diff --git a/src/__tests__/share-view-leaf-render-guard.test.ts b/src/__tests__/share-view-leaf-render-guard.test.ts
index 5f073d4f5..50b591b21 100644
--- a/src/__tests__/share-view-leaf-render-guard.test.ts
+++ b/src/__tests__/share-view-leaf-render-guard.test.ts
@@ -225,7 +225,9 @@ const DISPOSITIONS: Record<StructuredLeafId, Disposition> = {
   MEDICATION_LIST: {
     kind: "rendered",
     data: {
-      medications: [{ name: "Ramipril", dose: "5 mg", schedules: [] }],
+      medications: [
+        { id: "med-ramipril", name: "Ramipril", dose: "5 mg", schedules: [] },
+      ],
     },
     marker: "Ramipril",
   },
@@ -252,7 +254,13 @@ const DISPOSITIONS: Record<StructuredLeafId, Disposition> = {
     kind: "rendered",
     data: {
       compliance: {
-        Metformin: { total: 60, taken: 57, skipped: 1, missed: 2 },
+        "med-metformin": {
+          name: "Metformin",
+          total: 60,
+          taken: 57,
+          skipped: 1,
+          missed: 2,
+        },
       },
     },
     marker: "Metformin",
diff --git a/src/app/api/medications/[id]/glp1/route.ts b/src/app/api/medications/[id]/glp1/route.ts
index bb3f0c689..c8db311ee 100644
--- a/src/app/api/medications/[id]/glp1/route.ts
+++ b/src/app/api/medications/[id]/glp1/route.ts
@@ -47,6 +47,7 @@ import {
 } from "@/lib/crypto/note-cipher";
 import { NextRequest } from "next/server";
 import { dueSchedules } from "@/lib/medications/intake-tracking";
+import { floorWhole } from "@/lib/medications/units-per-dose";
 
 type RouteParams = { params: Promise<{ id: string }> };
 
@@ -175,7 +176,7 @@ export const GET = apiHandler(
         0,
       );
       const pensRemaining = usable.length;
-      const dosesRemaining = Math.floor(
+      const dosesRemaining = floorWhole(
         unitsRemaining / (Number(medication.unitsPerDose) || 1),
       );
       const weeksOfSupply = dosesRemaining;
diff --git a/src/app/api/medications/[id]/route.ts b/src/app/api/medications/[id]/route.ts
index 2d281fbff..ff3a6a91c 100644
--- a/src/app/api/medications/[id]/route.ts
+++ b/src/app/api/medications/[id]/route.ts
@@ -46,6 +46,7 @@ import {
   isRecordOnly,
   scheduleWireFields,
 } from "@/lib/medications/intake-tracking";
+import { floorWhole } from "@/lib/medications/units-per-dose";
 
 type RouteParams = { params: Promise<{ id: string }> };
 
@@ -216,7 +217,7 @@ export const GET = apiHandler(
     const stockDosesRemaining =
       stockUnitsRemaining === null
         ? null
-        : Math.floor(
+        : floorWhole(
             stockUnitsRemaining /
               effectiveUnitsPerDose(
                 schedulesDto,
diff --git a/src/components/clinician/report-sections.tsx b/src/components/clinician/report-sections.tsx
index 10efc951c..bf41f8535 100644
--- a/src/components/clinician/report-sections.tsx
+++ b/src/components/clinician/report-sections.tsx
@@ -309,14 +309,14 @@ export function MedicationsSection({
       empty={medications.length === 0 && complianceEntries.length === 0}
     >
       {medications.map((med) => {
-        const comp = report.compliance[med.name];
+        const comp = report.compliance[med.id];
         const rate =
           complianceOn && comp && comp.total > 0
             ? `${Math.round((comp.taken / comp.total) * 100)}%`
             : null;
         return (
           <StatRow
-            key={med.name}
+            key={med.id}
             label={med.dose ? `${med.name} — ${med.dose}` : med.name}
             value={
               rate
@@ -327,11 +327,11 @@ export function MedicationsSection({
         );
       })}
       {complianceEntries
-        .filter(([name]) => !medications.some((m) => m.name === name))
-        .map(([name, c]) => (
+        .filter(([id]) => !medications.some((m) => m.id === id))
+        .map(([id, c]) => (
           <StatRow
-            key={name}
-            label={name}
+            key={id}
+            label={c.name}
             value={t("clinicianView.adherence", {
               rate: `${Math.round((c.taken / c.total) * 100)}%`,
             })}
diff --git a/src/components/medications/__tests__/supply-runway.test.ts b/src/components/medications/__tests__/supply-runway.test.ts
index dd16adf8a..90c861570 100644
--- a/src/components/medications/__tests__/supply-runway.test.ts
+++ b/src/components/medications/__tests__/supply-runway.test.ts
@@ -371,3 +371,78 @@ describe("units runway with a mixed units-per-dose value (#1034)", () => {
     expect(estimateUnitsRunwayDays(10, [morning], 1.2)).toBe(8);
   });
 });
+
+describe("estimateDailyDoseCount — cadence parts the rate used to drop", () => {
+  it("stretches a monthly RRULE by its INTERVAL (every third month)", () => {
+    const perDay = estimateDailyDoseCount([
+      schedule({ rrule: "FREQ=MONTHLY;INTERVAL=3;BYMONTHDAY=10" }),
+    ]);
+    expect(perDay).toBeCloseTo(1 / 90, 10);
+    // Two doses left last about half a year, not two months.
+    expect(
+      estimateRunwayDays(2, [
+        schedule({ rrule: "FREQ=MONTHLY;INTERVAL=3;BYMONTHDAY=10" }),
+      ]),
+    ).toBe(180);
+  });
+
+  it("counts each BYMONTHDAY of a monthly RRULE", () => {
+    expect(
+      estimateDailyDoseCount([
+        schedule({ rrule: "FREQ=MONTHLY;BYMONTHDAY=1,15" }),
+      ]),
+    ).toBeCloseTo(2 / 30, 10);
+  });
+
+  it("stretches a daily RRULE by its INTERVAL (every other day)", () => {
+    expect(
+      estimateDailyDoseCount([schedule({ rrule: "FREQ=DAILY;INTERVAL=2" })]),
+    ).toBeCloseTo(1 / 2, 10);
+  });
+
+  it("stretches a yearly RRULE by its INTERVAL and counts BYMONTH", () => {
+    expect(
+      estimateDailyDoseCount([
+        schedule({ rrule: "FREQ=YEARLY;INTERVAL=2;BYMONTH=1;BYMONTHDAY=1" }),
+      ]),
+    ).toBeCloseTo(1 / 730, 10);
+    expect(
+      estimateDailyDoseCount([
+        schedule({ rrule: "FREQ=YEARLY;BYMONTH=3,9;BYMONTHDAY=1" }),
+      ]),
+    ).toBeCloseTo(2 / 365, 10);
+  });
+
+  it("scales a CYCLIC schedule by its on share (3 weeks on, 1 off)", () => {
+    const cyclic = schedule({
+      rrule: "FREQ=DAILY",
+      scheduleType: "CYCLIC",
+      cyclicOnWeeks: 3,
+      cyclicOffWeeks: 1,
+    });
+    expect(estimateDailyDoseCount([cyclic])).toBeCloseTo(3 / 4, 10);
+    expect(estimateRunwayDays(21, [cyclic])).toBe(28);
+  });
+
+  it("counts nothing for an as-needed (PRN) schedule", () => {
+    expect(estimateDailyDoseCount([schedule({ scheduleType: "PRN" })])).toBe(0);
+  });
+});
+
+describe("whole counts survive binary floating point", () => {
+  it("2.4 units at 0.8 per dose is three doses", () => {
+    // 2.4 / 0.8 === 2.9999999999999996 in IEEE 754.
+    expect(effectiveUnitsPerDose([schedule({})], 0.8)).toBe(0.8);
+    expect(estimateUnitsRunwayDays(2.4, [schedule({})], 0.8)).toBe(3);
+  });
+
+  it("a dose-count runway that divides exactly is not a day short", () => {
+    // Three doses on Mon/Wed/Fri: 9/7 a day, and 9 / (9/7) is
+    // 6.999999999999999 in IEEE 754 — a week of supply, not six days.
+    const s = schedule({
+      daysOfWeek: "1,3,5",
+      timesOfDay: ["08:00", "12:00", "20:00"],
+    });
+    expect(estimateRunwayDays(9, [s])).toBe(7);
+  });
+});
diff --git a/src/components/medications/detail/supply-runway.ts b/src/components/medications/detail/supply-runway.ts
index 77c58b4a5..1041acb0e 100644
--- a/src/components/medications/detail/supply-runway.ts
+++ b/src/components/medications/detail/supply-runway.ts
@@ -10,6 +10,7 @@
  */
 
 import { parseScheduleRecurrence } from "@/lib/medication-schedule";
+import { floorWhole } from "@/lib/medications/units-per-dose";
 
 /** The schedule fields the runway estimate reads. */
 export interface RunwaySchedule {
@@ -24,6 +25,30 @@ export interface RunwaySchedule {
    * `unitsPerDose`, exactly like the consumption path's resolver.
    */
   unitsPerDose?: number | null;
+  /**
+   * Schedule type. PRN consumes nothing on a cadence; CYCLIC consumes only
+   * in its "on" weeks, so its rate is scaled by on / (on + off).
+   */
+  scheduleType?: "SCHEDULED" | "PRN" | "CYCLIC" | string | null;
+  cyclicOnWeeks?: number | null;
+  cyclicOffWeeks?: number | null;
+}
+
+/** A positive integer RRULE part (`INTERVAL=3`), or `fallback`. */
+function rrulePositiveInt(
+  rrule: string,
+  key: string,
+  fallback: number,
+): number {
+  const m = new RegExp(`(?:^|;)${key}=(\\d+)(?:;|$)`, "i").exec(rrule);
+  const n = m ? Number(m[1]) : NaN;
+  return Number.isInteger(n) && n >= 1 ? n : fallback;
+}
+
+/** How many comma-separated values an RRULE list part carries, or 0. */
+function rruleListCount(rrule: string, key: string): number {
+  const m = new RegExp(`(?:^|;)${key}=([^;]+)`, "i").exec(rrule);
+  return m ? m[1].split(",").filter((v) => v.trim() !== "").length : 0;
 }
 
