Hi Shari,
Mestinon dosage is pretty hard to adjust because overdosage symptoms are the same as those for underdosage…
It is highly advisable to take it on a regular schedule, usually every 4 hours but some people do change it: Scotskat just told you she was taking it every 3 hrs and I take mine every 5 hrs…
You can also vary the dose by taking more than 60 mg at a time but personnally, I would prefer to shorten the cycle.
Because of this difficulty, you have to find out by yourself what is your best schedule, for example, if you forgot one intake and you feel fine, you may try to lengthen the cycle (or cut the dose). Shorten the cycle is more difficult except when there is a good external reason: extra physical work to be done, for ex. and you may need several trials, up and down to find out.
Also, always talk to your neuro about your modifications…
Good luck!
Maurice.