Typically 4-5 times a day. Almost 14 mos. out. I take Immodium at night (2 pills) and occasionally take Lomotil as needed, when I am out all day or exercising. I took 2 just before a 3 hour bike ride and did well. I didn't take any before a 5 k yesterday and also did fine. It depends on the time of day. Things are more active in the later afternoon/early evening. Happy j-poucher!