 /**
@@ -32,17 +57,40 @@ export interface RunwaySchedule {
  * weeks, monthly/yearly RRULEs).
  */
 function scheduleDailyDoseCount(s: RunwaySchedule): number {
+  if (s.scheduleType === "PRN") return 0;
+  const rate = cadenceDailyDoseCount(s);
+  if (s.scheduleType === "CYCLIC") {
+    // Doses fall only in the "on" weeks of the cycle.
+    const on = s.cyclicOnWeeks ?? 0;
+    const off = s.cyclicOffWeeks ?? 0;
+    if (on > 0 && off > 0) return (rate * on) / (on + off);
+  }
+  return rate;
+}
+
+function cadenceDailyDoseCount(s: RunwaySchedule): number {
   const times =
     s.timesOfDay && s.timesOfDay.length > 0 ? s.timesOfDay.length : 1;
   if (typeof s.rollingIntervalDays === "number" && s.rollingIntervalDays >= 1) {
     return times / s.rollingIntervalDays;
   }
   const rrule = s.rrule ?? "";
-  if (/FREQ=MONTHLY/.test(rrule)) {
-    return times / 30;
+  // INTERVAL stretches every calendar frequency: FREQ=MONTHLY;INTERVAL=3 is
+  // one dose a quarter, not one a month.
+  const interval = rrulePositiveInt(rrule, "INTERVAL", 1);
+  if (/FREQ=DAILY/i.test(rrule)) {
+    return times / interval;
   }
-  if (/FREQ=YEARLY/.test(rrule)) {
-    return times / 365;
+  if (/FREQ=MONTHLY/i.test(rrule)) {
+    const perMonth = Math.max(
+      1,
+      rruleListCount(rrule, "BYMONTHDAY") || rruleListCount(rrule, "BYDAY"),
+    );
+    return (times * perMonth) / (30 * interval);
+  }
+  if (/FREQ=YEARLY/i.test(rrule)) {
+    const perYear = Math.max(1, rruleListCount(rrule, "BYMONTH"));
+    return (times * perYear) / (365 * interval);
   }
   // FREQ=WEEKLY;BYDAY=…;INTERVAL=… is the modern weekly encoding (the
   // create path stores the cadence on the rrule and leaves daysOfWeek
@@ -52,14 +100,7 @@ function scheduleDailyDoseCount(s: RunwaySchedule): number {
   // daysOfWeek fallback below with daysPerWeek=7, over-estimating the
   // rate ~7× (≈14× bi-weekly) and firing low-stock alerts far too early.
   if (/FREQ=WEEKLY/.test(rrule)) {
-    const byday = /BYDAY=([^;]+)/.exec(rrule);
-    const bydayCount =
-      byday && byday[1].length > 0 ? byday[1].split(",").length : 1;
-    const intervalMatch = /INTERVAL=(\d+)/.exec(rrule);
-    const interval =
-      intervalMatch && Number(intervalMatch[1]) >= 1
-        ? Number(intervalMatch[1])
-        : 1;
+    const bydayCount = Math.max(1, rruleListCount(rrule, "BYDAY"));
     return (times * bydayCount) / (7 * interval);
   }
   const { daysOfWeek, intervalWeeks } = parseScheduleRecurrence(s.daysOfWeek);
@@ -137,7 +178,7 @@ export function estimateUnitsRunwayDays(
     medicationUnitsPerDose,
   );
   if (perDayUnits <= 0) return null;
-  return Math.floor(Math.max(0, unitsRemaining) / perDayUnits);
+  return floorWhole(Math.max(0, unitsRemaining) / perDayUnits);
 }
 
 /**
@@ -151,7 +192,7 @@ export function estimateRunwayDays(
   if (dosesRemaining <= 0) return null;
   const perDay = estimateDailyDoseCount(schedules);
   if (perDay <= 0) return null;
-  return Math.floor(dosesRemaining / perDay);
+  return floorWhole(dosesRemaining / perDay);
 }
 
 /**
diff --git a/src/components/medications/sections/inventory-dialogs.tsx b/src/components/medications/sections/inventory-dialogs.tsx
index c2f95cec8..73939f220 100644
--- a/src/components/medications/sections/inventory-dialogs.tsx
+++ b/src/components/medications/sections/inventory-dialogs.tsx
@@ -35,6 +35,7 @@ import { useTranslations } from "@/lib/i18n/context";
 import { apiPatch, apiPost, apiPut } from "@/lib/api/api-fetch";
 import { queryKeys } from "@/lib/query-keys";
 import {
+  floorWhole,
   formatUnitsPerDose,
   parseUnitsPerDoseInput,
 } from "@/lib/medications/units-per-dose";
@@ -267,10 +268,10 @@ export function AddInventoryDialog({
                 ? t("medications.detail.bestand.quantityInUnits", { units })
                 : // A unit count below one dose must not read "≈ 0 doses" —
                   // it is simply less than one dose.
-                  Math.floor(parsed / unitsPerDose) === 0
+                  floorWhole(parsed / unitsPerDose) === 0
                   ? t("medications.detail.bestand.quantityUnderOneDose")
                   : t("medications.detail.bestand.quantityInDoses", {
-                      doses: Math.floor(parsed / unitsPerDose),
+                      doses: floorWhole(parsed / unitsPerDose),
                     })}
             </p>
           )}
diff --git a/src/components/medications/sections/inventory-section.tsx b/src/components/medications/sections/inventory-section.tsx
index e6128df32..44750aa0d 100644
--- a/src/components/medications/sections/inventory-section.tsx
+++ b/src/components/medications/sections/inventory-section.tsx
@@ -60,7 +60,10 @@ import { useDateFormatPreference, useTranslations } from "@/lib/i18n/context";
 import { formatDate } from "@/lib/date-format";
 import { queryKeys } from "@/lib/query-keys";
 import { formatUnitCount } from "@/components/medications/units-per-dose";
-import { formatUnitsPerDose } from "@/lib/medications/units-per-dose";
+import {
+  floorWhole,
+  formatUnitsPerDose,
+} from "@/lib/medications/units-per-dose";
 import { apiDelete, apiGet } from "@/lib/api/api-fetch";
 import type { SupplySummary } from "@/lib/medications/inventory/summary";
 import {
@@ -382,8 +385,8 @@ export function InventorySection({
                   {item.unitsRemaining == null || item.unitsTotal == null
                     ? t("medications.detail.bestand.unknown")
                     : t("medications.detail.bestand.doses", {
-                        remaining: Math.floor(item.unitsRemaining / perDose),
-                        total: Math.floor(item.unitsTotal / perDose),
+                        remaining: floorWhole(item.unitsRemaining / perDose),
+                        total: floorWhole(item.unitsTotal / perDose),
                       })}
                   {perDose !== 1 &&
                     item.unitsRemaining != null &&
diff --git a/src/lib/__tests__/doctor-report-data.test.ts b/src/lib/__tests__/doctor-report-data.test.ts
index 44c70a82a..174171177 100644
Binary files a/src/lib/__tests__/doctor-report-data.test.ts and b/src/lib/__tests__/doctor-report-data.test.ts differ
diff --git a/src/lib/__tests__/doctor-report-pdf-core.test.ts b/src/lib/__tests__/doctor-report-pdf-core.test.ts
index a3295758f..b525b4857 100644
--- a/src/lib/__tests__/doctor-report-pdf-core.test.ts
+++ b/src/lib/__tests__/doctor-report-pdf-core.test.ts
@@ -71,10 +71,17 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
     glucoseUnit: "mg/dL",
     bmi: 24.1,
     compliance: {
-      Ramipril: { total: 90, taken: 85, skipped: 3, missed: 2 },
+      "med-ramipril": {
+        name: "Ramipril",
+        total: 90,
+        taken: 85,
+        skipped: 3,
+        missed: 2,
+      },
     },
     medications: [
       {
+        id: "med-ramipril",
         name: "Ramipril",
         dose: "5mg",
         schedules: [
@@ -324,7 +331,8 @@ describe("doctor-report pagination", () => {
   it("paginates a long compliance table across pages without throwing", () => {
     const compliance: DoctorReportData["compliance"] = {};
     for (let i = 0; i < 60; i++) {
-      compliance[`Medication ${i}`] = {
+      compliance[`med-${i}`] = {
+        name: `Medication ${i}`,
         total: 90,
         taken: 80,
         skipped: 5,
@@ -899,7 +907,8 @@ describe("extracted doctor-report section boundaries", () => {
   it("footer is drawn once on every dynamically added page", async () => {
     const compliance: DoctorReportData["compliance"] = {};
     for (let i = 0; i < 60; i += 1) {
-      compliance[`Medication ${i}`] = {
+      compliance[`med-${i}`] = {
+        name: `Medication ${i}`,
         total: 90,
         taken: 80,
         skipped: 5,
diff --git a/src/lib/ai/coach/glp1-snapshot.ts b/src/lib/ai/coach/glp1-snapshot.ts
index c452eaa8e..0a17ba5ca 100644
--- a/src/lib/ai/coach/glp1-snapshot.ts
+++ b/src/lib/ai/coach/glp1-snapshot.ts
@@ -24,6 +24,7 @@ import { readNote } from "@/lib/crypto/note-cipher";
 import { matchGlp1SideEffectTags } from "@/lib/medications/glp1-side-effect-tag-match";
 import type { Glp1SideEffectTag } from "@/lib/medications/glp1-side-effect-tags";
 import { isRecordOnly } from "@/lib/medications/intake-tracking";
+import { floorWhole } from "@/lib/medications/units-per-dose";
 
