I have found that I need to double the dose for Sara at 99 because it tends to flux very quickly. Like most kids she tends to run her fevers higher at night so if it is the slightest bit elevated when she is not well then I double her night time dose. I make sure to check it again when I go to bed. When she had ear infections before the tubes she could quickly go up to 104 while still running around the house. When she gets over 101 then the dose was tripled. I think there were times when we missed the fevers and she acted a little strange. She is one of those kids who can run faster and getvery crazy while her fever goes up and then she crashes. OUr endo said when in doubt play it safe and increase.