Metabolic and drug-induced muscle disorders

Drug-induced myopathy and neuropathy

We review the drugs that are known to induce muscle and/or nerve toxicity, describe the commonly encountered signs and symptoms, and discuss the mechanisms believed to be behind these iatrogenic effects. The diagnostic approach to patients suspected of having drug-induced neuromuscular disorders includes a comprehensive history and physical examination, proper blood workup, electrophysiological studies, and, if necessary, muscle or nerve biopsy. A lot of controversial issues continue to prevail when reviewing such a topic, secondary to the greatly variable levels of certainty for the association between drugs and their neuromuscular toxicity. We focus on drugs that are proven to cause these adverse effects, with less emphasis on the anecdotally suspected agents for which coincidence has not been eliminated.