Hi, Brian. Welcome to this forum.

Myasthenia gravis is caused by your immune system mistakenly attacking your muscles. CellCept works by suppressing your immune system. But it builds up very slowly. A month is probably too early to see results.

Mestinon, on the other hand, is just to treat symptoms, and it has its effect immediately. In fact, four hours after you take it, it's mostly out of your system. Do you notice a difference in your symptoms a half hour after you take your Mestinon? If you find your symptoms go away when you take the Mestinon, but come back after a few hours, you could talk to your doctor about taking the doses closer together. Be careful with the Mestinon, though--too much will make your symptoms worse.

Here's what we tell all the newbies around here: be very careful. Myasthenia can be unpredictable, and new symptoms can come on very suddenly. If you can't swallow, or have trouble breathing, or get very weak, or something gets suddenly worse, go to the ER or call 911. It can be an emergency.

For many of us, the disease settles down and gets more predictable after a while, but in the first year or so it can really send you surprises.

If the CellCept isn't working for you, there are other drugs your neuro can try that suppress the immune system. One of them is Prednisone, which works faster than the others, but has bad side effects. Another possibility is getting infused with immunoglobulin (through an IV. This is called IVIg). I just mention these so that you can see that if the CellCept really doesn't help, there are other options.

Abby