Hi,take whatever lotronex dose works for you we are all different. Lotronex does cut down on the cramps. Don't take the next dose until you have had a bm that avoids C. I like to take a dose before going to bed so I don't wake up with cramps and a false need to go to the bathroom. I have been on lotronex for four months. I notice lotronex effect has gotten weaker in my system so I'm starting to take 1/2 tablet every day instead of every other day.