 /**
  * Recommended generic name for the canonical GLP-1 drug brand. The Coach
@@ -372,7 +373,7 @@ export async function buildGlp1SnapshotBlock(
         0,
       );
       pensRemaining = usable.length;
-      dosesRemaining = Math.floor(
+      dosesRemaining = floorWhole(
         unitsRemaining / (Number(med.unitsPerDose) || 1),
       );
       weeksOfSupplyApprox = Math.round(dosesRemaining / dosesPerWeek);
diff --git a/src/lib/doctor-report-helpers.ts b/src/lib/doctor-report-helpers.ts
index 3c5e2c93d..305fe5e70 100644
--- a/src/lib/doctor-report-helpers.ts
+++ b/src/lib/doctor-report-helpers.ts
@@ -344,7 +344,8 @@ export function normaliseDateRange(
  * schedule, no expected dose — a fabricated 100 % on a clinical report).
  *
  * Pure / synchronous — bands come from pre-fetched schedules + intake
- * instants. Keyed by medication name to match the renderer contract.
+ * instants. Keyed by medication id: two medications can share a name, and
+ * a name key let the second overwrite the first. The name rides in the value.
  */
 export function buildLedgerCompliance(
   medications: DoctorReportComplianceMedication[],
@@ -385,7 +386,8 @@ export function buildLedgerCompliance(
     // `total = taken + missed` (the ledger denominator) so the renderer's
     // `taken / total` equals `tally.rate` — the exact number the detail page
     // shows. Deliberate skips are reported separately but stay out of `total`.
-    compliance[med.name] = {
+    compliance[med.id] = {
+      name: med.name,
       total: tally.denominator,
       taken: tally.taken,
       skipped: tally.skipped,
diff --git a/src/lib/doctor-report-pdf/medication-mood-wellness-section.ts b/src/lib/doctor-report-pdf/medication-mood-wellness-section.ts
index ce7929457..61b436cff 100644
--- a/src/lib/doctor-report-pdf/medication-mood-wellness-section.ts
+++ b/src/lib/doctor-report-pdf/medication-mood-wellness-section.ts
@@ -67,7 +67,7 @@ export function buildMedicationMoodWellnessSection(
     doc.text(t("doctorReport.complianceTitle"), margin, y);
     y += 6;
 
-    const compRows = complianceEntries.map(([name, c]) => {
+    const compRows = complianceEntries.map(([, c]) => {
       // v1.17 W1a — `total` is the ledger rate denominator (taken + missed,
       // deliberate skips excluded), so `taken / total` matches the app's
       // detail-page adherence %. The column is labelled "Expected" rather
@@ -77,7 +77,7 @@ export function buildMedicationMoodWellnessSection(
       const ratePct = adherenceRatePercent(c.taken, c.total);
       const rate = ratePct !== null ? `${num(ratePct, 0)}%` : "—";
       return [
-        name,
+        c.name,
         String(c.taken),
         String(c.skipped),
         String(c.missed),
diff --git a/src/lib/doctor-report-types.ts b/src/lib/doctor-report-types.ts
index 708b4de54..c37bab2c4 100644
--- a/src/lib/doctor-report-types.ts
+++ b/src/lib/doctor-report-types.ts
@@ -40,7 +40,14 @@ export interface DoctorReportStats {
   latest: number;
 }
 
