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    Should Azathioprine, Mestinon and Cortisone be continued for complete recovery from myasthenia gravis?

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Posted on Tue, 8 Aug 2017 in Brain and Spine
Question: My husband has Myasthenia Graves and the doctor gave him one Azathioprine 2 Mestinon and cortisone 2mg
An other doctor told him to stop Azatbioprine and Cortisone and to take only 2 Mestinon.

What should he do?




doctor
Answered by Dr. Erion Spaho 49 minutes later
Brief Answer:
He can use all three of them.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

All these three drugs are indicated for the treatment of myasthenia gravis.

It depends on the severity of symptoms, however, in my opinion, he should use all three of them in order to achieve the maximal effect on the disease.

Of course, it is necessary to close monitoring by his Neurologist.

Hope you found the answer helpful.


Take care.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Erion Spaho 2 hours later
What will happen if my husband stops taking Azatbioprine?
doctor
Answered by Dr. Erion Spaho 5 hours later
Brief Answer:
Lower chances of disease control.

Detailed Answer:
Welcome back.

Stopping Azathioprine lowers the chances of disease control.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho 20 hours later
Dear Doctor,

My husband who has Myasthenia his neurologist gave him Azathioprine, Cortisone and 2 Mestinon.

My husband wanted a second opinion and saw a different neurologist. He told him to stop the Azathioprine and Cortisone and to only take 2 Mestinon.

What is your opinion?

Thank you

doctor
Answered by Dr. Erion Spaho 6 hours later
Brief Answer:
If severe symptoms use all three drugs.

Detailed Answer:
Welcome back.

Since I can't examine your husband clinically, is difficult for me to give you the most correct answer.

However, if moderate to severe symptoms all three drugs should be used in my opinion.

Hope this helps.

Greetings.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho 18 minutes later
My husband has mild Myasthenia is Mestinon enough?
doctor
Answered by Dr. Erion Spaho 1 hour later
Brief Answer:
Mestinon could be tried alone.

Detailed Answer:
Hello again.

Okay, if very mild symptoms, then only Mestinon could be tried for a couple of weeks and to see how it is working.

Two other drugs may be added to the treatment if Mestinon alone doesn't work or any progression of the disease.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho 35 hours later
Dear Doctor,

Thank you for your help

Besides my husband has mid MG he has also Monclonal Gamopathy and maybe in the future Myeloma.

My question is will Azathioprine cause Myeloma in the future?

I have another question my husband only has mild MG closing eyelids only

Is Mestinon enough?

Thanking you in advance
doctor
Answered by Dr. Erion Spaho 7 hours later
Brief Answer:
Azathioprine may increase malignancy risk.

Detailed Answer:
Hello again.

Chronic immunosuppression with azathioprine may increase neoplasia risk, mutagenic risk, and hematologic toxicities, so, it may increase the risk of developing myeloma.

Since there is only extraocular muscles weakness, I think for the moment Mestinon should be sufficient.

However, if no improvement after a couple of weeks, it means that only Mestinon is not sufficient.

Hope I helped you.

In good health.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3850 Questions

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