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Treating myasthenia gravis.

Various treatment options are available to help treat myasthenia gravis. Work with your doctor to create a plan that’s best for you.

What happens in myasthenia gravis

One of the most basic parts of the immune system are antibodies. Their job is to fight harmful things like germs that come into your body, so you don’t get an infection. In an autoimmune disease, the immune system fights parts of itself. In the case of myasthenia gravis, the body makes antibodies that attack a certain chemical between nerve endings and muscles. This blocks signals from your nerve endings to certain muscles. Your muscles get tired and weak especially when you use them. There is no cure for myasthenia gravis. But there are medications that work on the immune system or help reduce symptoms.1 Sometimes more than one medication is given at a time. 

Medication options

  • Pyridostigmine (Mestinon). This medication increases the amount of the chemical the antibodies most commonly attack. This helps the nerves “talk” to the muscles. In some people, muscles work better.
  • Immunosuppressants. Immunosuppressants weaken (suppress) the immune system. This allows fewer antibodies to attack your body.2 Some examples are corticosteroids like prednisone. Others may include azathioprine (Azasan, Imuran), mycophenolate mofetil (Cellcept), cyclosporine [e.g., Sandimmune, Gengrafmethotrexate (e.g., Trexall) and tacrolimus (e.g., Astagraf XL, Prograf)]. 
  • Intravenous immunoglobulin (IVIg). IVIg may be used as needed when you have a flare-up or myasthenic crisis. In some cases, it may be used on a regular basis to help manage the condition. This medication gives you many healthy antibodies. And you have fewer autoimmune antibodies that mistakenly attach the chemical. The healthy antibodies live for a few weeks, so you may need infusions more often.
  • Monoclonal antibodies. These are group of medications that target different areas of your immune system. They’re given if the other medications haven’t worked well enough.  Rituximab (Rituxan) and eculizumab (Soliris) are examples of monoclonal antibodies that treat myasthenia gravis.
  • Efgartigimod (Vyvgart). This is a new medication has been recently approved by the U.S. Food and Drug Administration for adults with anti-AChR antibody positive generalized myasthenia gravis.

We’re here to help

All medications have possible side effects. Ask your CVS Specialty® CareTeam if you have questions about your medication. They can also help you manage side effects and help you feel your best. If your symptoms get worse, talk to your doctor or contact your CareTeam.


  1. Narayanaswami P, Sanders DB, Wolfe G, Benatar M, Cea G, Evoli A, Gilhus NE. International consensus guideline for management of myasthenia gravis. 2020 Update. Neurology. 2021;96(3):14-122. DOI: 10.1212/WNL.0000000000011124.
  2. Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, Kuntz N, International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016;87(4). Doi: 10.1212/WNL.0000000000002790.

CVS Specialty® and Coram® CVS Specialty Infusion Services (Coram) work together to dispense and administer Myasthenia Gravis’s therapy to patients. To learn more about how Coram is keeping you safe and healthy at home during infusion treatments, click here.

This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about your medical condition and prior to starting any new treatment. CVS Specialty assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result.

This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Specialty.