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Denver, CO
May 14
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Managing medications with myasthenia gravis (MG) requires extra care, as certain drugs can worsen muscle weakness or trigger serious complications. Here's a breakdown of what to watch out for:

Antibiotics to avoid when possible
- Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)
- Aminoglycosides (e.g., gentamicin, Show Full Answer

Managing medications with myasthenia gravis (MG) requires extra care, as certain drugs can worsen muscle weakness or trigger serious complications. Here's a breakdown of what to watch out for:

Antibiotics to avoid when possible:
- Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)
- Aminoglycosides (e.g., gentamicin, tobramycin)
- Macrolides (e.g., azithromycin, clarithromycin)
- Some tetracyclines (e.g., doxycycline, minocycline) Supplements and minerals to be cautious with:
- Magnesium supplements — especially intravenous (IV) magnesium, which can trigger a myasthenic crisis, a life-threatening breathing emergency
- High-dose Vitamin D — can raise calcium levels in the blood, worsening muscle weakness Antidepressants vary in safety — some can worsen MG symptoms, so always check with your neurologist before starting one.

Always inform your entire healthcare team, including your pharmacist, about every medication and supplement you take. A pharmacist can be especially helpful in spotting drug interactions with your MG medications.

May 14
A MGteam Member

Metronidazole (antibiotic) threw me into a flare recently. Just coming out of it. Not severe but bad enough to have issues-, but face drooping, fatigue, leg muscles feeling like concrete blocks. Today is first day that I've been out of house and I still have to rest every 10 minutes while watering plants. But! I was able to bathe in one go and then cut my hair, so I am definitely on the mend. Be careful! Just because a med isn't on 'the list' doesn't mean it won't cause you problems. Where do we report these drug reactions, besides our doctors?

May 14
A MGteam Member

Mike, all of the above is wonderful advice underlining how important to have at least one reachable Dr. on your team you can consult about meds, for day to day, dental work and surgery. I have looked over the list and had no idea high strength vit D could affect MG. as a sero-negative generalised MG patient it is very difficult to get joined up or even any mg specific care, so I have to be ultra careful, as well. I have noticed a lot increasing of mobility issues for past 2 months (since I was put on high dose vit d) and now another decline with very low dose amitriplyine(not sure of spelling) (prescribed by pain consultant for related spine issues, who knew I had MG) i have honestly had a neurologist say to me when I asked for assistance managing mg 'what's myasthenia gravis?'..I hope you have some good care givers and stay as well as possible.

October 8

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