One of the remarkable aspects of skeletal muscle is its capacity to adapt in response to mechanical loading and disuse throughout life, albeit to a gradually lesser extent with advancing age. Recovery of lost muscle mass and strength following periods of disuse is a challenge for ageing societies where loss of independent living is at stake. The ability of muscle to regenerate fully following injury is equally impressive and animal studies have clearly shown that satellite cells, the resident stem cells of skeletal muscle, are essential for this process. Whether satellite cells are required for hypertrophy has been keenly debated, but it would seem that maladaptation of the muscle as a whole occurs in response to overload where contribution from satellite cells is inhibited. In this context, the action of various pharmacological agents on muscle adaptation is receiving increasing attention. This talk will focus on a range of drugs, from the widely used over-the-counter available non-steroidal anti-inflammatory drugs to blood pressure-lowering prescription medication (Angiotensin II type I receptor blockers). Banned substances such as growth hormone and testosterone will also be touched upon. These will be addressed from the perspective of specific action on satellite cell function as well as skeletal muscle as a whole, with a focus on human data.