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Nasty cramps and diarrhea start about 36 hours after the weekly MTX, lasts a few days. Anyone else on this combo…and any advice? Thanks…

September 3
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MGteam

Welcome to the MG world — not the club anyone signs up for, but here we are! Managing MG alongside other conditions takes some real juggling, and it sounds like you're already navigating it thoughtfully.

The cramps and digestive upset you're experiencing are worth discussing with your doctor, as there are a few things Show Full Answer

Welcome to the MG world — not the club anyone signs up for, but here we are! Managing MG alongside other conditions takes some real juggling, and it sounds like you're already navigating it thoughtfully.

The cramps and digestive upset you're experiencing are worth discussing with your doctor, as there are a few things potentially at play here.

Mestinon (pyridostigmine) itself is known to cause GI side effects including cramps and diarrhea in some people. These side effects can sometimes be managed by:

- Adjusting the timing or dosage of Mestinon
- Taking it with food to ease stomach upset
- Asking your doctor about extended-release formulations It's important to let your neurologist and rheumatologist know about these symptoms together, since both specialists need the full picture of what you're taking.

A pharmacist can also be a great resource — they can review your full medication list and flag any interactions between methotrexate, Mestinon, and any other medications you're on.

Other MGteam members have found that keeping a symptom diary helps identify patterns and gives doctors useful information to work with.

September 3

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