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I had the same problems with Mestinon. Now, remember, this disease affects each of us differently, and different things work for different people. My first suggestion is to ALWAYS eat something with the pills. This helps a lot. My doctor prescribed 60 mg every 3 hours while awake and it worked very well for me, except for the diarrhea. If I go more than 3 hours, I start having increased symptoms, so I try to take them on time. After a while of taking the Mestinon, I found that the diarrhea subsided somewhat, but some days were worse than others. I couldn’t understand until I realized that the medication made me lactose intolerant. I cut out everything with milk/milk products and that helped a lot. I read online that Mestinon is made with a lactose base ingredient, and it can make you lactose intolerant. I also found that foods with a lot of fiber like lettuce or oatmeal caused the same problems. So I limit those as well. I hope this helps!