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Ranolazine-induced lipid storage myopathy presenting with respiratory failure and head drop
Pritikanta Paul1, Rocio Vazquez Do Campo2, Teerin Liewluck3
1Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, United States; Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States.
Neuromuscular Disorders : NMD
|April 27, 2021
Summary
Ranolazine can cause rare but serious muscle damage (myopathy), even with normal creatine kinase levels. Stopping ranolazine improved symptoms, highlighting its potential toxicity in ischemic heart disease patients.
Area of Science:
- Cardiology
- Neurology
- Toxicology
Background:
- Ranolazine is an anti-ischemic medication frequently prescribed with statins for ischemic heart disease.
- Ranolazine-induced myopathy is a rare adverse effect, often difficult to distinguish from statin toxicity.
Observation:
- A 68-year-old male presented with respiratory insufficiency and head drop.
- Initial creatine kinase levels were normal, and symptoms persisted despite statin cessation.
Findings:
- The patient experienced marked improvement only after discontinuing ranolazine.
- Muscle biopsy revealed excessive lipid accumulation, particularly in type 1 myofibers.
Implications:
- This case highlights a rare, potentially debilitating adverse effect of ranolazine.
- Physicians should consider ranolazine-induced myopathy in patients with unexplained muscle symptoms.
- Early drug discontinuation offers a good prognosis.
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