Having to up your dose to more than one pill is sometimes common and should not cause any harmful side effects. I am on Prevacid 30 and for a while, one just didn't cut it. My doc had me go to two a day, now I can go for days without taking one. My GERD is primarily nighttime and I haven't had a problem recently. I am a Medical Assistant and I definitely see increased doses. I have a patient who sometimes needs four 30 mg Prevacid's a day and that is per his gastroenterologist. Obviously with any medication where the preferred dosage is one pill per day, such as Zyrtec 10 mg for allergies or Singulair 10 mg for asthma, you want to try and use that maintenance dose. But, sometimes, I have to take two Zyrtecs a day when my allergies are really bad and that is fine. A PPI (proton pump inhibitor) is not in a medication class where doses need to be absolutely specific such as an insulin dose or a Coumadin dose. As long as you have the ok from the GI, you should be able to play with the med depending upon your symptoms at that time.