I'm on 20mg 4x a day. Most of the time it helps but there are times when severe pain pays me a visit without notice and I have to up it to 40mg for that particular time combined with other meds and the spasticity calms down. I don't know what stage you are or what level your pain is but its always a good idea to discuss this with your neuro. That's how I can take my meds the way I do.