Necrotizing myopathy:

• Cholesterol lowering medication: HMG-CoA reductase (statins), fibric acid derivatives, niacin, ezetimibe

• Red yeast rice (Monascus purpureus), a supplement used for its lipid-lowering effect, has also been reported to cause myopathy, including rhabdomyolysis.

• Cyclosporine, labetalol, propofol, alcohol

Amphiphilic:

• Chloroquine, hydroxychloroquine, amiodarone

Antimicrotbular:

• Colchicine, vincristine

Mitochondrial myopathy:

• Zidovudine and other HIV related antiretrovirals

Inflammatory myopathy:

• L-tryptophan, d-penicillamine, cimetidine, L-Dopa, phenytoin, lamotrigine, alpha-interferon, TNF-alpha blockers, hydroxyurea, Imatinib.

  • TNF-apha blockers can induce other autoimmune disorders such as SLE and autoimmune neuropathies - demyelinating (MMN, AIDP) besides CNS demyelination.  Patients with myositis are reported to have developed an inflammatory myopathy while on TNF-alpha blockers

  • Imatinib mesylate (Gleevec) is a tyrosine kinase inhibitor used to treat patients with CML.  Myalgias, PM.  These normalize with discontinuation of the drug and a course of corticosteroids. 

  • Immune-checkpoint inhibitors. 

Hypokalemic myopathy:

• Diuretics, laxatives, amphotericin, lithium, toluene abuse, licorice, corticosteroids, alcohol abuse.

Critical illness myopathy:

• Corticosteroids, non-depolarizing neuromuscular blocking agents.

Unknown:

• Omeprazole, isotretinoin, finasteride, emetine, febuxostat, levetiracetam.

• Chronic alcoholism

Immune checkpoint inhibitors, increasingly used in the treatment of advanced cancer, have recently been associated with the development of inflammatory myositis besides MG, AIDP, transverse myelitis and others. 

Drug-induced rhabdomyolysis 

Features That Raise Suspicion for a Toxic Myopathy 

Clinical Features

• Concomitant polyneuropathy (ie, a neuromyopathy): Amiodarone, Chloroquine/hydroxychloroquine, Colchicine, Telbivudine

• Concomitant myasthenia gravis: Immune checkpoint inhibitors

• Acute, painful myopathy: Statins, Other lipid-lowering agents, Cyclosporine, Labetalol Alcohol (with binge drinking).

EMG Features

• Myotonic discharges: Chloroquine/hydroxychloroquine, Colchicine, Cyclosporine, Fibrates, Statins

• Normal EMG in a patient with clinically suspected myopathy: Corticosteroids, Chronic alcoholic myopathy

Muscle Biopsy Features

• Vacuoles: Amiodarone, Chloroquine/hydroxychloroquine, Colchicine.

• Mitochondrial abnormalities (eg, many ragged red and cytochrome oxidase–negative fibers): Nucleoside-analogue reverse transcriptase inhibitors (eg, zidovudine)

• Type 2 fiber atrophy: Corticosteroids, Chronic alcoholic myopathy

• Sarcolemmal major histocompatibility complex 1 and membrane attack complex expression on non-necrotic fibers: Anti–3-hydroxy-3-methylglutaryl coenzyme A reductase myopathy associated with statins, Immune checkpoint inhibitors, D-Penicillamine.

Drugs Associated With an Increased Risk of Statin Muscle Toxicity

• Amiodarone

• Azole antifungals

• Calcium channel blockers

• Colchicine

• Cyclosporine

• Ezetimibe

• Fibrates (eg, gemfibrozil)

• Niacin

• Protease inhibitors

• Rapamycin

• Sirolimus

• Excessive intake of grapefruit juice

Sertraline is associated with mitochondrial dysfunction and hepatotoxicity. SSRIs inhibit a voltage-dependent anion channel in the pore of the mitochondrial inner membrane permeability transition (MPT), causing MPT induction and mitochondrial swelling. Sertraline also uncouples mitochondrial respiratory complexes I and V with adenosine triphosphate (ATP) depletion and energy failure. Moreover, sertraline induces the mitogen-activated protein kinase (MAPK) signaling pathway, activating both intrinsic and extrinsic caspase-dependent apoptotic pathways. 

Drug -related myopathies.

Myopathy secondary to empagliflozin therapy in diabetes type 2

https://link.springer.com/article/10.1007/s10157-007-0494-3