Drugs (including glucocorticoids and lipid-lowering agents) and toxins (e.g., alcohol) are associated with myopathies (Table 198-2 Drug-Induced Myopathies). In most cases, weakness is symmetric and involves proximal limb girdle muscles; myalgia and cramps may also occur. An elevated CK is often found. Diagnosis often depends on resolution of signs and symptoms with removal of offending agent.