Hi Linda,

Mestinon (pill) takes about 20 - 30 min to 'kick in'. On average, it lasts for 4 hours. For me, I get peak effectiveness in the 1 - 2 1/2 hour window.

You are right about the effectiveness being different depending on what you are doing. It's not necessarily that you 'use it up' - but rather your activity level, stress, heat, hormone levels, what you have eaten, other drugs you taken, etc. are taxing you more than on a day when you're sitting around the house in the air conditioning watching a movie drinking a cold ice tea!!

What you don't want to do is take more Mestinon looking for it to take away the heavy, tired muscle feeling...since too much can get you in a bad place too. There may come a time when you and your neuro will adjust your dosage based on experience and activity considerations. Right now, think of this as setting your baseline.

Re: food & drugs. There are lots of things that can influence MG (not Mestinon). Example: some antibiotics are contraindicated, caffine helps, alcohol can make us weaker, etc.

Hope this helps. Search some of the older posts for Drugs and Food threads. There has been much discussion about both in just that last few months.