i've been on 180 mg tr mestinon for 4 wks now full dose.i tapered up over 3 wks to this dose. i would like to know if patients can /do go higher and in what schedule. do you take extra smaller doses or just bigger q12 hr doses? i cannot take reg mestinon due to horrible muscle twitching even if i take 30 mg i get severe twitching which also makes tummy twitch until i vomit[sorry for the graphics] have a good sleep-it's 10 pm my time! time for all sickies to go to bed!!