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Contraindicated Medications


 • Contraindicated drugs

Many drugs are contraindicated in patients with myasthenia gravis. This means that the drugs should not be used or should only be used with extreme caution.

Contraindicated drugs can worsen symptoms of weakness in patients with myasthenia gravis. Therefore, it is important for patients to avoid using contraindicated drugs whenever possible. One way to avoid mistakenly using these drugs is to insure that your doctor, dentist, and other health provider is aware of a diagnosis of myasthenia gravis if a new drug is prescribed. You may also want to check with your pharmacist about the use of any newly prescribed drug. In addition, you should keep a list of contraindicated drug handy, and check any new drug that is prescribed against this list.

Remember, too, that new drugs are always being marketed. Many of these drugs may not have been used in patients with myasthenia gravis. As a result, the safety of these drugs for patients with myasthenia gravis may not be known at this time.

Of course, any given drug can affect patients in different ways. Some patients may have no significant side effects while others may have severe problems. It is important for you to note the effects of a newly prescribed drug and report any increase in myasthenia gravis symptoms or other problems to your prescribing doctor.

The list below identifies drugs that are contraindicated for patients with myasthenia gravis. You may find it helpful to print this list for personal reference. You may also wish to update your printed copy as you become aware of any drug that you cannot use.

Contraindicated drugs

Drugs that should NEVER be used by patients with myasthenia gravis:

- D-Penicillamine (Cuprimin, Depen)

Drugs that should be used with caution by patients with myasthenia gravis:

Certain Antibiotics

- Erythromycin (A/T/S, Akne-Mycin, E-Mycin, E.E.S, Emgel, ERY, Erycette, EryDerm, Erygel, Erymax, EryPed, Ery-Tab, Erythrocin, Erythrostatin, Ilosone, Ilotycin, PCE, Staticin, T-Stat;, Theramycin Z)
- Gentamicin (Garamycin)
- Kanamycin
- Neomycin (Mycifradin, Myciguent;, NeoTab)
- Streptomycin
- Tobramycin (Nebcin;, TOBI;, Tobrex)
- Fluoroquinolones: Ciprofloxacin (Cipro, Ciloxan)

Cardiovascular drugs

- Quinidine (Cardioquin, Quinidex;Quinaglute)
- Procainamide (Procan, Procanbid, Pronestyl)
- Calcium channel blockers
- Beta-blockers:
- Atenolol (Tenormin)
- Nadolol (Corgard)
- Propranolol (Betachron, Inderal)
- Timolol (Betimol, Blocadren, Timoptic)

Muscle relaxants

- Succinylcholine (Anectine, Quelicin;, Sucostrin)
- d-tubocurarine
- Any other neuromuscular blocking agent


- Meperidine (Demerol)
- Morphine

Other medications

- Iodinated contrast agents
- Magnesium Preparations

-- Magnesium aluminum hydroxide (Maalox)

- Quinine


Accordant Health Services. Myasthenia gravis: Care Management Action Plan

MG Foundation. Medications and myasthenia gravis. (

Rhynsburger J. Myasthenia gravis survival guide: A Guide to Patient Directed Health Management. 1997. (

Reviewed by a member of the

First published April 1, 2000
Last updated November 18, 2003
Copyright © 2000 Accordant Health Services, Inc. All Rights Reserved.

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