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 a large study published in 2022 found that the majority of muscle pain attributed to statins isn’t actually caused by statins at all. Still, many people associate statins with muscle pain, and this side effect is possible. And rarely, a serious muscle condition called rhabdomyolysis (severe muscle breakdown) may occur. So it’s worth discussing.

It’s not clear whether higher statin doses increase your chances of experiencing muscle pain. However, lowering your statin dose is one way to reduce muscle pain if it occurs. But don’t make these changes without talking to your prescriber first.

Often, muscle pain from statins goes away soon after it appears. But if it persists, your prescriber may consider switching you to a statin that’s less likely to cause problems. For example, simvastatin (Zocor) is one of the statins that’s most known for causing muscle-related side effects. Switching to a statin that’s less likely to cause muscle and joint pain, such as pravastatin, may be an option.

Certain people — including women, people over 65 years old, and people with certain health conditions such as diabetes — are at greater risk of statin-related muscle problems. So make sure your prescriber has your full health history before starting you on a statin.

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2. Fluoroquinolone antibiotics such as levofloxacin

Levofloxacin and ciprofloxacin (Cipro) belong to a group of antibiotics known as fluoroquinolones. This group of medications treats many bacterial infections. But fluoroquinolones also have several risks. So they’re not recommended for common bacterial infections, such as sinus or urinary tract infections.

We have a lot of research showing that fluoroquinolone use is associated with tendon injuries, muscle pain, and joint pain. Some research has shown that tendon rupture is most likely with levofloxacin compared with other fluoroquinolones. But ciprofloxacin may be more likely to cause tendon inflammation (tendonitis).

The risk for muscle and joint problems from fluoroquinolones is greater for certain groups of people, including those who:

• Take corticosteroid medications, such as prednisone

• Have had a kidney or heart transplant

• Engage in strenuous activities

• Are over the age of 60

• Have a history of tendon-related problems

Muscle and joint problems may begin within just a few days of starting a fluoroquinolone. But they can also happen several months later. Muscle and joint problems often resolve after stopping your fluoroquinolone, but in some cases tendon damage can be irreversible.

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 are a group of medications that treat high cholesterol levels. Examples include fenofibrate (Tricor) and gemfibrozil (Lopid). Though rare, fibrates can cause muscle-related problems that can lead to rhabdomyolysis. The risk is greater in older adults. These problems are also more likely if you have diabetes, kidney problems, or hypothyroidism.

If you experience muscle pain or weakness while taking a fibrate, let your prescriber know — especially if you feel sick or feverish at the same time. The risk of rhabdomyolysis is increased if you’re taking a statin or a gout medication called colchicine (Colcrys), along with a fibrate. In fact, combining gemfibrozil and simvastatin isn’t recommended at all. The risks of rhabdomyolysis with this combination outweighs any benefits it may provide. If your prescriber thinks you need a statin and a fibrate, they’ll likely choose fenofibrate.

4. Bisphosphonates such as alendronate

Bisphosphonates are medications that treat osteoporosis, a condition that causes weak and brittle bones. Bisphosphonates such as alendronate (Fosamax) and ibandronate (Boniva) can cause muscle and joint pain. Though rare, this can be severe in some cases.

Muscle and joint pain from bisphosphonates can happen right when you start treatment or several months later. But it’s not clear what makes some people more likely to experience this side effect. Usually, the pain goes away if you stop the medication. But don’t stop taking your bisphosphonate without talking to your prescriber first.

Bisphosphonates can also cause bone pain. If you’re experiencing bone pain, let your prescriber know. There’s a small risk for fractures when taking bisphosphonates, and bone pain may be a sign of this.

5. Teriparatide (Forteo)

Another medication that treats osteoporosis is teriparatide (Forteo). This is an injectable medication. It can cause joint pain as a side effect in up to 10% of people that take it. Neck pain has also been reported.

Usually, this side effect goes away quickly. But if it causes persistent or severe pain, let your prescriber know. They may recommend a different medication to treat osteoporosis.

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 number-one reason people stop taking aromatase inhibitors, with up to 50% of people experiencing joint pain within the first year of starting their medication. Symptoms don’t usually start right away, though. They may occur about 2 months or longer after starting your medication.

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

7. Oral steroids such as prednisone

Oral corticosteroids (commonly called just “steroids”) are a broad group of medications that relieve swelling, pain, and inflammation. But they have several side effects, some of which are short-term. Other side effects are associated with long-term use of steroids such as prednisone and dexamethasone. One side effect associated with long-term use of steroids is “steroid-induced myopathy.” It typically affects pelvic muscles and presents as muscle weakness without pain.

Older people and women are more likely to develop steroid-induced myopathy, but it can happen to anyone taking steroids for a long period of time. It’s also more common with higher doses of oral or intravenous steroids. Though muscle weakness is possible with inhaled steroids such as fluticasone (Flovent), it’s not common.

If you experience muscle weakness while taking a steroid, make sure to let your prescriber know. You may need to take a lower dose or switch to another steroid.

8. Isotretinoin (Accutane, Absorica)

Isotretinoin (Accutane, Absorica) is a medication that treats severe acne. It can commonly cause muscle and joint pain. Some studies report that up to 80% of people taking isotretinoin have lower back pain and about 50% have general joint and muscle pain. Back pain and other types of muscle and joint pain have also been seen in children taking isotretinoin.

Usually, muscle and joint pain from isotretinoin go away after you stop taking the medication. And since this medication isn’t used long-term, you may be able to manage minor muscle and joint pain during the months when you’re taking isotretinoin. Talk to your prescriber about ways to manage these side effects.

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 Lyrica are usually mild and goes 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). 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, including why you’re taking the medication and how severe your muscle- and joint-related 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 the dose of your medication without talking to your prescriber first.

• Switching to another medication. If your joint and muscle problems are severe, and/or your medication isn’t considered absolutely necessary, your prescriber may recommend stopping your current medication. There may be an alternative medication you can take that’s less likely to cause muscle and joint pain. But always check with your prescriber first.

• Non-medication treatment options. Your prescriber may recommend applying a cool or hot compress to the affected muscle. Or they may recommend compressing the joint with a wrap or brace and/or elevating the joint above heart level. Regular exercise can also improve joint mobility and strengthen your muscles. Additionally, massage therapy and weight loss (if you’re considered overweight or obese) can also help lessen the strain on your muscles and joints.

• 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, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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