I have to agree with Annie, the ups and down on the dosage are tough and I wouldn't recommend it (although I am not a doctor and it is possible there is a good reason for it sometimes).

My doctor did this to me too, first with having me take 60 mg every day with an additional 60 mg every second day. One day I was in bed tired most of the day from not enough Mestinon and the next I was energetic and shaky/nervous from too much mestinon.

For a while I didn't really care about this bad day/good day situation, because I was happy that I could eat, brush my teeth and shower, I really didn't mind that I had to go back to bed afterward. And I didn't mind the nervousness on the high Mestinon dosage day, although it was difficult being around people, lol.

After I complained, my doctor and I compromised and I took 60 mg in the morning and 30 mg in the evening, this was better but still I was shaky/nervous for the first half of the day (but funcional) and then the second half of the day I went to bed. My neuro still doesn't like me splitting the pills, but at least he approved it.

I complained again to my neuro and I am now taking 30 mg 3 times a day and occasionally a 4th time if needed.

This is helping me a lot, I am happy to have somewhat predictable days and the steady dose is much easier to deal with.

I just realized that I have a new eating habit now. After losing weight from not being able to eat enough before I started Mestinon and from those high dose/low dose of Mestinon on alternate days, I eat fast now and I have a hard time stopping myself from swallowing my food after barely chewing. Since I couldn't eat much on the low dose days I ate a lot on the high dose days and I gave myself this new bad habit.

I think you should talk to your doctor about a steady dosage.