+/**
+ * One medication's adherence over the report window. The report's
+ * `compliance` map is keyed by medication id, because two medications may
+ * share a name (an ended course and a new one, two strengths); `name` is the
+ * label every renderer prints.
+ */
 export interface DoctorReportCompliance {
+  name: string;
   total: number;
   taken: number;
   skipped: number;
@@ -102,8 +109,11 @@ export interface DoctorReportData {
    */
   glucoseClinical: GlucoseClinicalMetrics;
   bmi: number | null;
+  /** Keyed by medication id; see `DoctorReportCompliance`. */
   compliance: Record<string, DoctorReportCompliance>;
   medications: Array<{
+    /** The medication id, the key into `compliance`. */
+    id: string;
     name: string;
     dose: string;
     // v1.9.0 — optional user/clinician-asserted drug-classification
diff --git a/src/lib/doctor-report/collect.ts b/src/lib/doctor-report/collect.ts
index 502480dba..6dc45b463 100644
--- a/src/lib/doctor-report/collect.ts
+++ b/src/lib/doctor-report/collect.ts
@@ -583,6 +583,7 @@ export async function collectDoctorReportData(
     compliance: gate.admits("MEDICATION_COMPLIANCE") ? compliance : {},
     medications: gate.admits("MEDICATION_LIST")
       ? medications.map((m) => ({
+          id: m.id,
           name: m.name,
           dose: m.dose,
           atcCode: m.atcCode,
diff --git a/src/lib/doctor-report/medications.ts b/src/lib/doctor-report/medications.ts
index fa1def120..d6e420291 100644
--- a/src/lib/doctor-report/medications.ts
+++ b/src/lib/doctor-report/medications.ts
@@ -186,7 +186,7 @@ export function buildGlp1Block(params: {
     medications: glp1Meds.map((m) => {
       const latest = m.doseChanges[m.doseChanges.length - 1] ?? null;
       const lastIntake = m.intakeEvents[0] ?? null;
-      const comp = params.compliance[m.name] ?? {
+      const comp = params.compliance[m.id] ?? {
         taken: 0,
         total: 0,
         skipped: 0,
diff --git a/src/lib/fhir/__tests__/build-bundle.test.ts b/src/lib/fhir/__tests__/build-bundle.test.ts
index b454d2002..e8844d820 100644
--- a/src/lib/fhir/__tests__/build-bundle.test.ts
+++ b/src/lib/fhir/__tests__/build-bundle.test.ts
@@ -112,10 +112,17 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
     glucoseUnit: "mg/dL",
     bmi: 24.1,
     compliance: {
-      "Example Drug": { total: 90, taken: 85, skipped: 3, missed: 2 },
+      "med-example": {
+        name: "Example Drug",
+        total: 90,
+        taken: 85,
+        skipped: 3,
+        missed: 2,
+      },
     },
     medications: [
       {
+        id: "med-example-drug",
         name: "Example Drug",
         dose: "5mg",
         schedules: [
@@ -473,6 +480,7 @@ describe("buildFhirDocumentBundle", () => {
       makeData({
         medications: [
           {
+            id: "med-mounjaro",
             name: "Mounjaro",
             dose: "10mg",
             atcCode: "A10BX10",
@@ -510,7 +518,13 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         medications: [
-          { name: "Ramipril", dose: "5mg", atcCode: "C09AA05", schedules: [] },
+          {
+            id: "med-ramipril",
+            name: "Ramipril",
+            dose: "5mg",
+            atcCode: "C09AA05",
+            schedules: [],
+          },
         ],
       }),
       { insuranceNumber: null },
@@ -782,6 +796,7 @@ describe("buildFhirDocumentBundle", () => {
       makeData({
         medications: [
           {
+            id: "med-empagliflozin",
             name: "Empagliflozin",
             dose: "10mg",
             atcCode: "A10BK03",
@@ -811,6 +826,7 @@ describe("buildFhirDocumentBundle", () => {
       makeData({
         medications: [
           {
+            id: "med-empagliflozin",
             name: "Empagliflozin",
             dose: "10mg",
             atcCode: "A10BK03",
@@ -867,7 +883,14 @@ describe("buildFhirDocumentBundle", () => {
   it("never invents a BfArM coding when no ATC code is stored, even with germanAtc on", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
-        medications: [{ name: "Herbal mix", dose: "1 tab", schedules: [] }],
+        medications: [
+          {
+            id: "med-herbal",
+            name: "Herbal mix",
+            dose: "1 tab",
+            schedules: [],
+          },
+        ],
       }),
       { insuranceNumber: null },
       FIXED_NOW,
diff --git a/src/lib/fhir/__tests__/conformance.test.ts b/src/lib/fhir/__tests__/conformance.test.ts
index 195e5f618..693da6fdf 100644
--- a/src/lib/fhir/__tests__/conformance.test.ts
+++ b/src/lib/fhir/__tests__/conformance.test.ts
@@ -65,9 +65,17 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
     glucoseUnit: "mg/dL",
     bmi: 24.1,
     compliance: {
-      "Example Drug": { total: 90, taken: 85, skipped: 3, missed: 2 },
+      "med-example": {
+        name: "Example Drug",
+        total: 90,
+        taken: 85,
+        skipped: 3,
+        missed: 2,
+      },
     },
-    medications: [{ name: "Example Drug", dose: "5mg", schedules: [] }],
+    medications: [
+      { id: "med-example", name: "Example Drug", dose: "5mg", schedules: [] },
+    ],
     medicationAdministrations: [
       {
         medicationName: "Example Drug",
diff --git a/src/lib/fhir/resources/observation.ts b/src/lib/fhir/resources/observation.ts
index 72fc8d3af..1dd533cf8 100644
--- a/src/lib/fhir/resources/observation.ts
+++ b/src/lib/fhir/resources/observation.ts
@@ -177,7 +177,7 @@ function adherenceObservations(
 ): FhirObservation[] {
   const observations: FhirObservation[] = [];
   const period = reportingPeriod(data);
-  for (const [name, comp] of Object.entries(data.compliance)) {
+  for (const comp of Object.values(data.compliance)) {
     if (comp.total <= 0) continue;
     // Integer percent — the one canonical rounding the app card + PDF use, so
     // a clinician sees the same adherence figure on every surface. The helper
@@ -201,7 +201,7 @@ function adherenceObservations(
               "Adherence to prescribed medication instructions [Reported]",
           },
         ],
-        text: `Medication adherence — ${name}`,
+        text: `Medication adherence — ${comp.name}`,
       },
       subject: patientRef,
       effectivePeriod: period,
diff --git a/src/lib/jobs/__tests__/measurement-reminder-byhour.test.ts b/src/lib/jobs/__tests__/measurement-reminder-byhour.test.ts
new file mode 100644
index 000000000..511d06ff9
--- /dev/null
+++ b/src/lib/jobs/__tests__/measurement-reminder-byhour.test.ts
@@ -0,0 +1,119 @@
+/**
+ * A multi-hour protocol (`FREQ=DAILY;BYHOUR=7,19`, the morning-and-evening
+ * blood pressure course) must be sent at both hours. The tick used to gate
+ * on `notifyHour` alone and claim one send per local day, so the evening
+ * slot sat due until the next morning and was never sent in the evening.
+ *
+ * Drives the real tick every 15 minutes across two local days in several
+ * zones, with a claim ledger that behaves like the real one (a key claims
+ * once), and a Prisma double whose updates land on the row the next tick
+ * reads.
+ */
+import { beforeEach, describe, expect, it, vi } from "vitest";
+
+const claimed = vi.hoisted(() => new Set<string>());
+vi.mock("@/lib/notifications/reminder-dedup", async () => {
+  const actual = await vi.importActual<
+    typeof import("@/lib/notifications/reminder-dedup")
+  >("@/lib/notifications/reminder-dedup");
+  return {
+    ...actual,
+    claimNotificationEvent: vi.fn(
+      async (_prisma: unknown, args: { dedupKey: string }) => {
+        if (claimed.has(args.dedupKey)) return false;
+        claimed.add(args.dedupKey);
+        return true;
+      },
+    ),
+  };
+});
+
+import { wallClockInTz, zonedWallClockToUtc } from "@/lib/tz/wall-clock";
+import { computeReminderNextDueAt } from "@/lib/measurement-reminders/scheduling";
+
+import { runMeasurementReminderTick } from "../measurement-reminder";
+
+const ZONES = [
+  "Europe/Berlin",
+  "America/New_York",
+  "America/Los_Angeles",
+  "Asia/Tokyo",
+  "Pacific/Auckland",
+] as const;
+
+beforeEach(() => {
+  claimed.clear();
+});
+
+function at(tz: string, day: number, hour: number, minute = 0): Date {
+  return zonedWallClockToUtc({ year: 2026, month: 9, day, hour, minute }, tz);
+}
+
+describe.each(ZONES)("BYHOUR=7,19 in %s", (tz) => {
+  it("sends at 07:00 and at 19:00 on each day", async () => {
+    const base = {
+      intervalDays: null,
+      rrule: "FREQ=DAILY;BYHOUR=7,19",
+      anchorDate: at(tz, 14, 0),
+      notifyHour: 7,
+      lastSatisfiedAt: null,
+      createdAt: at(tz, 13, 12),
+    };
+    const row: Record<string, unknown> = {
+      id: "r-bp",
+      userId: "u1",
+      origin: "COACH",
+      measurementType: null,
+      label: "BP",
+      location: null,
+      lastSkippedAt: null,
+      lastNotifiedAt: null,
+      enabled: true,
+      endsOn: null,
+      ...base,
+      nextDueAt: computeReminderNextDueAt(base, tz, at(tz, 14, 0)),
+      user: { id: "u1", timezone: tz, locale: "en" },
+    };
+    const prisma = {
+      measurementReminder: {
+        findMany: vi.fn(async () =>
+          (row.nextDueAt as Date | null) === null ? [] : [row],
+        ),
+        update: vi.fn(async ({ data }: { data: Record<string, unknown> }) => {
+          Object.assign(row, data);
+          return row;
+        }),
+        updateMany: vi.fn(async () => ({ count: 0 })),
+      },
+      measurement: { findFirst: vi.fn(async () => null) },
+      labResult: { findFirst: vi.fn(async () => null) },
+    };
+    const sent: string[] = [];
+    const dispatch = vi.fn(async () => ({
+      dispatched: true,
+      channelsAttempted: 1,
+      channelsSucceeded: 1,
+    }));
+
+    for (
+      let t = at(tz, 14, 0).getTime();
+      t < at(tz, 16, 0).getTime();
+      t += 15 * 60_000
+    ) {
+      const now = new Date(t);
+      const before = dispatch.mock.calls.length;
+      await runMeasurementReminderTick(prisma as never, now, {
+        dispatch: dispatch as never,
+        isModuleEnabled: async () => true,
+      });
+      if (dispatch.mock.calls.length > before) {
+        const p = wallClockInTz(now, tz);
+        sent.push(
+          `${p.day} ${String(p.hour).padStart(2, "0")}:${String(p.minute).padStart(2, "0")}`,
+        );
+      }
+    }
+
+    expect(sent).toEqual(["14 07:00", "14 19:00", "15 07:00", "15 19:00"]);
+  });
+});
diff --git a/src/lib/jobs/__tests__/medication-reminder-check.test.ts b/src/lib/jobs/__tests__/medication-reminder-check.test.ts
index a6b259481..7bc66a553 100644
--- a/src/lib/jobs/__tests__/medication-reminder-check.test.ts
+++ b/src/lib/jobs/__tests__/medication-reminder-check.test.ts
@@ -851,3 +851,44 @@ describe("issue #664 — exact occurrence identity survives local midnight", ()
     expect(dispatchNotification).not.toHaveBeenCalled();
   });
 });
+
+describe("handleReminderCheck — a snooze holds only the slot it answered", () => {
+  function snoozed(at: string): Record<string, unknown> {
+    return {
+      ...medicationWithSchedule({ timesOfDay: ["08:00", "18:00"] }),
+      // A Telegram "skip" of the morning dose snoozes to the end of the day;
+      // the snooze write stamps the row's updatedAt.
+      snoozedUntil: new Date("2026-07-28T23:59:59.000Z"),
+      updatedAt: new Date(at),
+    };
+  }
+
+  it("still reminds the evening dose after the morning one was snoozed", async () => {
+    vi.useFakeTimers();
+    vi.setSystemTime(new Date("2026-07-28T18:40:00.000Z"));
+    prismaMock.medication.findMany.mockResolvedValue([
+      snoozed("2026-07-28T08:30:00.000Z"),
+    ] as never);
+
+    await handleReminderCheck([]);
+
+    expect(dispatchNotification).toHaveBeenCalledTimes(1);
+    expect(dispatchNotification).toHaveBeenCalledWith(
+      expect.objectContaining({
+        metadata: expect.objectContaining({ timeOfDay: "18:00" }),
+      }),
+    );
+  });
+
+  it("holds the slot whose reminder was open when the snooze was set", async () => {
+    vi.useFakeTimers();
+    vi.setSystemTime(new Date("2026-07-28T08:40:00.000Z"));
+    prismaMock.medication.findMany.mockResolvedValue([
+      snoozed("2026-07-28T08:30:00.000Z"),
+    ] as never);
+
+    await handleReminderCheck([]);
+
+    expect(dispatchNotification).not.toHaveBeenCalled();
+  });
+});
diff --git a/src/lib/jobs/measurement-reminder.ts b/src/lib/jobs/measurement-reminder.ts
index 93ca3e0a0..407eb9489 100644
--- a/src/lib/jobs/measurement-reminder.ts
+++ b/src/lib/jobs/measurement-reminder.ts
@@ -50,6 +50,7 @@ import { getEvent } from "@/lib/logging/context";
 import { isModuleEnabled } from "@/lib/modules/gate";
 import type { ModuleKey } from "@/lib/modules/registry";
 import {
+  byHourTimesOfDay,
   computeReminderNextDueAt,
   type ReminderScheduleInput,
 } from "@/lib/measurement-reminders/scheduling";
@@ -169,12 +170,51 @@ async function cleanupExpiredCoachReminders(
 }
 
 /**
- * Pure due-predicate: at this instant, is the reminder due AND inside its
- * local notify-hour window?
+ * The local hours a reminder fires at: every `BYHOUR` of its rule (the
+ * twice-daily BP protocol `FREQ=DAILY;BYHOUR=7,19`), else its `notifyHour`.
+ */
+function reminderFireHours(reminder: {
+  notifyHour: number;
+  rrule?: string | null;
+}): number[] {
+  const byHour = byHourTimesOfDay(reminder.rrule ?? null);
+  return byHour
+    ? byHour.map((hhmm) => Number(hhmm.slice(0, 2)))
+    : [reminder.notifyHour];
+}
+
+/**
+ * The local hour the reminder's current slot belongs to: the hour of
+ * `nextDueAt` on the user's clock when that is one of its fire hours, else
+ * `notifyHour` (a slot stamped before the hour was edited, or a test
+ * fixture with no real slot). For a single-hour reminder this is always
+ * `notifyHour`; for `BYHOUR=7,19` the evening slot reads 19, so it is sent
+ * in the evening instead of waiting for the next morning.
+ */
+export function reminderSlotHour(
+  reminder: {
+    nextDueAt: Date | null;
+    notifyHour: number;
+    rrule?: string | null;
+  },
+  timezone: string,
+): number {
+  const hours = reminderFireHours(reminder);
+  if (reminder.nextDueAt !== null && hours.length > 1) {
+    const slotHour = wallClockInTz(reminder.nextDueAt, timezone).hour;
+    if (hours.includes(slotHour)) return slotHour;
+  }
+  return reminder.notifyHour;
+}
+
+/**
+ * Pure due-predicate: at this instant, is the reminder due AND inside the
+ * local hour of its current slot?
  *
  * "Due" = `nextDueAt != null` and `now >= nextDueAt`. The hour gate keeps
  * a reminder that became overdue overnight from firing at 03:00 — it
- * waits for the user's chosen `notifyHour` to come round in their local
+ * waits for its slot's hour (`reminderSlotHour`: the `notifyHour`, or the
+ * matching `BYHOUR` of a multi-hour rule) to come round in the user's
  * timezone. Pulled out so the unit tests can pin the window boundary
  * (08:59 → no, 09:00 → yes, 09:59 → yes, 10:00 → no) without the DB.
  */
@@ -183,6 +223,7 @@ export function evaluateMeasurementReminderDue(
     enabled: boolean;
     nextDueAt: Date | null;
     notifyHour: number;
+    rrule?: string | null;
   },
   timezone: string,
   now: Date,
@@ -190,9 +231,10 @@ export function evaluateMeasurementReminderDue(
   if (!reminder.enabled || reminder.nextDueAt === null) {
     return { fire: false, inHourWindow: false, isDue: false };
   }
+  const tz = timezone || "Europe/Berlin";
   const isDue = now.getTime() >= reminder.nextDueAt.getTime();
-  const parts = wallClockInTz(now, timezone || "Europe/Berlin");
-  const inHourWindow = parts.hour === reminder.notifyHour;
+  const parts = wallClockInTz(now, tz);
+  const inHourWindow = parts.hour === reminderSlotHour(reminder, tz);
   return { fire: isDue && inHourWindow, inHourWindow, isDue };
 }
 
