Noticing and avoiding myasthenia gravis triggers is one thing you can do to manage your disease. These factors can make MG worse:
- Fatigue, insufficient sleep
- Stress, anxiety
- Overexertion, repetitive motion
- Sudden fear, extreme anger
- Extreme temperatures (hot or cold weather, hot showers or baths, sunbathing, saunas, hot tubs)
- Sunlight or bright lights (affects eyes)
- Hot foods or beverages (affects mouth and throat)
- Some medications, including beta blockers, calcium channel blockers, and some antibiotics
- Alcoholic beverages
- Quinine or tonic water
- Low potassium levels or low thyroid levels
- Some chemicals, including some household cleaners, insecticides and pet flea sprays
- Exposure to chemical lawn treatments
Infections and respiratory illnesses can produce increased weakness that lasts for a while after the illness is gone. The stress of surgery can make MG temporarily worse. The disease may intensify during certain times of a woman’s menstrual cycle.
Drugs to avoid
Commonly-used medications like ciprofloxacin or certain other antibiotics, beta-blockers like propranolol, calcium channel blockers, Botox, muscle relaxants, lithium, magnesium, verapamil and more, can worsen the symptoms of myasthenia gravis. Some medications should be avoided altogether (unless there is no alternative). This includes medications that have a “black box warning” that specifically advise against use by individuals who have myasthenia gravis (e.g., ciprofloxacin). Others may have caused adverse reactions in a small number of people and could be used with close monitoring. Click here for Drugs to Avoid or Use with Care with MG (written by Kourosh Rezania, MD, University of Chicago).
Any time you have surgery, your medical team needs to fully understand your medical history. Because some anesthesia can worsen MG, your surgeon and anesthesiologist will want to be prepared to manage your symptoms. Click here for information about Anesthesia and MG (article written by Kourosh Rezania, MD, University of Chicago) that is important to share with your doctors.
The University of Illinois at Chicago College of Pharmacy website describes medications that can make your MG worse. You also can find a list of medications to avoid on the Myasthenia Gravis Foundation of America website at www.myasthenia.org.
can make your MG worse. Click on the links in the paragraph above for details.
Be sure to check with your primary MG doctor before taking any new medication, even over-the-counter drugs.
Reviewed by the Conquer MG Medical Advisory Board, April 2016.
Unless otherwise stated, the information provided here is of a general nature, composed by non-medical personnel. It is meant to be accurate and helpful advice for MG patients. It is not intended to be medical opinion, nor is it a substitute for personal professional medical care.