Written by Sharon Orrange, MD, MPH | Reviewed by Christina Aungst, PharmD Updated on May 6, 2022
Key takeaways:
- Joint or muscle pain is a rare side effect of some medications.
- Fluoroquinolone antibiotics, statins, and aromatase inhibitors are among the medications that most commonly cause joint or muscle pain.
- If you think that a medication you take is causing joint or muscle pain, talk with your healthcare provider. They may suggest OTC pain relievers or other treatments, like compression, heat, or ice.
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Joint pain, back aches, and other musculoskeletal complaints are among the most common health issues out there. When it comes to joint pain specifically, arthritis is a common cause. But before you blame your achy joints on arthritis, did you know that everyday medications can cause joint pain too?
Here are nine common offenders that can cause medication joint pain.
Medications that can cause joint and muscle pain
1. Antibiotic: levofloxacin
Levofloxacin belongs to a group of antibiotics known as fluoroquinolones and is commonly prescribed for sinus infections and pneumonia. Research shows that muscle and joint aches occur in about 14% of people who take fluoroquinolone antibiotics. This same study found that levofloxacin was more likely than other medications in this class to cause muscle and joint pain. Researchers also noted that adults over 60 had a greater risk of these side effects than younger adults. Experts found that among those reporting muscle or joint aches, symptoms began about 3 days after starting the antibiotic. Other studies have found that, on average, these side effects resolve about 7 days after people discontinue the medication.
2. Cholesterol-lowering medications: statins
The group of cholesterol drugs known as statins are notorious for causing muscle pain. Statins lower cholesterol levels by blocking the liver from making cholesterol. The dose of statins does not seem to be related to the occurence of muscle pain. But lowering the dose of statins is one way to reduce statin-induced pain. In one study, about 0.03% of people taking 20 mg of simvastatin had muscle pain, and 0.9% of people taking 80 mg of simvastatin had muscle pain. In another study, about 9% of people taking 80 mg of atorvastatin had muscle pain, compared to a little less than 5% for those taking a placebo (a pill with no medication in it).
3. Osteoporosis medication: bisphosphonates
Bisphosphonates are medications that treat osteoporosis, a condition that causes weak and brittle bones. These medications prevent the minerals in bones from dissolving and leaking back into the bloodstream, but they can also cause joint pain. For example, the labeling for alendronate (Fosamax) warns that severe bone, muscle, or joint pain can occur with bisphosphonates, even though it is a low risk.
4. Asthma inhalers
Inhaled corticosteroids (“steroids” for short) are common inhalers that treat lung conditions like asthma and chronic obstructive pulmonary disease (COPD). They work by lowering inflammation (swelling) in the lungs and opening the airways.
Although it’s very rare, these inhaled steroids can cause a severe and painful bone complication called osteonecrosis in a small number of people. Osteonecrosis is when bone cells don’t get enough oxygen and start to die.
Long-term use of oral steroids or steroids that are injected into a joint are much more likely to cause this severe bone side effect than inhaled steroids.
Muscle pain is also possible with inhaled steroids. For example, muscle pain is listed as a possible side effect on the labeling for fluticasone (Flovent). However, it’s relatively uncommon.
5. Breast cancer medications: anastrozole, exemestane, letrozole
Anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) are medications used in the treatment of breast cancer. They belong to a group of medications known as aromatase inhibitors that block the body from making estrogen hormones. People usually take these medications for several years after initial treatment to prevent breast cancer from returning. Some studies have found that as many as 47% of people taking one of these medications may experience joint pain.
6. Acne treatment: isotretinoin
Isotretinoin (Absorica and other brands) can treat severe acne. Between 16% and 51% of people who take this medication experience muscle pain or stiffness. A smaller study reported even greater numbers of pain. That study found that about 70% of people taking isotretinoin had back pain, and 53% had muscle pain. Additionally, 48% of study participants taking isotretinoin had joint pain.
7. Nerve pain / anti-seizure medication: pregabalin
Pregabalin (Lyrica) can treat certain kinds of nerve pain issues, like those related to fibromyalgia and diabetes. It can also treat seizures. Joint pain can occur as a side effect of this medication. If you experience joint pain with pregabalin, consider talking to your doctor about gabapentin (Neurontin), an alternative medication that is useful for many of the same conditions as pregabalin. It does not cause the joint pain side effect.
8. Estrogen medication: Premarin
Premarin (conjugated estrogens) is a hormone medication that many female people take to treat hot flashes and other symptoms related to menopause or low estrogen. This medication causes joint pain in up to 6% of people who take it.
9. Blood pressure medication: carvedilol
Carvedilol (Coreg) is a type of medication known as a beta blocker, which relaxes the muscle cells in the heart and blood vessels to lower blood pressure. Carvedilol is used to treat high blood pressure and heart failure. almost. Up to 6% of people who take it report joint aches and back pain.
How can you stop joint pain caused by medication?
The main way to stop joint pain caused by a medication is to stop taking the medication that’s causing it. But always check with your healthcare provider before stopping a medication. It’s possible that there could be other explanations for the pain.
There are many over-the-counter (OTC) medications and products that can help with pain relief. Your healthcare provider may recommend using one or more of these products if they expect the pain to be short term or if it is mild.
Your healthcare provider may also recommend applying ice or heat to the affected area, compressing the joint with a wrap or brace, and/or elevating the joint above heart level. An appropriate exercise program that does not worsen damage to your muscles or joints can also be helpful.
The bottom line
Joint pain as a true side effect is rare for most medications. But there are some medications that are more likely than others to cause joint or muscle pain. Fluoroquinolone antibiotics (such as levofloxacin), oral acne medications (such as isotretinoin), and aromatase inhibitors (such as anastrozole) are among those with the most common reports of joint or muscle pain.
If you think that one of the medications you are taking is causing joint or muscle pain, talk to your healthcare provider. They may ask you to stop the medication or help you find an alternative. They may also recommend OTC or non-medication treatments like ice, heat, or compression of the affected area. It’s important that you don’t stop taking any of your prescribed medication without talking to your healthcare provider.
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