I have always taken my Timespan in the morning along with Predison& Cellcept per my Neuro. I take 30mg of mestinon during the day as needed. I always take 30mgs when I get up before the other meds. I find that helps me chew better. Since adding the Cellcept I'm relying on the 30mgs less throughout the day.

after first being diagnosed with myasthenia gravis big thing was drooping eye lids after being experimented on for about7-or-8 months I was referred to a neurologist who put me on mestinon timespan and got my eyes open-that was 2012-i have taken it for good many years and it has done me a good job-now I recently changed neurologists and the first visit told me she was going to change me to 60mg mestinon twice daily then once daily then take it away and give me low dose prednisone-I was put on 10mg prednisone twice daily a few months ago and three days after starting it I went to the hospital as my blood pressure was 191 over 180 then I was told that is stroke level and to just take it once a day ( I took it once a day only I cut it to 5mg and that worked fine (except i don't know if it did anything but at least didn't raise my blood pressure-so i went back to my timespan and next appointment she said that was alright-then she told me to take 5mg prednisone too-i thought since i had taken it before i could do it again- i took one and then had horrible leg cramps= next i took one and went to the store and when it kicked in my memory went south i couldn't remember from one aisle to another what i was looking for-next day i tried it again and it was worse, she told me to break it in half-i did and same thing-I think i'm allergic to prednisone-then she prescribed something to cut down on over production of saliva and mucas in the throat-I always ask the pharmacist about precriptions i know nothing about-he looked in the computer and said he found three places that said don't take it and he would call the neuro and tell her-couple days later she called and said she had sent another prescription-this time my insurance wouldn't cover it-i let it go-
I think the trouble with changing from timespan to 60mg was to soon changing as last week i started taking timespan once a day which worked ok now i have been taking the 60mg once a day for two days and cut out the mestinon and so far so good (time will tell ).