Drugs for MG

Those are two good questions, Mark. Cellcept is an immunosuppressant similar to the azathioprine I take. They work by slightly different mechanisms. There is no clinical difference in effectiveness. Usually, your doctor will switch to the other drug if you have a bad set of side effects with the first one prescribed. They both suppress production of antibodies by your immune system. They thus make you more vulnerable to infections, sun exposure, etc. They both can have terrible long-term consequences to bone density and many other things.

That having been said, take your Cellcept without complaint. It will actually permit you to reduce or eliminate other drugs, like Mestinon and prednisone. MG is a serious condition and needs to be treated seriously. Sorry. There is no easy way out. The acetylcholine-binding antibody is destroying the receptors on your muscles, making weakness permanent. Mestinon does nothing to protect those receptors. Cellcept does.

The muscle cramps are a guaranteed side effect of Mestinon. Stay well hydrated. If the pain is too severe, ask your doctor if you can reduce your doses of Mestinon. As the Cellcept begins to work, you'll notice the on-and-off effectiveness of Mestinon begin to stabilize. It's an indication it's time to taper off Mestinon.

The AChR antibody destroys the messenger molecule in your neuromuscular junctions. Acetylcholine. Mestinon works by flooding your junctions with extra acetylcholine. It does that by suppressing the action of an enzyme which would normally control the amount of acetylcholine. As Cellcept reduces the destruction of acetylcholine, Mestinon may cause a dangerous, toxic buildup of extra acetylcholine. The result is, among other things, screaming leg cramps, the kind of cramps that keep the whole neighborhood awake. At that point your Mestinon is dangerous. Stay in communication with your neurologist.

Hope that helps, Mark. Best of luck to you.