Mestinon and ketotifen combo questions

Anyone been on both and run into issues?

I've been titrating up mestinon for a few months and added ketotifen about a month ago. Had 0 side effects at first and got up to 1mg a day no problem.

The last 2 weeks or so, I've been much more tired, and my HR has been higher. I'm about to try split dosing for ketotifen to see if it helps.

I'm so frustrated because both were so helpful at first.

I'm working with my doctor, but wanted to hear people's first hand experiences.