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) Decreases acetylcholine release May cause MG Checkpoint inhibitors May cause MG and other autoimmune neuromuscular disorders (e.g., myositis, inflammatory neuropathy) | |||
| Drugs with important interactions in MG | |||
Cyclosporine and Tacrolimus Broad range of drug interactions, which may raise or lower levels Avoid allopurinol-combination may result in myelosuppression |