10 best drugs for myasthenia gravis

In the treatment of myasthenia are used:

• anticholinesterase agents;
• corticosteroids and nonsteroidal immunosuppressants;
• B vitamins and potassium. 

Let us examine in more detail all these types of drugs and their effect.

List of 10 effective drugs for myasthenia gravis according to the KP

If there is a failure in the transmission of excitation in the nerve fibers, as in myasthenia gravis, anticholinesterase drugs are prescribed. Their main task is to suppress the activity of cholinesterase, an enzyme that interferes with the normal transmission of a nerve impulse. This group of drugs includes: Prozerin, Aksamon, Kalimin N. 

Even against the background of myasthenia, specific antibodies are produced, the level of which is successfully reduced by non-steroidal immunosuppressants:

• azathioprine, 
• cyclosporine, 
• methotrexate, 
• tacrolimus.

In the course of treatment, the use of B vitamins and trace elements, in particular potassium, is shown. it is washed out during therapy. Potassium chloride, Potassium-normin, Milgamma can be prescribed. Consider all effective drugs for myasthenia gravis in more detail. 

Anticholinesterase agents

1. Proserin 

The drug is available in the form of tablets and solutions for subcutaneous, intravenous and intramuscular administration. It significantly improves neuromuscular transmission. 

The drug has quite a few contraindications: arrhythmia, ulcers, etc. Before use in children, a safe dosage should be determined. During pregnancy and breastfeeding, the drug is prohibited, as it crosses the placenta, it also enters breast milk. This drug for myasthenia gravis is a prescription drug.

2. Axamon 

This drug has a stimulating effect on the central nervous system. Indicated for use as prescribed by a doctor (requires a prescription!) for myasthenia gravis and myasthenic syndrome. 

It is forbidden to take Axamon for epilepsy, bronchial asthma and angina pectoris. During pregnancy and lactation, this drug should be discarded. 

3. Kalimin N 

This cholinesterase inhibitor has a similar principle of action to the drugs above. It contains pyridostigmine bromide and is available as a prescription tablet. The only indication for use is myasthenia gravis.

Contraindications include bronchitis, asthma, gastrointestinal problems. Pregnant and lactating women, along with children under 18, the drug is prohibited. 

Corticosteroids and non-steroidal immunosuppressants

4. Azathioprine 

Azathioprine is an immunosuppressant drug with the same active ingredient. Helps in the treatment of myasthenia gravis, rheumatoid arthritis and other diseases. It has significant side effects, so the specialist must weigh the benefits and risks of using this remedy. 

Not used during pregnancy, lactation and in children.

It is dispensed from pharmacies exclusively by prescription. It is extremely important to observe the dosage in order to minimize the toxic effect of the drug. 

5. Cyclosporine 

Cyclosporine is effective in autoimmune diseases, including myasthenia gravis. The list of adverse reactions of the body is also impressive, so the drug is prescription and is taken by patients under the strict supervision of a physician. 

It does not apply if the patient is a nursing mother or an infant under one year old. Exclude the drug for malignant neoplasms of the skin. The experience of use during pregnancy has been little studied. 

6. Methotrexate 

This drug is also used to treat myasthenia gravis.¹, and can be administered together with prednisolone. It has an immunomodulatory and anti-inflammatory effect. 

The drug is contraindicated in many diseases of the immune system, hematopoietic system and others.

This solution for injection is dispensed from a pharmacy by prescription, and only a doctor can determine the desired dosage and duration of the course of use. 

7. Tacrolimus

This drug is a highly active immunosuppressive agent. Available in the form of capsules with different concentrations of the active substance (tacrolimus monohydrate). The dose is set by a specialist in each individual case. 

Contraindications include: pregnancy, breastfeeding, childhood and hypersensitivity to the components of the drug.

Like all immunosuppressants, this drug is available by prescription. 

B vitamins and potassium

8. Potassium-normin 

Potassium-normin in the form of tablets is prescribed for myasthenia without fail, in order to make up for the deficiency of potassium while taking the above drugs, which wash it out. 

Potassium-normin is contraindicated in peptic ulcer disease, pregnancy, lactation, and kidney and adrenal insufficiency.

During the period of use, you should regularly check the level of K + in the blood. A prescription is required to purchase from a pharmacy. 

9. Potassium chloride 

Potassium chloride is available as a concentrate for solution for infusion and oral administration. 

Potassium chloride injection solution has an impressive list of contraindications. It includes renal failure, ventricular fibrillation, Addison’s disease. The use of potassium chloride is not indicated for people under 18 years of age, pregnant women are not prohibited from taking it, but this should be done with caution and under the supervision of a doctor.

10. Milgamma 

The drug to compensate for the deficiency of B vitamins is available in the form of tablets and a solution for intramuscular injection and is used as part of complex therapy. 

Contraindications are similar to other drugs: pregnancy, lactation, childhood and intolerance to the components.

This drug is also sold by prescription, as the doctor must determine the duration of the course so that there is no overdose. 

How to choose drugs for myasthenia gravis

None of the medicines in this article can be used without a doctor’s prescription. Treatment of an acute condition – myasthenic crisis – occurs exclusively in a hospital.

Since this is a chronic disease that requires constant drug therapy, the patient should be managed by one attending physician, who will prescribe drugs suitable for myasthenia gravis. 

Popular questions and answers 

Sources of

1. Myasthenia gravis: modern treatment strategies O. Lapshina, K. Komshina, E. Antipenko, MD, A. Gustov, MD, Professor Nizhny Novgorod State Medical Academy, 2017

   https://vrachjournal.ru/sites/default/files/fulltext-pdf/25877305-2017-06-03.pdf