I've been trying Amitiza off and on for several months. I say off and on because I've seen no clear signs that it works, so I felt compelled to supplement with occasional Miralax, which makes it hard to determine which actually helped. I've also waffled between twice a day, which is recommended, or just once. I recently decided to give it one more try and to stay with only Amitiza for as long as I could. I started with one a day for several days then increased to two. It was almost a week before I had a bowel movement. Hardly a roaring success. I cut back to one when I realized I only had a few pills left and couldn't quickly refill the prescription. Because of the delay, I decided to take a laxative tablet, something I rarely do. It's almost 24 hours since I took it, and nothing has happened. Has my system just decided to become super slow due to so much experimentation with different things (I also tried Trulance for a short time earlier this year, but it didn't help)? I should be able to pick up the Amitiza refill tomorrow and get back to giving it one more chance. However, I"m also thinking about taking another laxative to see if I can get cleared out first, since the Amitiza won't have an immediate effect. On top of that, I've just been diagnosed with osteoporosis, and the OTC and prescription medications I'll need to take could increase my constipation. I wish I felt there was something I could rely on to help. Trying this and trying that may have just made things worse.