I take Mestinon syrup, due to my lack of stomach acid. It absorbs better than the tablets for me. It also goes to work a little more quickly.

I am on 90 - 100 mg. every three hours, round the clock.

Using an "under the tongue" drug, like sublingual methylcobalamin or nitroglycerin, is useful for a couple reasons. One, it goes to work quickly. Two, it goes directly into the blood stream and bypasses the GI tract for those with GI issues.

I don't have any side effects of Mestinon. Probably because I don't have stomach acid (if you want me to explain that, I will). I have had to go off of Mestinon for testing. When I go back on, I take the full dose. Nope, no side effects then either.

Mestinon also increases peristalsis. Peristalsis is how food is moved through the GI tract. It involves MUSCLES. The weaker them muscles, the slower food moves through. That's why on most bottles of Mestinon, there is that little sticker that says to take it with bread or crackers if it upsets your stomach. Carbohydrates "stop up" the GI tract.

Symptoms off of Mestinon depend upon the day (what muscles I've been using and for how long) and time of day for me. I sometimes choke when it runs out. Don't even need to see a clock to know that my 3 hours are up - actually my 2-1/2 hours since that's when it runs out. I am noticeably weaker and short of breath.

This is a good idea, Lizzie. Everyone has slightly different experiences with Mestinon.

Annie