My neuro lets me adjust the mestinon as needed - of course, that wasn't right after I started on the med. As Julie said, too much mestinon can mimic the symptoms of mg to a greater degree. As she suggested, it might just be too large a dose for your body. The best thing would be to discuss it with your neuro, but if you can't get a callback, you might try the 30 mg as she suggested and see how you react to it. Mestinon does not linger long in your system, about 4 hours max. So if you do have a reaction, just don't take the second dose and you should be back to normal in about 3-4 hours. Of course, I'm not a doctor and would never presume to advise you. This is a suggestion if you need some help and can't get a call from your doc. If you can't breathe, you should be in the hospital until they get you regulated.

Good luck!