Rhabdomyolysis is a rare and serious side effect of cocaine use. To avoid this symptom, it’s best to get treatment for cocaine addiction.

Article at a Glance:

Important takeaways about cocaine use and rhabdomyolysis include:

  • Rhabdomyolysis is the death and breakdown of muscle cells
  • Cocaine suffocates, or over-excites, muscle cells, causing them to die
  • When muscle cells die, they spill toxic contents into the bloodstream
  • These contents can irreparably damage the heart, kineys and liver
  • Rhabdomyolysis with cocaine is unpredictable. The best way to prevent it is to stop using cocaine

Cocaine & Rhabdomyolysis

Rhabdomyolysis is the breakdown of healthy muscle tissue and is one of the most dangerous side effects of cocaine use.

When muscle tissue breaks down, the muscle cells break, spilling their contents into the bloodstream. The body then has to filter out the remains of the destroyed cells. If it cannot, the kidneys, heart and liver can be damaged.

Cocaine use is risky for many reasons, including that it can cause rhabdomyolysis. Cocaine can cause rhabdomyolysis in two different ways:

  1. Cocaine decreases the blood flow to different parts of the body: Cocaine causes blood vessels to constrict (tighten) and deliver less oxygen to some tissue. This tissue can be muscles, skin or organs. If these tissues lose blood flow and oxygen for a long period, the cells start to die.
  2. Cocaine changes the levels of neurotransmitters in the bloodstream: Brain cells (neurons) use neurotransmitters to send messages to each other. Cocaine increases the levels of epinephrine, norepinephrine and dopamine in the body. High levels of these neurotransmitters cause muscle cells to over-activate, which damages them.

What Is Rhabdomyolysis?

Rhabdomyolysis is the abnormal breakdown of skeletal muscle cells. Skeletal muscles are the large muscles under the skin that people usually envision when they think of muscles. Some examples of skeletal muscles are biceps, triceps, deltoids, trapezius muscles, obliques and quadriceps.

Other muscle types that are not impacted by rhabdomyolysis are smooth muscles in the intestines and cardiac muscle in the heart. Rhabdomyolysis does damage the heart, but not by direct muscle damage; it damages the heart by releasing too much potassium into the bloodstream.

Besides cocaine use, other common causes of rhabdomyolysis are:

  • Alcohol abuse
  • Certain medications, like statins for cholesterol
  • An injury that crushes the muscles
  • Overexertion, or straining muscles too hard

Symptoms of Rhabdomyolysis

Common symptoms of rhabdomyolysis include:

  • Brown or tea-colored urine
  • Confusion or disorientation
  • Dizziness, light-headedness or feeling faint
  • Irregular heartbeat
  • Muscle weakness
  • Unexplained muscle aches

The most common symptoms of rhabdomyolysis are brown-colored urine and unexplained muscle weakness. Since muscle aches happen commonly with exercise, it is important to keep in mind when and how a person last exercised. If they have not exercised in a while and are experiencing muscle aches and pain, it could be a symptom of rhabdomyolysis.

Rhabdomyolysis Treatment

Rhabdomyolysis is an emergency medical condition that needs to be treated right away. If these symptoms occur, call a doctor or go to an emergency department right away. Muscle breakdown is toxic to the kidneys and can cause permanent damage.

At the doctor’s office or emergency room, a provider can run blood and urine tests to confirm rhabdomyolysis. The blood will likely have abnormally high potassium, myoglobin and creatinine kinase. These substances are normally stored in muscle cells and spill out when the cells die. The urine will contain higher than normal myoglobin, which is a protein that carries oxygen to the cells of the body.

During treatment for rhabdomyolysis, a person is admitted to a hospital to receive supportive care. The heart and kidneys are the most vulnerable to harm, so they are protected first. The hospital team can correct any electrolyte imbalances and administer intravenous (IV) fluid.

Preventing Cocaine-Induced Rhabdomyolysis

Rhabdomyolysis is an unpredictable side effect of cocaine use. It could develop after using cocaine a few times, or it might take years. Not everyone who uses cocaine experiences rhabdomyolysis. However, if it happens, the damage might be permanent. The best way to protect oneself is to stop using cocaine.

If you or someone you know needs treatment for cocaine addiction, The Recovery Village can help. We have facilities located across the country and offer comprehensive treatment programming for drug and alcohol addiction. To take the first step toward recovery, call The Recovery Village today.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Richards, John R, and Jacqueline K Le. “Cocaine Toxicity.” StatPearls, updated in 2019. Accessed 15 May 2019.

Sauret, John M, et al. “Rhabdomyolysis.” American Family Physician, 2013. Accessed 14 May 2019.

Selvaraj, Vithyalakshmi, et al. “A Case of Cocaine-Induced Myopathy.” The Primary Care Companion, 2013. Accessed 15 May 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.