Shari, It's always best to talk to your neuro before making any med changes.

I am on 90 - 100 mg. every 3 hours, round the clock. When I go out and do things, my neuro has approved me to have an extra 10 because of how worse I get. I can't take the other MG drugs for various reasons so I have to rely on Mestinon and rest.

Everyone's situation is different. Sometimes neuros increase the time between doses, increase the actual mgs. or both.

Like others, I can always tell when Mestinon is running out. It kicks in about 20 minutes after taking it (I'm on the syrup and it tends to kick in faster) and wears off about 30 minutes before the 3 hour mark. Don't even have to see a clock to know what stage I'm in!

If you get weaker off of it, that's an obvious sign that you need to take it more often. If not and you get worse on a dose, you may need to back off the dose amount. That's why it's so important to really notice how you feel and when and to tell your neuro about it all. Then they can adjust things accordingly.

I hope you can get it all balanced out.

Annie