- https:
//www.myastheniagravis.org/about-mg/treatments/ [last accessed November 2023] - https:
//myasthenia.org/Newly-Diagnosed/Cautionary-Drugs-for-MG-Patients [last accessed November 2023] - https:
//myasthenia.org/Newly-Diagnosed/Treatment-Strategy [last accessed November 2023] - https:
//www.medicinenet.com/pyridostigmine-oral/article.htm#what_is_oral_pyridostigmine_what_are_the_uses_for_oral_pyridostigmine [last accessed November 2023] - https:
//www.frontiersin.org/articles/10.3389/fneur.2020.00538/full [last accessed November 2023] - https:
//www.myastheniagravis.org/about-mg/treatments/ [last accessed November 2023] - https:
//www.nhs.uk/conditions/myasthenia-gravis/treatment/ [last accessed November 2023]
Medications
There are numerous medications your healthcare provider may prescribe, and these will be recommended to you based on your age, the nature of your condition and other background health issues. Your healthcare provider will assess you and help you to decide which medications will best suit your needs.
Anticholinesterase Inhibitors
Anticholinesterase (AChE) inhibitors, a symptomatic treatment, are typically the first kind of medication your healthcare provider may prescribe as they have few long-term side effects and are the fastest-acting medications currently available. They act by temporarily relieving the symptoms of MG.
Anticholinesterase helps prevent the activity of the immune system by stopping the breakdown of the chemical messenger acetylcholine, which creates muscle contraction in your body. When a person produces acetylcholine, they benefit from normal levels of muscle strength. AChE inhibitors can partially control MG symptoms in some patients, completely in others.
- Pyridostigmine is the most commonly used AChE inhibitor for treating MG. It affects the chemical messengers in the body that serve nerve impulse to muscle movement communications. It can improve muscle strength in patients by breaking down the natural substance acetylcholine in the body, which is needed for normal muscle function.
Immunosuppressants (ISTs)
Immunosuppressants, sometimes referred to as Immunosuppressive Agents, work by activating or suppressing target genes. These include both corticosteroids, such as prednisone, and non-steroidal ISTs. While such treatments can be effective in lessening symptoms, they carry risks including an increased susceptibility to infection.
Corticosteroids, such as prednisone may be recommended if your healthcare provider thinks you are not responding well or meeting your MG treatment goals. Healthcare professionals are more likely to prescribe this treatment once a sufficient trial of Pyridostigmine has been undertaken.
Non-steroidal ISTs can eliminate the need for prednisone when effective, however they take a while to work and can be complicated to give correctly. Azathioprine, Mycophenolate Mofetil, Tacrolimus, Methotrexate, Cyclosporine and Cyclophosphamide are all types of non-steroidal ISTs.
By suppressing your body's immune system, immunosuppressants will stop the damage from harmful antibodies that cause MG weakness. However, this type of medication can make you more susceptible to disease as your immune system will be low during treatment. Therefore, it's best to avoid groups of people and wash your hands regularly while you are taking immunosuppressants.
As certain drugs and over-the-counter medications may worsen your symptoms, talk to your healthcare provider before taking any medications not prescribed by them.