away over time. But if your joint pain is severe or isn’t improving, let your prescriber know. In some cases, they may recommend switching you to a medication closely related to pregabalin called gabapentin (Neurontin, Gralise, Horizant). Gabapentin isn’t known to cause muscle or joint pain.

How can you manage joint or muscle pain from medications?

The best way to manage joint and muscle pain from medications depends on several factors. These might be why you’re taking the medication and how severe your symptoms are.

Before attempting to manage joint and muscle pain on your own, talk to your prescriber. They’ll evaluate your symptoms and consider why you’re taking the offending medication in the first place. Then you can weigh your options for how to proceed. Some possible solutions to joint and muscle pain include:

• Decreasing your dose: In some cases (such as with statins) reducing your dose can help relieve muscle aches and pains. But don’t make changes to your dose without talking to your prescriber first.

• Switching to another medication: If your joint and muscle problems are severe, your prescriber may recommend switching to a different medication that’s less likely to cause these side effects.

• Trying home remedies: Your prescriber may recommend options beyond medication to manage the pain. This may include applying a cool or hot compress to the muscle, compressing the joint with a wrap or brace, or getting massage therapy. Regular exercise can also improve joint mobility and strengthen your muscles.

• Taking medications to relieve pain: Over-the-counter (OTC) pain relievers such as ibuprofen, naproxen (Aleve), or acetaminophen (Tylenol) may help with muscle and joint pain. Topical products such as diclofenac sodium (Voltaren Arthritis Pain) or lidocaine patches may also be an option.

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Written by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, was a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD, MWC

Christina Aungst, PharmD, MWC is a senior pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019.

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