People with Myasthenia Gravis (MG) should be cautious with certain medications, as some drugs can worsen muscle weakness, trigger deterioration, or precipitate a myasthenic crisis. Always inform your doctor, dentist, or pharmacist that you have MG before starting any new medication.
Common Medication Groups Known to Worsen MG
1. Antibiotics (Use With Caution)
Some antibiotics can impair neuromuscular transmission and worsen MG symptoms:
- Fluoroquinolones (e.g. ciprofloxacin, levofloxacin)
- Macrolides (e.g. azithromycin, erythromycin)
- Aminoglycosides (e.g. gentamicin, amikacin)
These are recognised in hospital guidance as drugs that may aggravate MG and are usually avoided or used only with close monitoring.
2. Cardiovascular Medications
- Beta-blockers (e.g. propranolol, atenolol)
- Certain anti-arrhythmic drugs
These medications may worsen muscle weakness and fatigue in MG patients.
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3. Neurological & Psychiatric Medications
- Magnesium-containing medications (including some laxatives and supplements)
- Certain antipsychotics and sedatives
- Some anti-seizure medications
Magnesium interferes directly with neuromuscular transmission and is a known risk factor for symptom worsening.
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4. Muscle Relaxants & Anaesthetic Agents
- Neuromuscular blocking agents (used during surgery)
- Certain sedatives
This is especially important during surgery or dental procedures, where anaesthetists must be informed of the MG diagnosis in advance.
⚠️ Important Note
This is not a complete list. Medication safety varies between individuals.