For the first 5 years or so I needed 6-8 Imodium a day. But that was before I knew I had chronic cuffitis. Once that was treated, I still needed Imodium, but less. I then was able to reduce to 4 a day. Now, 18 years later, I am down to 1 a day, but I also take Norco daily for my arthritis, so that is sort of a replacement.
I don't know if there is a best time of day to take it, as there will be a constant serum level after a few days where the level builds up. If it helps, the peak is about 4-5 hours after you take it. So, if you take it twice a day, about 12 hours apart, you are pretty much covered. When I was taking more, I took it when I first got up in the morning and around dinner time.
Imodium slows the gut and increases water absorption, so it thickens some just because of that. But many people want thicker stool to help reduce urgency and leaks. This is where the fiber supplements come in. Both Metamucil and Citrucel come in sugar-free varieties, so that should not be a big deal, but they still have a small amount of carb calories. Another option is the capsules, which have none. You'll have to take more for the same result, so it will be more expensive that way. I was put on Metamucil right after surgery, but it gave me too much gas and cramps. So then I tried Citrucel, which was better, but it did not reduce my frequency at all. It just made it thicker and more bulky. Since I was not having any issues with continence, I gave up on it because it was more hassle than I was interested in.
Other fiber options are chia seeds and apple pectin. You just have to look a little harder to find them.
Jan