@@ -298,7 +340,8 @@ export async function runMeasurementReminderTick(
         reminder.lastNotifiedAt != null &&
         reminder.nextDueAt !== null &&
         reminder.lastNotifiedAt.getTime() >= reminder.nextDueAt.getTime() &&
-        wallClockInTz(now, timezone).hour !== reminder.notifyHour
+        wallClockInTz(now, timezone).hour !==
+          reminderSlotHour(reminder, timezone)
       ) {
         summary.skippedOutsideWindow += 1;
         continue;
@@ -338,6 +381,7 @@ export async function runMeasurementReminderTick(
           enabled: reminder.enabled,
           nextDueAt: reminder.nextDueAt,
           notifyHour: reminder.notifyHour,
+          rrule: reminder.rrule,
         },
         timezone,
         now,
@@ -409,10 +453,16 @@ export async function runMeasurementReminderTick(
       const localDate = new Date(now).toLocaleDateString("sv-SE", {
         timeZone: timezone,
       });
+      // A multi-hour rule sends more than once a day, so its claim is per
+      // slot hour; a single-hour reminder keeps the per-day key.
+      const slotSuffix =
+        reminderFireHours(reminder).length > 1
+          ? `T${String(reminderSlotHour(reminder, timezone)).padStart(2, "0")}`
+          : "";
       const claimed = await claimNotificationEvent(prisma, {
         recordUserId: reminder.user.id,
         eventType: "MEASUREMENT_REMINDER",
-        dedupKey: `measurement:${reminder.id}:${localDate}`,
+        dedupKey: `measurement:${reminder.id}:${localDate}${slotSuffix}`,
         since: new Date(now.getTime() - REMINDER_DEDUP_LOOKBACK_MS),
       });
       if (!claimed) {
diff --git a/src/lib/jobs/medication-low-stock.ts b/src/lib/jobs/medication-low-stock.ts
index 9990943fc..86df5a22c 100644
--- a/src/lib/jobs/medication-low-stock.ts
+++ b/src/lib/jobs/medication-low-stock.ts
@@ -422,6 +422,11 @@ export async function runMedicationLowStockTick(
               rollingIntervalDays: true,
               // v1.37.19 — per-slot units feed the slot-aware burn rate.
               unitsPerDose: true,
+              // A PRN schedule consumes nothing on a cadence, a CYCLIC one
+              // only in its "on" weeks.
+              scheduleType: true,
+              cyclicOnWeeks: true,
+              cyclicOffWeeks: true,
             },
           },
         },
diff --git a/src/lib/jobs/reminder/medication-reminder-check.ts b/src/lib/jobs/reminder/medication-reminder-check.ts
index fd46f6a15..c913a3af4 100644
--- a/src/lib/jobs/reminder/medication-reminder-check.ts
+++ b/src/lib/jobs/reminder/medication-reminder-check.ts
@@ -141,6 +141,24 @@ export async function cleanupScheduledTelegramDeletions(): Promise<void> {
   }
 }
 
+/**
+ * Whether a medication-level snooze holds the reminder of one slot. It
+ * holds only while it runs (`now < snoozedUntil`) and only for a slot whose
+ * reminder window had opened when the snooze was set (`snoozedAt`, the
+ * medication row's @updatedAt of the snooze write). A later edit to the
+ * row moves `snoozedAt` forward, which can only widen the hold back to the
+ * old medication-wide behaviour, never lose a snooze.
+ */
+export function snoozeHoldsSlot(
+  snoozedUntil: Date | null,
+  snoozedAt: Date,
+  slotWindowStart: Date,
+  now: Date,
+): boolean {
+  if (!snoozedUntil || now.getTime() >= snoozedUntil.getTime()) return false;
+  return slotWindowStart.getTime() <= snoozedAt.getTime();
+}
+
 /**
  * Check all active medications for each user and determine reminder phases.
  * Uses phase-based logic (GREEN/YELLOW/ORANGE/RED) to send one notification
@@ -477,6 +495,7 @@ export async function handleReminderCheck(
                 return currentPhase
                   ? {
                       slotScheduledFor: occurrence.at,
+                      windowStart: phaseWindow.start,
                       minutesToEnd,
                       currentPhase,
                     }
@@ -489,8 +508,12 @@ export async function handleReminderCheck(
               )[0];
             if (!phaseCandidate) continue;
 
-            const { slotScheduledFor, minutesToEnd, currentPhase } =
-              phaseCandidate;
+            const {
+              slotScheduledFor,
+              windowStart,
+              minutesToEnd,
+              currentPhase,
+            } = phaseCandidate;
             const slotInstant = slotScheduledFor.getTime();
             if (liveEraStart !== null && slotInstant < liveEraStart) {
               continue;
@@ -544,8 +567,16 @@ export async function handleReminderCheck(
               continue;
             }
 
-            // Skip if medication is snoozed
-            if (med.snoozedUntil && now < med.snoozedUntil) {
+            // A snooze answers the reminder of the slot that was open when it
+            // was set, so it holds only slots whose window had opened by then.
+            // `snoozedUntil` lives on the medication row and the snooze write
+            // stamps the row's @updatedAt, which dates the decision (the same
+            // reading the skip / pin suppression above uses). A later slot of
+            // the same medication, such as the evening dose after a morning
+            // "skip" that snoozes to the end of the day, is still reminded.
+            if (
+              snoozeHoldsSlot(med.snoozedUntil, med.updatedAt, windowStart, now)
+            ) {
               continue;
             }
 
diff --git a/src/lib/mcp/doctor-visit-summary.ts b/src/lib/mcp/doctor-visit-summary.ts
index f647cc071..6b00444d6 100644
--- a/src/lib/mcp/doctor-visit-summary.ts
+++ b/src/lib/mcp/doctor-visit-summary.ts
@@ -73,8 +73,8 @@ export function summariseForVisit(
     };
   });
 
-  const compliance = Object.entries(data.compliance).map(([name, c]) => ({
-    medication: name,
+  const compliance = Object.values(data.compliance).map((c) => ({
+    medication: c.name,
     takenDoses: c.taken,
     expectedDoses: c.total,
     missedDoses: c.missed,
diff --git a/src/lib/measurement-reminders/__tests__/scheduling-timezones.test.ts b/src/lib/measurement-reminders/__tests__/scheduling-timezones.test.ts
new file mode 100644
index 000000000..560d08bbc
--- /dev/null
+++ b/src/lib/measurement-reminders/__tests__/scheduling-timezones.test.ts
@@ -0,0 +1,77 @@
+/**
+ * A reminder's `anchorDate` / `endsOn` are instants (the form sends local
+ * midnight), while the recurrence engine takes calendar dates. The adapter
+ * must hand over the day the instant falls on in the user's zone: east of
+ * UTC local midnight is still the previous UTC day, and a weekly plan
+ * anchored there must not start a day early.
+ */
+import { describe, expect, it } from "vitest";
+
+import { wallClockInTz, zonedWallClockToUtc } from "@/lib/tz/wall-clock";
+
+import { computeReminderNextDueAt } from "../scheduling";
+
+const ZONES = [
+  "America/New_York",
+  "America/Los_Angeles",
+  "America/Santiago",
+  "Europe/Berlin",
+  "Asia/Tokyo",
+  "Pacific/Auckland",
+  "Pacific/Tongatapu",
+] as const;
+
+function localMidnight(tz: string, y: number, m: number, d: number): Date {
+  return zonedWallClockToUtc(
+    { year: y, month: m, day: d, hour: 0, minute: 0 },
+    tz,
+  );
+}
+
+function localLabel(at: Date | null, tz: string): string | null {
+  if (!at) return null;
+  const p = wallClockInTz(at, tz);
+  return `${p.year}-${String(p.month).padStart(2, "0")}-${String(p.day).padStart(2, "0")} ${String(p.hour).padStart(2, "0")}:${String(p.minute).padStart(2, "0")} w${p.weekday}`;
+}
+
+describe.each(ZONES)("reminder anchors in %s", (tz) => {
+  it("a daily RRULE starts on the local anchor day", () => {
+    const anchor = localMidnight(tz, 2026, 9, 14);
+    const next = computeReminderNextDueAt(
+      {
+        intervalDays: null,
+        rrule: "FREQ=DAILY",
+        anchorDate: anchor,
+        notifyHour: 8,
+        lastSatisfiedAt: null,
+        createdAt: new Date("2026-09-01T12:00:00Z"),
+      },
+      tz,
+      new Date("2026-09-10T12:00:00Z"),
+    );
+    expect(localLabel(next, tz)).toBe("2026-09-14 08:00 w1");
+  });
+
+  it("a course that ends on a local day keeps that day's evening slot", () => {
+    const next = computeReminderNextDueAt(
+      {
+        intervalDays: null,
+        rrule: "FREQ=DAILY;BYHOUR=7,19",
+        anchorDate: localMidnight(tz, 2026, 9, 14),
+        endsOn: zonedWallClockToUtc(
+          { year: 2026, month: 9, day: 20, hour: 10, minute: 0 },
+          tz,
+        ),
+        notifyHour: 7,
+        lastSatisfiedAt: null,
+        createdAt: new Date("2026-09-01T12:00:00Z"),
+      },
+      tz,
+      zonedWallClockToUtc(
+        { year: 2026, month: 9, day: 20, hour: 8, minute: 0 },
+        tz,
+      ),
+    );
+    expect(localLabel(next, tz)).toBe("2026-09-20 19:00 w0");
+  });
+});
diff --git a/src/lib/measurement-reminders/scheduling.ts b/src/lib/measurement-reminders/scheduling.ts
index abb58ba5d..11ea9440b 100644
--- a/src/lib/measurement-reminders/scheduling.ts
+++ b/src/lib/measurement-reminders/scheduling.ts
@@ -29,6 +29,7 @@ import {
   type RecurrenceContext,
   nextOccurrenceAfter,
 } from "@/lib/medications/scheduling/recurrence";
+import { wallClockInTz } from "@/lib/tz/wall-clock";
 
