Hi All,

Just thought I'd document another odd side effect in myasthenia gravis.

I'm a medical practitioner and I've had MG for 17 years. Early on it was severe with a thymoma and thymectomy. The last 10 years or so my only real complaint is some facial weakness - otherwise I'm doing very well.

I've been on azathioprine for 14 years, and on Mestinon (pyridostigmine) since the start.

I believe Mestinon causes some facial flushing or redness. This makes sense, since as a side effect Mestinon acts on blood vessels and dilates (some of) them.

My current dose of Mestinon is 60mg three times a day. People often tell me I look "red in the face" or "flushed" or "you've been in the sun".

In the early days I was on larger doses of mestinon, up to 15 x 60mg per day. I found that the higher doses of Mestinon, combined with ALCOHOL, caused EXTREME facial redness/flushing.

The Mestinon/alcohol interaction thankfully isn't really a problem on the lower doses. Cheers!