The symptoms you mentioned can be an indicator that your dose is too high. It is important to be very careful when taking mestinon because "too much" or "not enough" can both lead to a crisis. Confused yet ;-)

Everyone takes different amounts depending on their individual need. Sometimes, I take my 60mg and don't feel anything. Other days, I take 60mg and will have a very mild eye twitch or a little foot cramp. I just get up and move my body, and that uses up all the extra acetylcholine.

Our bodies very day to day. Some days we might not need much mestinon, while other days we need extra.

It has taken me a couple months to figure out the right dose for me :-)

For me, titrating up slowly worked out really well.

I took 60mg once per day every four hours with zero side effects. Then, I started taking 60mg twice a day, and then 3-x-day, still with zero side effects. Well, one POSITIVE side effect was that mestinon has cured my chronic constipation :-D ((LOL))

But, when I started taking the 80mg every 3 hours, I had a lot of eye twitching and terrible foot cramping. So, I went back down to 60mg, every 4 hours, 3-4 times per day, and this seems to be my sweet spot.