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Wow, that seems a lot but I have heard that during puberty there has to be a lot of adjusting with the meds. Our 8 year old SWCAH daughter takes a total of 10mg spread between 3 doses - she has 4mg in morning, 2 mg in afternoon and 4 mg at night. I'm not looking forward to the teen years, teens have a hard enough time with hormones etc, let alone problems with meds for CAH children.