You can order a copy of this article from MGFI, see
MG Brochures.
Special thanks are due to the Director of Pharmacy, Horace B.
Williams, Jr., Ph. B., and the Assistant Director of Pharmacy,
Donald T DeFazio, Pharm.D., at Methodist Hospital of Southern
California, Arcadia, California, for their assistance with the
Table of drugs which affect myasthenia.
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A. Drugs generally accepted to unmask or
exacerbate MG: |
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Excessive anticholinesterases |
Neuromuscular blocking agents (incl. BOTOX) |
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Adrenocorticosteroids &ACIH |
Anesthetic agents (including alcohol) |
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Thyroid preparations |
Magnesium salts, Epsom salts |
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Antiarrhythnucs: |
lidocaine (Xylocaine) intravenously but not
locally |
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quinidine.(Quinaglute, Qulnidex, Quinora,
Cardioquin) |
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procainamide (Procamide, Procan SR, Pronestyl) |
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phenytoin (Dilantin) |
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Antibiotics |
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Aminoglycosides |
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gentamicin (Garamycin) |
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tobramycin (Nebcin) |
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amikacin (Amikin) |
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kanamycin (Kantrex) |
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neomycin (Mycifradin, Neobiotic) |
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streptomycin |
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paromomycin (Humatin) |
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Polypeptides |
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polymyxin B (Aerosporin) |
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colistin (Coly-Mycin, Mycin) |
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colistimethate (parenteral Coly-Mycin) |
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Tetracyclines |
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chlortetracycline (Aureomycin) |
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oxytetracycline (Terramycin) |
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tetracycline (Achromycin, Tetracyn) |
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demeclocycline (Declomycin) |
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methacycline (Rondomycin) |
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doxycycline (Vibramycin, Doryx) |
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minocycline (Minocin, Vectrin) |
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Miscellaneous |
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clindamycin (Cleocin) |
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ciprofloxacin (Cipro) |
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ampicillin - very high doses |
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Ketek (added by
MGFI) |
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intravenous erythromycin (E-Mycin, Erythrocin) |
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B. Drugs or toxins which can induce MG by
precipitating an autoimmune reaction: |
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D-penicillamine (Cuprimine) |
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trimethadione (Tridione) |
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wasp stings |
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coral snake bite |
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C. Other drugs implicated in isolated
instances of MG exacerbations (Not every patient with MG is
expected to react adversely to these medications): |
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cimetidine (Tagamet) |
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meglumide diatrizoate (Reno-M-dip) |
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citrate |
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propanolol (Inderal) |
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chioroquine (Aralen, Avioclor, Rosochin) |
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quinine |
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cocaine |
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timolol maleate
drops (Timoptic) |
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diazepam Valium) |
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trihexyphenidyl (Artane) |
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lithium (Lithotabs, Eskalith, Lithane) |
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