I have struggles with the same. I had to stop taking it during the first the winter with Dr S who has treated me so minimally. She has consistantly not prescibed me ANY even saying stop taking the mestinon just last year to solved the problem which truly showed me how little she understands my symptoms, how bad the MGis. Thankfully I get better in the winter as the cold really improves me. But I had to find a way to go back on in January of of 2010. So started with bitting off the side of the pill. For me it didnt help me do much but breath better and that was a blessing. About 2 months later I did a pulm test and had to take 30mg. Even with food in me I vomited twice on way home.

Since I 'happened' to go thru a major learning experince in July when the neuro-optho department tested my vision muscles by givimg me an injection of neostigmine AND atropine leaving me with only moments of a tiny bit of bowel feeling of ya gotta go I say get your doc to do an atropine drug. I found 2. One is Lomotil and one is Saltropine. I talked to my pharmacist about this and when he heard this worked for neuro-optho he said take atropine! I didnt know it came in any over the counter version. Now docs worry about it affecting you heart it seems so in my case I still havent got the presciption. I think my new neuro will do it eventually.

Annie59