Most common myotoxic agents

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What are the most common myotoxic agents?

• Statins and fibrates—myalgias, rhabdomyolysis, necrotizing myopathy

• Steroids—type 2 fiber atrophy

• Alcohol—rhabdomyolysis, proximal myopathy with type 2 fiber atrophy

• Chloroquine—vascular myopathy

• d -Penicillamine—drug-induced DM

• Protease inhibitors (saquinavir, ritonavir, indinavir, nelfinavir, amprenavir)—rhabdomyolysis, risk is increased with concurrent use of statins

• Nucleoside-analog reverse transcriptase inhibitors (mainly zidovudine [AZT])—mitochondrial myopathy with ragged red fibers

• Amiodarone

• Colchicine, vincristine

• Snake venoms

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