I have not discussed this with my current endo, but my daughters 1st endo gave me these instructions. If I miss the 1st dose in the morining: give as soon as possible and continue reg schedule during the day If I miss the mid-day dose: give dose if not more than 2 hrs after missed dose time. If after 2 hr time frame, do not give If missed pm dose, give as soon as possible, wake child up if necessary