Rhabdomyolysis is the condition of massive muscle tissue trauma. When muscle tissues are damaged, they release high levels of calcium from their storage location within the membrane of the muscle, into the muscle cell. Additionally, myoglobin, the oxygen-carrying structure of the cell and many other cellular components are dumped into the bloodstream. The kidneys cannot properly excrete some of the products of muscle breakdown, and they lead to kidney damage, possible kidney failure and systemic shock. Rhabdomyolysis is an uncommon, but severe side effect of some medications.
Statin Drugs
Statin drugs, used to treat high cholesterol, are a very commonly prescribed medication class in the United States. This drug is so commonly used, a trade name statin drug by Pfizer, Lipitor, was ranked by Drugs.com as the number one top selling drug in 2009. Due to this drug's popularity is important in exposing its potential contribution to muscle pain and the side effect of rhabdomyolysis.
The New Zealand Medicines and Medical Devices Safety Authority suggests that while these drugs are very beneficial for preventing cardiovascular related events, their effects on the muscles should not be minimized. Rhabdomyolysis, as well as death from the rising kidney failure, and shock have been reported. All prescribed patients should be monitored for signs and symptoms of muscle pain and weakness during initial treatment with the drug, as well as with any subsequent dose increases.
Adderall
Adderall is a trade-name drug that is a blend of four amphetamines. Adderall is a central nervous system stimulant, used to treat narcolepsy and attention deficit hyperactivity disorder, and as an illicit drug to induce psychological and emotional changes. Amphetamines are categorized as scheduled drugs, meaning that they have the potential for addiction. Drug News explains that amphetamines work by stimulating the brain to induce the stress response. They increase the release of stress hormones, increase heart rate and blood pressure, and redirect blood flow into the muscles. These rapid changes can lead to a heart attack and muscle damage in other areas of the body, especially when overdosed. Among many other symptoms, overdose of this substance can lead to rhabdomyolysis and kidney damage.
Benadryl
Benadryl is an antihistamine and a routinely used, over-the-counter medication for treating the symptoms of allergies brought on by foods, rising pollen counts, encounters with a poison oak or ivy, as well as others. Antihistamines are also often found in over-the-counter sleeping aids. A 2003 "Southern Medical Journal" article notes that rhabdomyolysis is often overlooked as a potential complication of excessive dosing of antihistamines.
Drug-Drug Interactions
Many other drugs are associated with rhabdomyolysis. A 2006 "Pharmacy Times" article notes that these categories of drugs include other cholesterol-lowering drugs like the fibrates; the antibiotic drug, erythromycin; the antifungal drug, itraconazole; and many immunosuppressive pharmaceuticals. The article notes that the symptom of rhabdomyolysis is often not a primary side effect of these medications, but when used in with other drugs that are metabolized similarly, their compounded effects may lead to rhabdomyolysis.
References
- Drugs.com: Top 200 Drugs for 2008 by Sales
- New Zealand Medicines and Medical Device Safety Authority: "Myopathy with Statins -- Check CK Levels and Interactions"
- Drug News: "20 Deaths Linked to Adderall XR"
- Southern Medical Journal: "Antihistamine-induced rhabdomyolysis"
- Pharmacy Times: "Many Potential Sources of Drug-Induced Rhabdomyolysis"