 /**
  * The reminder fields this module reads. A subset of the Prisma row so
@@ -50,6 +51,12 @@ export interface ReminderScheduleInput {
   endsOn?: Date | null;
 }
 
+/** The calendar day `instant` falls on in `tz`, as UTC midnight of that date. */
+function calendarDayInZone(instant: Date, tz: string): Date {
+  const p = wallClockInTz(instant, tz);
+  return new Date(Date.UTC(p.year, p.month - 1, p.day));
+}
+
 function hourToHhmm(hour: number): string {
   const safe = Number.isInteger(hour) && hour >= 0 && hour <= 23 ? hour : 9;
   return `${safe.toString().padStart(2, "0")}:00`;
@@ -120,17 +127,30 @@ export function buildReminderRecurrence(
   // First-due anchor when never satisfied: anchorDate ?? createdAt. After
   // a satisfy the rolling path re-anchors on `lastIntakeAt + N`, so we
   // feed `lastSatisfiedAt` through `lastIntakeAt`.
-  const startsOn = reminder.anchorDate ?? reminder.createdAt;
+  //
+  // The engine's `startsOn` / `endsOn` are calendar dates (the medication
+  // columns are `@db.Date`, UTC midnight of the date). A reminder's
+  // `anchorDate` / `endsOn` are instants instead (the form sends local
+  // midnight, a Coach course sends `now + days`), so hand the engine the
+  // calendar day each instant falls on in the user's zone.
+  const tz = timeZone || "Europe/Berlin";
+  const startsOn = calendarDayInZone(
+    reminder.anchorDate ?? reminder.createdAt,
+    tz,
+  );
+  const endsOn = reminder.endsOn
+    ? calendarDayInZone(reminder.endsOn, tz)
+    : null;
 
   const ctx: RecurrenceContext = {
     medication: {
       id: "measurement-reminder",
       startsOn,
-      endsOn: reminder.endsOn ?? null,
+      endsOn,
       oneShot: false,
       createdAt: reminder.createdAt,
     },
-    timeZone: timeZone || "Europe/Berlin",
+    timeZone: tz,
     lastIntakeAt: reminder.lastSatisfiedAt,
   };
 
diff --git a/src/lib/medications/inventory/__tests__/summary.test.ts b/src/lib/medications/inventory/__tests__/summary.test.ts
index ae5b930ce..9a42d76d6 100644
--- a/src/lib/medications/inventory/__tests__/summary.test.ts
+++ b/src/lib/medications/inventory/__tests__/summary.test.ts
@@ -195,3 +195,14 @@ describe("supply surfaces — server computes, the detail-page clients render th
     expect(src).toContain("medications.detail.bestand.expiredSuffix");
   });
 });
+
+describe("summariseSupply — whole doses survive binary floating point", () => {
+  it("2.4 mL at 0.8 mL per dose is three doses, not two", () => {
+    const summary = summariseSupply(
+      [{ state: "ACTIVE", unitsRemaining: 2.4, unitsTotal: 2.4 }] as never,
+      0.8,
+    );
+    expect(summary.dosesRemaining).toBe(3);
+    expect(summary.dosesTotal).toBe(3);
+  });
+});
diff --git a/src/lib/medications/inventory/summary.ts b/src/lib/medications/inventory/summary.ts
index d1d5c6f21..ed764695a 100644
--- a/src/lib/medications/inventory/summary.ts
+++ b/src/lib/medications/inventory/summary.ts
@@ -30,6 +30,8 @@
  * the client detail surfaces that also render from it.
  */
 
+import { floorWhole } from "@/lib/medications/units-per-dose";
+
 export type SupplyItemState = "ACTIVE" | "IN_USE" | "EXPIRED" | "USED_UP";
 
 export interface SupplyItem {
@@ -102,8 +104,8 @@ export function summariseSupply(
   return {
     unitsRemaining,
     unitsTotal,
-    dosesRemaining: Math.floor(unitsRemaining / perDose),
-    dosesTotal: Math.floor(unitsTotal / perDose),
+    dosesRemaining: floorWhole(unitsRemaining / perDose),
+    dosesTotal: floorWhole(unitsTotal / perDose),
     expiredUnits,
   };
 }
diff --git a/src/lib/medications/list-read.ts b/src/lib/medications/list-read.ts
index 0556502e1..b9a5ca0a3 100644
--- a/src/lib/medications/list-read.ts
+++ b/src/lib/medications/list-read.ts
@@ -34,6 +34,7 @@ import {
   scheduleWireFields,
 } from "@/lib/medications/intake-tracking";
 import { liveEraStartsByMedication } from "@/lib/medications/scheduling/live-era";
+import { floorWhole } from "@/lib/medications/units-per-dose";
 
 export type MedicationsListResult = Array<Record<string, unknown>>;
 
