Myasthenia gravis is treated with pyridostigmine to improve muscle strength symptomatically, plus immune-directed treatment including corticosteroids and steroid-sparing agents. Certain common medications can worsen the condition markedly and must be checked. Certain antibiotics, magnesium preparations and some cardiac drugs can precipitate serious weakening, so every new prescription should be checked against the diagnosis.
Myasthenia gravis is treated with pyridostigmine to improve muscle strength symptomatically, plus immune-directed treatment including corticosteroids and steroid-sparing agents. Certain common medications can worsen the condition markedly and must be checked. Certain antibiotics, magnesium preparations and some cardiac drugs can precipitate serious weakening, so every new prescription should be checked against the diagnosis.
Pyridostigmine increases available acetylcholine at the neuromuscular junction and improves strength, but it does not modify the underlying autoimmune process. For that, corticosteroids are commonly used, often alongside a steroid-sparing immunosuppressant so the steroid dose can be reduced over time. Newer targeted biologic therapies are available for some people. Intravenous immunoglobulin and plasma exchange are used for severe worsening; those require a facility with infusion capability, which this practice does not have.
A number of widely used drugs can markedly worsen myasthenia gravis, including certain antibiotics, particularly aminoglycosides and fluoroquinolones, magnesium preparations, some cardiac medications, and certain anaesthetic agents. This is not a minor caution: a single dose of the wrong antibiotic can precipitate serious weakening. Carry written information about the diagnosis, tell every prescriber, and have any new medication checked against the condition rather than assumed safe.
Weakness affecting breathing or swallowing is a medical emergency requiring immediate hospital assessment, not a call to the clinic. Warning signs include increasing breathlessness, difficulty clearing secretions, a weak cough, choking on food or fluids, and rapidly worsening generalised weakness. Infection, missed medication, certain drugs and stress can all precipitate it. Everyone with this diagnosis and their household should know these signs in advance.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.