I don't have an answere for you as my son has always been on the cortisone. But Debbie's point about a larger dose at night reminded me about a conversation I had with our endo once. She had wanted to put our son in a study the hospital was doing. We opted for many reasons not to involve him however, the point of the study was to try a new medicine that would only be given once a day. Unfortunately the "perfect" time was at 3am. She explained to me that the pertuitary (sp??) gland shuts off sometime around then and doesn't turn back on for several hours. I don't remember everything, it's been awhile, but They felt that if they could administer it when the glan shut off it would carry for 24hrs and with the largest dose hitting the system when it first shut down. She also explained that was why my son gets a larger dose at night. She mentioned that this form of treatment is already being done in Europe.