Azathioprine is a very slow-acting drug, and maximum improvement may take several months to a year or more to achieve. Side effects can include decreased activity of the bone marrow, liver toxicity and flu-like symptoms. Like prednisone therapy, use of azathioprine requires close monitoring. Other immunosuppressants prescribed include cyclosporine and cyclophosphamide. Improvement usually follows within a week, and may last for weeks to months.
Side effects are usually minor, and include headache, fever and nausea.
IVIg therapy is very expensive, and is usually used for short-term benefit, to get patients over a difficult period of weakness or to improve a person's strength before surgery. A course of plasmapheresis requires a hospital stay, during which a large intravenous line is placed in a chest or leg vein. Five sessions of plasmapheresis are usually performed, spaced over seven to 10 days. Improvement in strength usually follows within a week and lasts four to eight weeks. The major side effect is low blood pressure.