{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:33:49Z","timestamp":1776447229059,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Some groups of cardiovascular drugs (beta\u2010blocking drugs, Ca antagonists, antiarrhythmics) are listed as potentially worsening myasthenia. An empirical basis for alternative recommendations for antihypertensive and antiarrhythmic therapy in myasthenia patients has not yet been provided.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From the World Health Organization pharmacovigilance database, we retrieved total and myasthenia\u2010related counts of adverse drug reactions for various groups of drugs used in cardiovascular disease and drugs with related mechanism of action used in other indications. We calculated the reporting odds ratio as a measure of a disproportional fraction of myasthenia\u2010related events among all events. A 95% confidence interval of reporting odds ratio (ROR) &gt;1 was taken as an indication for a higher risk. Because our approach involves a considerable number of tests, this situation is referred to as a signal that requires additional confirmation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A signal for an increased risk was noted for tizanidine, for alpha\u2010blocking drugs, for beta\u2010blocking drugs, and for Ca antagonists. ROR indicated a lower\u2010than\u2010average risk for salbutamol, angiotensin receptor antagonists, oral anticoagulants, thrombocytic function inhibitors, and heparins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Angiotensin receptor antagonists, angiotensin\u2010converting enzyme inhibitors, and diuretics seem to be safe in antihypertensive therapy. Surprisingly, and yet requiring confirmation by case reports, alpha receptor\u2013blocking drugs seem to carry a risk of myasthenia worsening. Amiodarone seems to be a safe alternative in antiarrhythmic therapy in patients with myasthenia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14996","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T03:17:05Z","timestamp":1624936625000},"page":"2965-2970","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The risk of worsening of myasthenia by cardiovascular medication as reflected by reporting frequency"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3434-0295","authenticated-orcid":false,"given":"Peter","family":"Trillenberg","sequence":"first","affiliation":[{"name":"Department of Neurology University Hospital of Schleswig\u2010Holstein, Campus L\u00fcbeck L\u00fcbeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Katalinic","sequence":"additional","affiliation":[{"name":"Institute of Social 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