The increased weakness 1 hour after pill is of some concern. Perhaps the dose is too much...or too much too soon. My neuro started me out slower..and ramped up with time. I never had any side effects and noticed immediate improvement in my ptosis and duration of muscle duration.

Talk to your doc, but some folks here (myself included) take less. but more often. I take 30 mg roughly every 3 hours....making some time adjustments depending upon how I'm feeling. But I don't recommend making adjustments without your doc on board...and most especially without some experience of how you and Mestinon get along over a week or more period of time.

But....if you have any significant increased weakness after Mestinon....don't fool with that. Stop taking it and call neuro for advice.

Let us know how it goes.