Title: Myasthenia: medications to avoid - Armstrong Neurology
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Content: Caution should also be exercised with others in the family (e.g. Moxifloxacin) as it is thought that quinolones directly affect neuromuscular transmission. Macrolide antibiotics – Erythromycin / Azithromycin
There is one case report of a serious exacerbation with azithromycin requiring mechanical ventilation for 6 days. This patient also had an exacerbation from erythromycin. Tetracyclines (e.g. oral forms doxycycline, minocycline; IV form tigecycline)
Sulfonamides (e.g. Septrin™ Bactrim™)
Ampicillin
There is little evidence of problems with other penicillins. Primaxin™ (Imipenem / cilastatin)
Only available for intravenous treatment of serious infections in hospitalised patients. 4. Malaria Treatment & Chloroquine (Chlorquin™), Hydroxychloroquine (Plaquenil™),
Quinidine. Avoid use if possible
These drugs from the quinine family are also commonly used to treat SLE. They have been shown to induce MG (with or without anti-acetylcholine receptor antibodies) but can also exacerbate pre-existing MG by interfering with neuromuscular transmission.