Drugs with Interactions in Myasthenia Gravis (MG)
Drugs That May Exacerbate MG |
Antibiotics |
Aminoglycosides: e.g., streptomycin, tobramycin, kanamycin |
Quinolones: e.g., ciprofloxacin, levofloxacin, ofloxacin, gatifloxacin |
Macrolides: e.g., erythromycin, azithromycin |
Nondepolarizing muscle relaxants for surgery |
D-Tubocurarine (curare), pancuronium, vecuronium, atracurium |
Beta-blocking agents |
Propranolol, atenolol, metoprolol |
Local anesthetics and related agents |
Procaine, Xylocaine in large amounts |
Procainamide (for arrhythmias) |
Botulinum toxin |
Botox exacerbates weakness |
Quinine derivatives |
Quinine, quinidine, chloroquine, mefloquine (Lariam) |
Magnesium |
Decreases acetylcholine release |
Penicillamine |
May cause MG |
Drugs with Important Interactions in MG |
Cyclosporine |
Broad range of drug interactions, which may raise or lower cyclosporine levels. |
Azathioprine |
Avoid allopurinolcombination may result in myelosuppression. |