Ask An Expert: Therapy for Rhabdomyolysis

Content provided by the Faculty of the Harvard Medical School

Ask An Expert: Therapy for Rhabdomyolysis

Question:

My boyfriend (age 50) has rhabdomyolysis from taking statin drugs. Is there any therapy for his destroyed muscles? His kidneys are OK but he has terrible pain in all muscles. His doctors just say to give it time. Is there some kind of physical therapy that would help?

Answer:

One of the more common side effects of all the statin drugs (atorvastatin, fluvastatin, lovastatin, rosuvastatin, pravastatin, simvastatin) is muscle pain with or without muscle injury. The problem can occur at any time a person is taking a statin, even many years after starting the drug. The risk of muscle injury increases with higher doses of statins.

A rare complication of taking a statin is very substantial muscle injury called rhabdomyolysis. Usually the person has diffuse muscle aches and pains. When rhabdomyolysis occurs, it is often related to a drug-drug interaction. For example, a person taking a statin might be given a prescription for the antibiotic erythromycin. In some people, the erythromycin can markedly increase the blood level of the statin enough to cause rhabdomyolysis.

In some cases of rhabdomyolysis, such high levels of chemicals and proteins get released from the injured muscles that they cause temporary kidney damage. I am glad to hear that this was not a problem for your boyfriend.

The treatment of rhabdomyolysis has two primary components — high volumes of intravenous saline (sometimes with bicarbonate added) and stopping any drug that may be contributing to muscle injury. Any pain will need to be managed with medications. Physical therapy won't help decrease the pain, but he may need the encouragement to get up and out of bed.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

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Last updated:	April 24, 2007
Reviewed By:	Faculty of Harvard Medical School

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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