Drugs for the Treatment of Rhabdomyolysis

What is Rhabdomyolysis: Symptoms, Causes, Drugs for Treatment and Prevention

In the medical field, we talk about rhabdomyolysis when skeletal muscle cells undergo a serious breakdown, most often following an injury; when muscle fibers die, numerous substances are released into the bloodstream, such as phosphate, potassium, creatinine, uric acid and myoglobin, causing a series of problems for the body (e.g. renal failure due to accumulation of myoglobins in the kidneys).
A damaged muscle that releases large quantities of harmful/noxious substances into the blood generates rhabdomyolysis. Muscle injuries can be favored by: pathologies (e.g. asthma, bacterial/viral infections, diarrhea and vomiting, diabetes, hyperthyroidism), too high basal temperature/hypothermia, extreme sport (bodybuilding), endurance sport (marathon), burns , electric shock and drug addiction. Even the (excessive) administration of some drugs can promote rhabdomyolysis: acetylsalicylic acid, drugs for the treatment of high cholesterol, antibiotics.


Among the first signs of rhabdomyolysis, the reddish color of the urine stands out, indicating the presence of the pigment myoglobin. Other symptoms include: mood alteration, mental confusion, muscle bruising, nausea, breathing problems, tachycardia. From blood tests, the patient suffering from rhabdomyolysis records a marked or significant alteration in the levels of potassium, calcium, myoglobin, nitrogen and uric acid in the blood.

  • Complications: renal failure, kidney damage, coagulation disorders, cardiac and pulmonary alterations, death (extremely serious cases)

The information on Rhabdomyolysis – Medicines for the Treatment of Rhabdomyolysis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and/or specialist before taking Rhabdomyolysis – Medicines for the Treatment of Rhabdomyolysis.


Considering the complications and risks deriving from rhabdomyolysis, the need for immediate intervention is evident, from the very first symptoms. In order to prevent damage caused by the release of myoglobin into the blood, intravenous fluid administration (rehydration) is indicated. The increase in fluids favors the elimination of myoglobin from the kidneys, therefore preventing the risk of kidney damage.
In addition to liquids, some active ingredients can be added to hydration therapy: sodium bicarbonate and mannitol.

Sodium Bicarbonate (NaHCO3) is indicated to reduce the acidity of urine, as well as the harmful effects of myoglobin on the kidney; mannitol (e.g. Osmohale, Man10%BIN, Isotol) and other diuretics promote the elimination of water, “cleaning” the kidneys of harmful substances. Furosemide (e.g. Lasix) is also a diuretic drug widely used for this purpose: generally, the recommended dose of furosemide must be such as to encourage urination equal to 100ml/hour.
If hydration therapy is not sufficient to restore serum potassium, calcium, nitrogen, uric acid and myoglobin values, the doctor will choose one of the following therapeutic options:

  1. Hemodialysis: very useful for filtering the blood and retaining substances that would cause damage. Reserved for severe cases of rhabdomyolysis.
  2. Blood transfusion
  3. Surgery: the surgical treatment for rhabdomyolysis is called fasciotomy; this is a therapeutic strategy in which the muscle lining tissues are cut to reduce the pressure within the blood vessels, exerted by the swelling and pain of the damaged muscle.

Notes: the administration of statins (hypocholesterolemic drugs), especially when associated with antibiotics such as clarithromycin, enormously increases the risk of rhabdomyolysis; therefore, those following a similar therapy are recommended to undergo regular blood tests in order to intervene promptly if necessary. In this case, we recommend discontinuing statin treatment and replacing the drug with an alternative one.

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