Tracie, Kuvan is different from PreKunil. Kuvan is just like any other medication that a person might take for conditions such as blood pressure problems, depression etc. You take Kuvan in the morning and then your done with it. They are very small, about half the size of a tylenol. nDo you see Dr Koch? I’m just assuming that’s who you see because you mentioned your from California. Talk to him about Kuvan. From what I’ve seen and heard he is a very knowledgable man. Or contact Biomarin and speak to them directly because I doubt you would need to take 60 pills if you choose to take Kuvan. Like I said I take nine pills a day, in the morning, and that is the maximum dosage for somebody my size.