Sunday, March 15, 2009

Contraindicated medication list in Myasthenia gravis

from Continuum 2009

1. Absolute contraindication-- curare, d-penicillamine, botulinum toxin, interferon alpha
2. Contraindicated
a. Antibiotics-- aminoglycosides (gentamycin, kanamycin, neomycin, streptomycin, tobramycine); macrolides (erythromycin, azithromycin (Z-pack), telithromycin, Biaxin)
Fluoroquinolones ( ciprofloxacin, norfloxacin, levofloxacin);
b. quinine, quinidine, procainamide,
c. magnesium salts, iv magnesium replacement.
3. Caution- may exacerbate weakness in some myasthenics
a. Calcium channel blockers
b. Beta blockers
c. Lithium
d. Statins
e. Iodinated contrast agents

article on public domain

link to article by Pascuzzi discussing contraindicated drugs in more detail

1 comment:

wannarun said...

Thanks for your list. I have seronegative myasthenic syndrome for 22 years. I HAVE found that tonic water (quinine), magnesium laxative in a Fleets, erythromycin, zithomax, cipro have made me weak. K-lyte when very weak has made me stronger for awhile. I am on atenolol and quinapril (any quinine in quinapril) for high blood pressure. Any ideas for best blood pressure med? Unfortunately I am also obese -240 pounds--from prednisone in the past, inability to exercise or to say "no" to food.
I have two sisters who also have what I have. We got sick in our twenties and early thirties.
I will keep list for myself and doctors.