Hi, TexasRose. Does your neuro know that Plaquenil has some immunosuppressive qualities as well?

Is your pain well controlled with lupus or are you on pain meds? The reason I'm asking is that the anti-inflammatory drugs tend to reduce the gel coating in the stomach that we all have. That can leave you open for more gastric distress. Do you take a daily fish or flax supplement or eat fish? Or nuts, which have omega 3's too to help keep the gel coating in good shape.

You could try a trial of Mestinon syrup. You can titrate it to a smaller dose and then go up gradually. Also, the liquid absorbs more easily and quickly. 1 ml. = 12 mg. You could start there and gradually increase to see if your body gets used to it and what dose is optimum for you. Then you could always use the tablets on a regular basis.

It can be a little hard to have the syrup both due to cost and to portability issues. So it depends upon your insurance and your daily schedule. I use the syrup and really like the flexibility in dosing. I have no gastric side effects at all but that could be just me and not the syrup formula.

What we need to make stomach acid are gastrin, histamine and acetylcholine. So when you up your acetylcholine, you can up the amount of stomach acid you make. That's why they say to take Mestinon with a little food. I think it helps to understand what effect a drug has on your body, not only on your muscles!

I hope you can find the right combo that works for you.

Annie