Mestinon in an empty stomache is bad for me - I drool, get diarhea and it makes me shaky if taken without food. Even a small amount of food helps and then I have to also drink a glass of water afterwards. Every time I skip the food or water with Mestinon I regret it. Those Mestinon side effects are no fun. I don't get any kind of choking reaction though, just drooling.

I hope this helps