When you have myasthenia gravis, certain antibiotics can worsen muscle weakness by interfering with acetylcholine — the chemical your muscles need to contract. Since MG already affects how well acetylcholine works, these antibiotics can make symptoms significantly worse.
The main classes to avoid if possible are:
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When you have myasthenia gravis, certain antibiotics can worsen muscle weakness by interfering with acetylcholine — the chemical your muscles need to contract. Since MG already affects how well acetylcholine works, these antibiotics can make symptoms significantly worse.
The main classes to avoid if possible are:
- Fluoroquinolones (e.g., ciprofloxacin, levofloxacin, ofloxacin)
- Macrolides (e.g., azithromycin, clarithromycin)
- Aminoglycosides (e.g., gentamicin, tobramycin, neomycin)
- Some tetracyclines (e.g., doxycycline, minocycline)
Fluoroquinolones in particular can trigger serious issues like breathing problems, difficulty swallowing, drooping eyelids, and double vision. That said, sometimes treating an infection is more urgent than the risk of an MG flare — and an untreated infection can actually trigger a flare on its own. So it's really important to check with your neurologist or MG specialist before taking any antibiotic. They can help find the safest option for your specific situation.
September 10
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