Statins are the primary class of medication used to lower serum cholesterol 
concentration for both primary and secondary prevention of cardiovascular 
disease. Muscle pain is a frequent adverse effect of statins. Severe myonecrosis 
leading to clinical rhabdomyolysis is rare. We encountered a 63-year-old 
male with a medical history of hypertension, type 2 diabetes mellitus, 
and coronary artery disease with angioplasty in 2008 and 2020. He was started on 
rosuvastatin 40 mg (0-0-1) along with dual anti-platelets post angioplasty and 
was discharged home. He traveled back to his hometown and noticed progressive 
symmetric muscle weakness with decreased urine output. After visiting another 
hospital he presented to us with severe proximal muscle weakness and acute renal 
failure. Laboratory investigations were initiated which demonstrated 
clinically significant derangement in serum creatinine phosphokinase, 
serum creatinine, urine myoglobin along with deranged liver enzymes. He was 
subjected to nerve conduction studies for his muscle weakness which was normal 
and electromyography showed abnormal spontaneous muscle activity in all examined 
muscles (fibrillations, positive sharp waves, and pseudomyotonic 
discharges) suggestive of an irritable myopathy. The medication was stopped and 
he was treated with eight cycles of hemodialysis until his muscle weakness and 
laboratory parameters improved. He was then discharged with some improvement in 
muscle weakness. On two week follow-up, the patient showed partial improvement 
after discontinuation of all lipid-lowering medication.