I've been reading everyone's experience with Linzess but have not read of anyone needing to take it 2 x day. Lucky for you :-) Long story short, colon resection for sigmoid diverticulitis, followed by IBS-C. After several failed medications I started out taking Linzess 145 once daily, then my doctor increased to 290, then increased the 290 to twice daily. I'm still working with my doctor to adjust the time of my second dosage, so that it doesn't interfere with dinner or sleep, which it has on many occasions. I think I've finally found the right time, approximately 4:45 PM, however results are inconsistent. Overall, Linzess truly has helped in may ways. Would appreciate your comments.