From the Guidelines
Medications for Muscle Weakness
Muscle weakness can be treated with various medications, including corticosteroids like prednisone (0.5-1 mg/kg/day) 1, which are commonly used for short-term treatment of weakness associated with inflammatory conditions.
- Pyridostigmine (30-60 mg orally every 6-8 hours) may be used to treat weakness in patients with myasthenia gravis, with treatment duration and dosage adjusted based on individual patient response 1.
- Immunosuppressive drugs such as methotrexate, azathioprine, and mycophenolate mofetil may be used as steroid-sparing agents in the treatment of muscle weakness associated with inflammatory myopathies 1.
- Intravenous immunoglobulin (IVIG) and plasmapheresis may be considered in severe cases of muscle weakness, particularly in patients with myasthenia gravis or Guillain-Barré syndrome 1.
- Methylprednisolone (1-2 mg/kg daily) may be used in severe cases of muscle weakness, with dosage adjusted based on symptom improvement 1.
It is essential to note that the choice of medication and treatment approach depends on the underlying cause of muscle weakness and the severity of symptoms. A thorough evaluation by a healthcare professional is necessary to determine the most appropriate treatment plan. Additionally, medications that can worsen myasthenia, such as β-blockers, IV magnesium, fluoroquinolones, aminoglycosides, and macrolides, should be avoided in patients with myasthenia gravis 1.
From the FDA Drug Label
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that they affect the ultimate outcome or natural history of the disease. An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with disorders of neuromuscular transmission (e.g., myasthenia gravis), or in patients receiving concomitant therapy with neuromuscular blocking drugs (e.g., pancuronium). The treatment of the two conditions obviously differs radically. Whereas the presence of myasthenic crisis suggests the need for more intensive anticholinesterase therapy, the diagnosis of cholinergic crisis, according to Osserman and Genkins1, calls for the prompt withdrawal of all drugs of this type.
Medications used to treat muscle weakness:
- Anticholinesterase therapy, such as pyridostigmine, may be used to treat muscle weakness in patients with myasthenia gravis.
- Corticosteroids, such as prednisone, may be used to treat muscle weakness in patients with multiple sclerosis or other conditions. However, high doses of corticosteroids can cause acute myopathy, which may involve muscle weakness. 2 3
From the Research
Medications for Muscle Weakness
- Vitamin B12 is used to treat muscle weakness caused by vitamin B12 deficiency, with oral administration being as effective as intramuscular administration 4, 5
- High oral doses of vitamin B12 (1000 mcg and 2000 mcg) can achieve haematological and neurological responses in vitamin B12 deficient patients 4
- Vitamin D supplementation is also important for maintaining bone health and preventing muscle weakness, particularly in older people 6, 7, 8
- The recommended daily intake of vitamin D varies, but maintenance of repletion in healthy older people requires intakes of ≥800IU/day [20μg] 8
- Some experts suggest that ≥1000-2000 IU [25-50μg] of vitamin D daily is necessary for older people, especially when independence is lost, or hypovitaminosis D could add to the clinical problem[s] 8
Treatment of Vitamin Deficiencies
- Vitamin B12 deficiency can be treated with oral or intramuscular administration of vitamin B12, with 1000 microg/day vitamin B12 orally being a recommended dose 5
- Vitamin D deficiency can be treated with supplementation, with doses <4000 IU/day being considered safe 8
- Treatment of vitamin D deficiency is desirable to reduce the risk of developing chronic diseases, even if there is not sufficient evidence to recommend vitamin D supplementation as treatment of chronic diseases 7