@@ -272,7 +273,7 @@ export async function buildMedicationsList(
     const stockDosesRemaining =
       stockUnitsRemaining === null
         ? null
-        : Math.floor(
+        : floorWhole(
             stockUnitsRemaining /
               effectiveUnitsPerDose(schedulesDto, Number(m.unitsPerDose)),
           );
diff --git a/src/lib/medications/scheduling/__tests__/recurrence-timezones.test.ts b/src/lib/medications/scheduling/__tests__/recurrence-timezones.test.ts
new file mode 100644
index 000000000..c20840400
--- /dev/null
+++ b/src/lib/medications/scheduling/__tests__/recurrence-timezones.test.ts
@@ -0,0 +1,364 @@
+/**
+ * Calendar-day correctness of the recurrence engine across time zones.
+ *
+ * `Medication.startsOn` / `endsOn` are `@db.Date` columns: a calendar date
+ * carried as UTC midnight. The engine used to read that midnight in the
+ * user's zone, which west of UTC is the previous evening, so every
+ * calendar-anchored cadence landed one day early there: a Monday plan fired
+ * on Sundays in New York, a course starting on the 14th produced a dose on
+ * the 13th, and a dose on the last course day in the evening vanished.
+ *
+ * Every assertion here is read back on the user's wall clock, and the whole
+ * matrix runs under several HOST zones as well (the engine must not depend
+ * on the machine it runs on). The host zone is switched through
+ * `process.env.TZ` inside the test, because a `TZ=` prefix on the command
+ * line is overridden by the vitest config.
+ */
+
+import { afterAll, beforeAll, describe, expect, it } from "vitest";
+
+import { wallClockInTz } from "@/lib/tz/wall-clock";
+
+import {
+  advanceRollingOccurrence,
+  expandRollingRetrospective,
+  nextOccurrenceAfter,
+  occurrencesBetween,
+  type CanonicalSchedule,
+  type RecurrenceContext,
+} from "../recurrence";
+
+const USER_ZONES = [
+  "America/New_York",
+  "America/Los_Angeles",
+  "America/Santiago",
+  "Europe/Berlin",
+  "Asia/Tokyo",
+  "Pacific/Auckland",
+  "Pacific/Tongatapu",
+  "UTC",
+] as const;
+
+const HOST_ZONES = ["UTC", "America/Los_Angeles", "Pacific/Auckland"] as const;
+
+function makeSchedule(
+  overrides: Partial<CanonicalSchedule> = {},
+): CanonicalSchedule {
+  return {
+    id: "sched-tz",
+    rrule: null,
+    rollingIntervalDays: null,
+    timesOfDay: ["09:00"],
+    daysOfWeek: null,
+    windowStart: "09:00",
+    windowEnd: "10:00",
+    reminderGraceMinutes: null,
+    scheduleType: "SCHEDULED",
+    cyclicOnWeeks: null,
+    cyclicOffWeeks: null,
+    ...overrides,
+  };
+}
+
+function makeCtx(
+  timeZone: string,
+  medication: Partial<RecurrenceContext["medication"]> = {},
+  lastIntakeAt: Date | null = null,
+): RecurrenceContext {
+  return {
+    timeZone,
+    lastIntakeAt,
+    medication: {
+      id: "med-tz",
+      startsOn: null,
+      endsOn: null,
+      oneShot: false,
+      createdAt: new Date("2026-01-01T12:00:00Z"),
+      ...medication,
+    },
+  };
+}
+
+/** A calendar date the way Prisma hands back a `@db.Date` column. */
+function date(ymd: string): Date {
+  return new Date(`${ymd}T00:00:00.000Z`);
+}
+
+function localYmd(at: Date, tz: string): string {
+  const p = wallClockInTz(at, tz);
+  return `${p.year}-${String(p.month).padStart(2, "0")}-${String(p.day).padStart(2, "0")}`;
+}
+
+function localHm(at: Date, tz: string): string {
+  const p = wallClockInTz(at, tz);
+  return `${String(p.hour).padStart(2, "0")}:${String(p.minute).padStart(2, "0")}`;
+}
+
+const WIDE_FROM = new Date("2026-07-25T00:00:00Z");
+const WIDE_TO = new Date("2026-12-31T00:00:00Z");
+
+describe.each(HOST_ZONES)("recurrence engine on a %s host", (hostZone) => {
+  const originalTz = process.env.TZ;
+  beforeAll(() => {
+    process.env.TZ = hostZone;
+  });
+  afterAll(() => {
+    process.env.TZ = originalTz;
+  });
+
+  describe.each(USER_ZONES)("user in %s", (tz) => {
+    it("FREQ=WEEKLY;BYDAY=MO fires on local Mondays at the local time", () => {
+      const slots = occurrencesBetween(
+        makeSchedule({ rrule: "FREQ=WEEKLY;BYDAY=MO" }),
+        WIDE_FROM,
+        WIDE_TO,
+        makeCtx(tz, { startsOn: date("2026-09-01") }),
+      );
+      expect(slots.length).toBeGreaterThan(10);
+      for (const s of slots) {
+        expect(wallClockInTz(s.at, tz).weekday).toBe(1);
+        expect(localHm(s.at, tz)).toBe("09:00");
+      }
+      expect(localYmd(slots[0].at, tz)).toBe("2026-09-07");
+    });
+
+    it("FREQ=DAILY starts on startsOn, never the day before", () => {
+      const slots = occurrencesBetween(
+        makeSchedule({ rrule: "FREQ=DAILY", timesOfDay: ["00:30", "23:30"] }),
+        WIDE_FROM,
+        new Date("2026-09-20T00:00:00Z"),
+        makeCtx(tz, { startsOn: date("2026-09-14") }),
+      );
+      expect(localYmd(slots[0].at, tz)).toBe("2026-09-14");
+      expect(localHm(slots[0].at, tz)).toBe("00:30");
+      // One slot per time per day: no duplicate, no missing day.
+      const days = slots.map((s) => localYmd(s.at, tz));
+      for (const day of ["2026-09-14", "2026-09-15", "2026-09-16"]) {
+        expect(days.filter((d) => d === day)).toHaveLength(2);
+      }
+      expect(days.every((d) => d >= "2026-09-14")).toBe(true);
+    });
+
+    it("FREQ=DAILY keeps the evening dose of the last course day", () => {
+      const ctx = makeCtx(tz, {
+        startsOn: date("2026-09-14"),
+        endsOn: date("2026-09-16"),
+      });
+      const schedule = makeSchedule({
+        rrule: "FREQ=DAILY",
+        timesOfDay: ["08:00", "23:00"],
+      });
+      const slots = occurrencesBetween(schedule, WIDE_FROM, WIDE_TO, ctx);
+      expect(
+        slots.map((s) => `${localYmd(s.at, tz)} ${localHm(s.at, tz)}`),
+      ).toEqual([
+        "2026-09-14 08:00",
+        "2026-09-14 23:00",
+        "2026-09-15 08:00",
+        "2026-09-15 23:00",
+        "2026-09-16 08:00",
+        "2026-09-16 23:00",
+      ]);
+      // The next-due walk must reach the same last dose.
+      const lastMorning = slots[4].at;
+      const next = nextOccurrenceAfter(schedule, lastMorning, ctx);
+      expect(next?.at.toISOString()).toBe(slots[5].at.toISOString());
+      expect(nextOccurrenceAfter(schedule, slots[5].at, ctx)).toBeNull();
+    });
+
+    it("FREQ=MONTHLY;BYMONTHDAY=1 lands on the first of the local month", () => {
+      const slots = occurrencesBetween(
+        makeSchedule({ rrule: "FREQ=MONTHLY;BYMONTHDAY=1" }),
+        WIDE_FROM,
+        WIDE_TO,
+        makeCtx(tz, { startsOn: date("2026-08-01") }),
+      );
+      expect(slots.map((s) => localYmd(s.at, tz))).toEqual([
+        "2026-08-01",
+        "2026-09-01",
+        "2026-10-01",
+        "2026-11-01",
+        "2026-12-01",
+      ]);
+    });
+
+    it("legacy every-other-Monday honours startsOn and the week phase", () => {
+      const slots = occurrencesBetween(
+        makeSchedule({ daysOfWeek: "i2;1" }),
+        WIDE_FROM,
+        new Date("2026-10-31T00:00:00Z"),
+        makeCtx(tz, { startsOn: date("2026-09-14") }),
+      );
+      expect(slots.map((s) => localYmd(s.at, tz))).toEqual([
+        "2026-09-14",
+        "2026-09-28",
+        "2026-10-12",
+        "2026-10-26",
+      ]);
+    });
+
+    it("legacy daily walk stops after the evening dose of endsOn", () => {
+      const slots = occurrencesBetween(
+        makeSchedule({ timesOfDay: ["21:00"] }),
+        WIDE_FROM,
+        WIDE_TO,
+        makeCtx(tz, {
+          startsOn: date("2026-09-14"),
+          endsOn: date("2026-09-15"),
+        }),
+      );
+      expect(slots.map((s) => localYmd(s.at, tz))).toEqual([
+        "2026-09-14",
+        "2026-09-15",
+      ]);
+    });
+
+    it("a one-shot dose lands on its own date", () => {
+      const slots = occurrencesBetween(
+        makeSchedule({ timesOfDay: ["08:00"] }),
+        WIDE_FROM,
+        WIDE_TO,
+        makeCtx(tz, {
+          startsOn: date("2026-09-14"),
+          endsOn: date("2026-09-14"),
+          oneShot: true,
+        }),
+      );
+      expect(
+        slots.map((s) => `${localYmd(s.at, tz)} ${localHm(s.at, tz)}`),
+      ).toEqual(["2026-09-14 08:00"]);
+    });
+
+    it("a rolling first dose is due on startsOn", () => {
+      const schedule = makeSchedule({ rollingIntervalDays: 7 });
+      const ctx = makeCtx(tz, { startsOn: date("2026-09-14") });
+      const next = nextOccurrenceAfter(
+        schedule,
+        new Date("2026-09-01T12:00:00Z"),
+        ctx,
+      );
+      expect(next && localYmd(next.at, tz)).toBe("2026-09-14");
+      expect(next && localHm(next.at, tz)).toBe("09:00");
+    });
+
+    it("a rolling cadence counts calendar days from a late-evening intake", () => {
+      // 23:30 local on 2026-10-30; +7 calendar days crosses the northern
+      // fall-back weekend and the southern spring-forward season.
+      const intake = zoned(tz, 2026, 10, 30, 23, 30);
+      const schedule = makeSchedule({ rollingIntervalDays: 7 });
+      const ctx = makeCtx(tz, { startsOn: date("2026-09-14") }, intake);
+      const next = nextOccurrenceAfter(schedule, intake, ctx);
+      expect(next && localYmd(next.at, tz)).toBe("2026-11-06");
+      const after = next && advanceRollingOccurrence(schedule, next, ctx);
+      expect(after && localYmd(after.at, tz)).toBe("2026-11-13");
+    });
+
+    it("a rolling retrospective back-fill keeps calendar days", () => {
+      const first = zoned(tz, 2026, 9, 1, 23, 30);
+      const last = zoned(tz, 2026, 9, 22, 23, 30);
+      const slots = expandRollingRetrospective(
+        makeSchedule({ rollingIntervalDays: 7 }),
+        makeCtx(tz, { startsOn: date("2026-09-01") }),
+        WIDE_FROM,
+        new Date("2026-09-25T00:00:00Z"),
+        [first, last],
+        new Date("2026-09-24T12:00:00Z"),
+      );
+      expect(slots.map((s) => localYmd(s.at, tz))).toEqual([
+        "2026-09-01",
+        "2026-09-08",
+        "2026-09-15",
+        "2026-09-22",
+      ]);
+    });
+
+    it("CYCLIC 3 on / 1 off counts whole weeks from startsOn in the local calendar", () => {
+      // Starts on a Wednesday; the three "on" weeks are 21 consecutive days.
+      const slots = occurrencesBetween(
+        makeSchedule({
+          rrule: "FREQ=DAILY",
+          scheduleType: "CYCLIC",
+          cyclicOnWeeks: 3,
+          cyclicOffWeeks: 1,
+          timesOfDay: ["23:30"],
+        }),
+        WIDE_FROM,
+        new Date("2026-11-10T00:00:00Z"),
+        makeCtx(tz, { startsOn: date("2026-09-16") }),
+      );
+      const days = slots.map((s) => localYmd(s.at, tz));
+      expect(days[0]).toBe("2026-09-16");
+      expect(days).toContain("2026-10-06");
+      expect(days).not.toContain("2026-10-07");
+      expect(days).not.toContain("2026-10-13");
+      expect(days).toContain("2026-10-14");
+      expect(days.filter((d) => d < "2026-10-14")).toHaveLength(21);
+    });
+  });
+
+  describe("DST transition days", () => {
+    const cases: Array<[string, string, string]> = [
+      ["America/New_York", "2026-03-08", "2026-11-01"],
+      ["America/Los_Angeles", "2026-03-08", "2026-11-01"],
+      ["Europe/Berlin", "2026-03-29", "2026-10-25"],
+      ["America/Santiago", "2026-09-06", "2026-04-05"],
+      ["Pacific/Auckland", "2026-09-27", "2026-04-05"],
+    ];
+    it.each(cases)(
+      "%s keeps one dose per local day across %s and %s",
+      (tz, springDay, fallDay) => {
+        for (const day of [springDay, fallDay]) {
+          const start = date(day);
+          const slots = occurrencesBetween(
+            makeSchedule({
+              rrule: "FREQ=DAILY",
+              timesOfDay: ["00:30", "08:00", "23:30"],
+            }),
+            new Date(start.getTime() - 3 * 86_400_000),
+            new Date(start.getTime() + 3 * 86_400_000),
+            makeCtx(tz, { startsOn: date("2026-01-01") }),
+          );
+          const onDay = slots.filter((s) => localYmd(s.at, tz) === day);
+          expect(onDay).toHaveLength(3);
+          expect(localHm(onDay[1].at, tz)).toBe("08:00");
+          expect(localHm(onDay[2].at, tz)).toBe("23:30");
+        }
+      },
+    );
+
+    it.each(cases)(
+      "%s: a rolling cadence across the spring-forward day %s keeps calendar days",
+      (tz, springDay) => {
+        const [y, m, d] = springDay.split("-").map(Number);
+        // 23:30 local three days before the clocks go forward; seven times
+        // 24 h later is 00:30 on the day after the due day.
+        const intake = zoned(tz, y, m, d - 3, 23, 30);
+        const schedule = makeSchedule({ rollingIntervalDays: 7 });
+        const ctx = makeCtx(tz, { startsOn: date("2026-01-01") }, intake);
+        const next = nextOccurrenceAfter(schedule, intake, ctx);
+        const due = new Date(Date.UTC(y, m - 1, d - 3 + 7));
+        expect(next && localYmd(next.at, tz)).toBe(
+          due.toISOString().slice(0, 10),
+        );
+      },
+    );
+  });
+});
+
+function zoned(
+  tz: string,
+  year: number,
+  month: number,
+  day: number,
+  hour: number,
+  minute: number,
+): Date {
+  // Solve the local wall clock to an instant without the engine under test.
+  let guess = Date.UTC(year, month - 1, day, hour, minute);
+  for (let i = 0; i < 3; i++) {
+    const p = wallClockInTz(new Date(guess), tz);
+    const asUtc = Date.UTC(p.year, p.month - 1, p.day, p.hour, p.minute);
+    guess += Date.UTC(year, month - 1, day, hour, minute) - asUtc;
+  }
+  return new Date(guess);
+}
diff --git a/src/lib/medications/scheduling/recurrence.ts b/src/lib/medications/scheduling/recurrence.ts
index 71d2717b3..75716adc9 100644
--- a/src/lib/medications/scheduling/recurrence.ts
+++ b/src/lib/medications/scheduling/recurrence.ts
@@ -225,8 +225,8 @@ export function occurrencesBetween(
 
