I now after several Yrs take time released 90 mg bid and add 60 mg reg mestinon as needed. I srted tr due to side effects and yes it has increased over the yrs. My Dr gave me directions so I could vary doses and keep track to see what worked best instead of waiting for Dr appts good luck felEl well

My neuro gave me a prescription that was 90 mg 6x per day -- the max she thought I should take, but told me to take it on an as needed basis, like aspirin for a head ache. I ended up taking about 60 mg every 2.5 hours to be functional, and less in the afternoon and evening when I could chill out and didn't care if I vegetated.

I was also taking prednisone but it had not taken effect yet. As the prednisone worked, I backed off and took less and less mestinon as the side effects were bothersome (extreme perspiration when I did anything, night time leg and foot muscle cramps that were agony and stomach pains). Never had to worry about constipation ;-)

If you take more than your prescription, you run out of pills, and those of us who depend on them get rather desperate if that happens. At first I kept having my neuro's office rewrite the prescription, but having the max written meant I quit worrying about running out as I never quite took that much. I had an idea of what a drug addict feels like when they can't get their next fix!
Good Luck

I am on 3 60mg pills every 4 hours and imuran and prednisone just can not get off the prednisone and have tried with no luck.
I can call my neuro any time if it is during the day I talk to his nurse I also have some freedom with my drug amount.
So good luck and keep a diary so when you talk to te doc you will have it with you and be sure to write all your questions and conserns down.
Chuck

I have taken as much as 540MG Mestinon daily in the past. I am off Mestinon at the present time. I took it like Rhanson described on an as needed basis. My side effect was leg cramps.

I have taken more Mestinon than most would ever consider. Certainly more than what is mentioned on this thread. Having said that, I feel comfortable telling you that moving up a little is ok. Yes, contact your doctor for increase in prescription.

Please understand that if you feel the need to keep increasing your dosage, it means your underlying condition is worsening. Without treatment, you can get much worse. You need treatment to get off of mestinon. Hope the Imuran works for you. It may take a year to show benefits. I hope it works sooner. May want ask about IVIG to push back your MG until Imuran works. Sometimes it can take a lot of time and devotion to figure out what works best.

Get exercise as much as possible and set goals to improve upon.

That is my advice for you along with sending luck.

Best wishes for peace,
TJ from CA

I was started on a very low dose but now i am on 90mg in the at the morning and midday dose and 60mg for the afternoon and evening I take 4 doses a day but i have been told to up each dose to 90mg if needed.
I think the dosage is entirely individual and can be adjusted as needed but yes have a word with your neuro as if you do it yourself then i guess you run the risk of getting the overdose symptoms which (please correct me if i am wrong) are very similar to mg symptoms???!!

I hope you start to feel better soon

I take 90 every 4 hours as needed. I have been on tratement for 5 years now, so mestinon is only need when I am really active or stressed. In the beginning I was on 30. After my crisis and being in the hospital I was on 90 every 4 hours. When I was at my worse
I took it throughout the night. I wouldn't set an alarm but I would take it when I got up to go to the bathroom.
My first neuro said no to more but the specialist said 90 was ok to take every 4 hours. try 90 today and see if it helps . I think you will be happy you did. You will get more relief immediately. This drug only last 3-4 hours in my system. In my bad times I could tell immediately when. It was wearing off.
You can just call your neurons office and ask for an increased prescription and they can call it in for you. Just tell them apoplectic in your support group take 90 and you tried it and it helped and you are requesting more.
Remember we are part of our health team.
Have a great day.

Thanks to all very much for the replies here ... and I've now been able to settle into my current daily prescription dosage .. which is 4 tablets of 60 mg each. It's doing the job, just get a bit of very mild speech, swallowing difficulty at the end of each four hours If I know in advance that I'm going to have to be speaking (e.g. had to give a talk the other night at a choir practise) ... I just take the pill a half hour earlier ... cus, thanks to all ur advice, I learned that it wouldn't hurt to take it 30 minutes before a four hour span.
I know these questions must seem really small but they're definitely not for those of us new to MG and the experience shared by the support group here is a huge help, thank you again!
I'm getting my thymus scanned tomoro ... and meet again with the neuro doc in mid march .. to .. hopefully, start the imuran.
Thanks again for the continued help and advice.

Does anyone notice if you over do it mestinon wears off sooner?...and then next dose doesn't seem to work as well....like not until I get some rest and then starts working again. Does that make sense?

Yes that seems to be the norm