I wonder why though that they say 4am to 4pm because if cortisol levels start to raise at 3am and it takes some 1 to 1 1/2 hours to peak, then you really need to dose from 2am to 4pm?  Where they giving them the dose in an IV to be able to hit the blood serum quicker. Though  it is excreted the same length of time as oraklly there is no doubt that it would have taken considerably longer to peak than being administered by IV.   Maybe that is what they did---who knows---but we dose at 2am now.  Yes our regime did change for a week and then I got those blood results above and got jittery.  I was dosing 4 times a day and the school nurse gave a 12 noon dose.  I took the daily dose and divided it percentage wise according to Moeller's abstract that you posted dated 15 years ago.  I even split the flroinef four ways and dosed that four times a day also!  I guess after a week I woke up and smelled the roses.  I mean he was on school hols and we had alrams going off left right and centre and then the 17 OHP blood results came in at 88nmol and that topped it for me.  I thought I had better switch back to three times a day and dose as we had said at the last appointment.  I was hoping to leave it until they monitored. 

I had a thought that pred would be better dose in the morning with us.  Perhaps 1.5mg (equiv to 7.50mg) and that that would carry him through then until 4pm perhaps and he could dose a small dose of hct perhaps 2.50mg to 3.75mg.  Then at 2am give him 2.50mg---but this is just daydreaming and what I would really want to try. I see no prob with it as they are giving kids the 1.5mg pred at night that are on hct to solve the prob of raised 17 OHP between 4am and 7am--and I mean pred at night is disastrous where the growth is concerned I would think!  Much better in the day when it is needed and the potency can cover better?  Aaahhh well my two cents worth for the day. 

Regards

Val