Hi there, thanks for asking your question here. If you have specific questions about your prescription instructions you can ask your doctor or pharmacist. That said, medications such as a nebulizer can be ordered for twice a day (standing order) and then for up to two more times a day (as needed). Essentially the first two treatments (morning and night) are every day and the additional two times would be prescribed in the situation where you need extra help. Does this clear things up? All the best, Lauren (team member)