Drugs To Avoid
Myasthenia Gravis
Certain types of drugs should be avoided when in myasthenic crisis.
Below is a list of common drugs to avoid when in myasthenic crisis. This is not a definitive list and may be updated periodically to reflect new drugs or information. Always consult your physician before stopping or taking any medication.
Antibiotics
Drugs that impair neuromuscular junction transmission and may increase weakness
Aminoglycosides
- Tobramycin
- Gentamycin
- Netilmicin
- Neomycin
- Streptomycin
- Kanamycin
Fluoroquinolones
- Ciprofloxacin
- Norfloxacin
- Ofloxacin
- Gatifloxacin
Tetracyclines
- Clindamycin
- Sulfonamides
Penicillins
considered safe, though anecdotes of Ampicillin causing resp depression
Macrolides
- Azithromycin
- Clarithromycin
Quinolones
Ritonavir
Potentially Harmful
Drugs implicated as potentially harmful in myasthenia gravis patients based on either anecdotal case reports or in-vitro microelectrode studies
Amphetamines
Anticonvulsants
- Phenytoin
- Barbiturates
- Ethosuximide
- Gabapentin
Beta blockers
- Atenolol
- Labetalol
- Metoprolol
- Nadolol
- Oxprenolol
- Practolol
- Propanolol
- Timolol
Calcium channel blockers
- Verapamil
Ophthalmologic meds
- Timolol
Other cardiac drugs
- Bretylium
- Procainamide
- Trimethaphan
Psychiatric meds
- Amitriptyline
- Haldol
- Imipramine
- Lithium
- Phenothiazines