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Medicine for Myasthenia Gravis

Myasthenia gravis (MG) is a chronic autoimmune disorder that causes certain muscles to become weak, especially after use. There is no cure for myasthenia gravis, but there are drugs to help treat its symptoms.

Sometimes MG symptoms can be unpredictable, and each person’s case can be quite different from the next person’s. This means that there is no one-size-fits-all set of drugs to treat MG.1

Your doctor’s goals for any drugs prescribed for MG will be to control the symptoms and improve your quality of life, using the lowest doses possible. Some people find that their symptoms disappear, or go into remission, for at least some time during treatment.

Types of drugs used

A few medicines, alone or in combination, can help relieve MG symptoms. The best treatment for you will depend on your age, how severe your MG is, whether you are pregnant, and the type of antibodies your body produces. The main treatments for MG include:1,2

  • Acetylcholinesterase inhibitors, a type of fast-acting drug that improves nerve signals to the muscles. Pyridostigmine (Mestinon® and Regonol®) is the medicine most often prescribed.
  • Steroids, especially glucocorticoids, are a type of hormone used to control MG symptoms quickly when acetylcholinesterase inhibitors are not enough. Doctors try to avoid long-term, high doses of steroids because these drugs can have many side effects. Prednisone is most often prescribed.
  • Immunotherapies are prescribed in moderate to severe MG as an alternative to high doses of steroids or when steroids are not working. Immunotherapies can make the immune system less active (immunosuppressants) or act differently (immunomodulators), depending on what is needed for that person.
  • Antidepressant and anti-anxiety medicines can help improve and regulate mood if myasthenia gravis triggers mental health challenges.
  • Anti-diarrheal medicine may be prescribed to help manage one of the side effects of acetylcholinesterase inhibitors.
  • Bisphosphonates, calcium, and vitamin D may be needed to help manage osteoporosis or weakening of the bones caused by steroids.

If you are trying to get pregnant or already are pregnant, your doctor may need to change or add to some of the drugs you take in order to support a healthy pregnancy.

People with MG must also be careful about the other prescription drugs they take. Some commonly prescribed medicines make MG symptoms worse, such as beta-blockers and some antibiotics and anesthetics.1

Drugs are only part of the overall approach to managing myasthenia gravis. Your doctors will also recommend several lifestyle changes, and maybe thymectomy surgery, plasmapheresis, IVIG, and complementary and alternative treatments.

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Written by: Jessica Johns Pool | Last reviewed: May 2021