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Sept 23, 1968

Methocarbamol and Myasthenia Gravis

Author Affiliations

Shreveport, La

JAMA. 1968;205(13):938. doi:10.1001/jama.1968.03140390062022

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To the Editor:—  The usual contraindications to use of methocarbamol, a well-known muscle relaxant, are hypersensitivity to the drug, and known or suspected renal disease (for the injectable form only, because of the vehicle). A recent case makes us wonder whether myasthenia gravis should not be added to this list.

Report of a Case:—  A 50-year-old white woman, was readmitted to the Veterans Administration hospital on Jan 8, 1968, for increasingly severe weakness and fatigability since a previous discharge July 3,1967. Since 1965 she has been treated for myasthenia gravis, effectively with pyridostigmine bromide since June 1966. After the appearance of the present symptoms, she tried successively an increase and a decrease of the doses of pyridostigmine bromide, with no improvement whatever.Because of constant back pains "for quite a while," she had been taking methocarbamol orally and propoxyphene hydrochloride, with satisfactory results. At the time of admission, neostigmine methylsulfate