I'm just curious... why is the dose split up? My daughter takes one pill in the morning. On days when my daughter used to have surgical procedures and could not eat/drink anything, I was always told not to even give her her meds on those days. She would be given her hydrocortisone by IV during the procedure. The florinef I was always told not to worry about, that she would not suffer any ill effects by not taking it at all on that one day. This was ONLY for the days when she was being given anesthesia. But I guess what that means is that if you missed your daughters dose, it would have been safe to just not give it to her at all if too much time had gone by and it was already time for the next dose. It would be interesting to find out if that extra dose was the cause of the rough night you had.