In general Cellcept will allow you to manage your symptoms with either no prednisone or a minimum amount. Mestinon does not treat the cause of the MG symptoms like cellcept or prednisone (the antibodies that attack your receptors). Rather it helps improve communication at the receptors. Like an aspirin doesn't stop what caused your headache, but it relieves the symptoms. When I got to the point with cellcept and mestinon that I didn't think the mestinon helped any more (symptoms gone without it) my doctor said to take it mostly when I was going to do something more strenuous.

In terms of the double vision, I had a flare-up after thanksgiving, and my doctor put me back on prednisone. I tapered up weekly from 5 mg to 30 mg. Yesterday when I started at 30 mg I started to get significant improvement, so I will now need to stay at 30 mg for about a month then slowly taper back down. Last time I went to zero prednisone with just my cellcept, but most likely the doctor will encourage me this time to stay at 2-1/2 or 5 mg every other day. Good luck with the double vision. This is the first time I got hit with it. When I was originally diagnosed I had ptosis along with breathing and swallowing problems, which prednisone quickly took care of. This double vision is frustrating, and all indications that it takes a month or so to shake.

Thanks for your reply. When I started on the prednisone last May, it seemed to help immediately and I never went over 30 mg a day. I took the Mestinon for a while and stopped. I was riding my bike, playing tennis, working, very active and felt great. In September I started to taper the prednisone on my own and got down to 2.5 mg and still felt fine and then went off of it. Seven weeks ago, I stopped it. Then I got this DV. I am back on the prednisone 40 mg a day and the Mestinon and it doesn't seem to have made a dent. I am a bit concerned about this, as I feel it should be working. I am almost 3 weeks with the DV. I am wearing an eye patch, otherwise I couldn't function. I am suppose to go back to the neuro around 1/21 and I may go in earlier if I don't see any results, but it does concern me, as I had such a good result the first time around. It seems it has come back with vengeance.

Definitely keep your doctor involved, but it can take awhile to take care of double vision. Just a small misalignment in your eyes can cause the double vision, but a small issue with other muscles (including eyelids) might not be so noticeable. The other thing that may help is to increase your mestinon. I was at 30 mg as needed, and my doctor put me to 90 mg/4 times a day. It doesn't fix the underlying problem, but it helps minimize the issues while the prednisone does its' thing.

Sounds like you are in the same boat as me; doing well, got off prednisone, then a flare-up. In reality it means we weren't really in remission. But, work with your doctor; it is manageable.