 /**
  * v1.7.0 — true when `instant` falls in an "on" week of the cyclic
- * on/off phase. The anchor is the medication's `startsOn ?? createdAt`,
- * snapped to its UTC week start. `phase = weeksFromAnchor mod
+ * on/off phase. The anchor is the local calendar day of the medication's
+ * `startsOn ?? createdAt`; a week is seven calendar days from it. `phase = weeksFromAnchor mod
  * (on + off)`; the slot survives iff `phase < on`. A non-positive or
  * missing `cyclicOnWeeks` keeps every slot (defensive — the route + Zod
  * require a positive value for CYCLIC, but the engine never throws on a
@@ -243,11 +243,13 @@ function isInCyclicOnWeek(
   const cycleLen = onWeeks + offWeeks;
   if (cycleLen <= 0) return true;
 
-  const anchor = ctx.medication.startsOn ?? ctx.medication.createdAt;
-  const anchorWeekStart = startOfUtcWeek(anchor).getTime();
-  const instantWeekStart = startOfUtcWeek(instant).getTime();
-  const weeksFromAnchor = Math.round(
-    (instantWeekStart - anchorWeekStart) / WEEK_MS,
+  // Whole weeks counted in the user's calendar from the start day itself:
+  // "three weeks on" starting on a Wednesday is 21 consecutive days, and the
+  // slot's day is its local day, not the UTC day its instant falls on.
+  const anchorDay = anchorCivilDay(ctx).getTime();
+  const slotDay = civilDayOfInstant(instant, ctx.timeZone).getTime();
+  const weeksFromAnchor = Math.floor(
+    Math.round((slotDay - anchorDay) / DAY_MS) / 7,
   );
   const phase = ((weeksFromAnchor % cycleLen) + cycleLen) % cycleLen;
   return phase < onWeeks;
@@ -272,10 +274,15 @@ export function nextOccurrenceAfter(
   // v1.7.0 — PRN never has a next due instant.
   if (schedule.scheduleType === "PRN") return null;
 
-  const endsOn = ctx.medication.endsOn;
+  const endsOnDay = endsOnCivilDay(ctx);
   const hardCap = new Date(after.getTime() + 365 * 10 * DAY_MS);
-  const limit = endsOn
-    ? new Date(Math.min(endOfUtcDay(endsOn).getTime(), hardCap.getTime()))
+  const limit = endsOnDay
+    ? new Date(
+        Math.min(
+          endOfCivilDayInstant(endsOnDay, ctx.timeZone).getTime(),
+          hardCap.getTime(),
+        ),
+      )
     : hardCap;
 
   const cyclic = schedule.scheduleType === "CYCLIC";
@@ -331,7 +338,7 @@ export function nextOccurrenceAfter(
     // day short and re-clips the very slot it meant to admit. `endsOn` stays
     // enforced inside `expandRolling`, so a course-window reminder still
     // self-expires.
-    const rollingSlotInstant = applyTimeOfDayToDate(
+    const rollingSlotInstant = applyTimeOfDayToCivilDay(
       rollingDoseAnchor(schedule, ctx),
       schedule.timesOfDay[0] ?? schedule.windowStart,
       ctx.timeZone,
@@ -403,11 +410,11 @@ function expandOneShot(
   from: Date,
   to: Date,
 ): Occurrence[] {
-  const anchor = ctx.medication.startsOn ?? ctx.medication.createdAt;
+  const anchor = anchorCivilDay(ctx);
   const times = effectiveTimesOfDay(schedule);
   const slots: Occurrence[] = [];
   for (const time of times) {
-    const at = applyTimeOfDayToDate(anchor, time, ctx.timeZone);
+    const at = applyTimeOfDayToCivilDay(anchor, time, ctx.timeZone);
     if (at.getTime() < from.getTime() || at.getTime() > to.getTime()) continue;
     slots.push(buildOccurrence(at, time, schedule));
   }
@@ -460,17 +467,25 @@ function rollingDoseAnchor(
   ctx: RecurrenceContext,
 ): Date {
   const intervalDays = schedule.rollingIntervalDays ?? 0;
+  // N calendar days after the local day of the last intake, not N × 24 h:
+  // a late-evening dose across a DST change would otherwise slide onto the
+  // wrong day.
   return ctx.lastIntakeAt !== null
-    ? new Date(ctx.lastIntakeAt.getTime() + intervalDays * DAY_MS)
-    : (ctx.medication.startsOn ?? ctx.medication.createdAt);
+    ? addCivilDays(
+        civilDayOfInstant(ctx.lastIntakeAt, ctx.timeZone),
+        intervalDays,
+      )
+    : anchorCivilDay(ctx);
 }
 
 function rollingDoseDayFloor(
   schedule: CanonicalSchedule,
   ctx: RecurrenceContext,
 ): number {
-  const anchor = rollingDoseAnchor(schedule, ctx);
-  return startOfLocalDayInTz(anchor, ctx.timeZone).getTime();
+  return startOfCivilDayInstant(
+    rollingDoseAnchor(schedule, ctx),
+    ctx.timeZone,
+  ).getTime();
 }
 
 function expandRolling(
@@ -486,16 +501,14 @@ function expandRolling(
   // FIRST dose is the start date itself (no `+ N`) — see the doc comment.
   const nextDue = rollingDoseAnchor(schedule, ctx);
 
-  // endsOn cap.
-  if (
-    ctx.medication.endsOn &&
-    nextDue.getTime() > endOfUtcDay(ctx.medication.endsOn).getTime()
-  ) {
+  // endsOn cap — both sides are calendar days.
+  const endsOnDay = endsOnCivilDay(ctx);
+  if (endsOnDay && nextDue.getTime() > endsOnDay.getTime()) {
     return [];
   }
 
   const time = schedule.timesOfDay[0] ?? schedule.windowStart;
-  const at = applyTimeOfDayToDate(nextDue, time, ctx.timeZone);
+  const at = applyTimeOfDayToCivilDay(nextDue, time, ctx.timeZone);
   if (at.getTime() < from.getTime() || at.getTime() > to.getTime()) return [];
 
   return [buildOccurrence(at, time, schedule)];
@@ -515,14 +528,15 @@ export function advanceRollingOccurrence(
   const n = schedule.rollingIntervalDays;
   if (n === null || n <= 0) return null;
   const time = schedule.timesOfDay[0] ?? schedule.windowStart;
-  const nextDay = new Date(occurrence.at.getTime() + n * DAY_MS);
-  const at = applyTimeOfDayToDate(nextDay, time, ctx.timeZone);
-  if (
-    ctx.medication.endsOn &&
-    at.getTime() > endOfUtcDay(ctx.medication.endsOn).getTime()
-  ) {
+  const nextDay = addCivilDays(
+    civilDayOfInstant(occurrence.at, ctx.timeZone),
+    n,
+  );
+  const endsOnDay = endsOnCivilDay(ctx);
+  if (endsOnDay && nextDay.getTime() > endsOnDay.getTime()) {
     return null;
   }
+  const at = applyTimeOfDayToCivilDay(nextDay, time, ctx.timeZone);
   return buildOccurrence(at, time, schedule);
 }
 
@@ -586,8 +600,9 @@ export function expandRollingRetrospective(
   // Tolerance: a gap up to 1.5·N is "on time" (a dose logged a little
   // late). Only a gap strictly beyond this synthesizes skipped cycles.
   const gapToleranceMs = 1.5 * cycleMs;
-  const endsCap = ctx.medication.endsOn
-    ? endOfUtcDay(ctx.medication.endsOn).getTime()
+  const endsOnDay = endsOnCivilDay(ctx);
+  const endsCap = endsOnDay
+    ? endOfCivilDayInstant(endsOnDay, ctx.timeZone).getTime()
     : Infinity;
 
   const inWindow = (at: Date): boolean =>
@@ -616,11 +631,21 @@ export function expandRollingRetrospective(
     const gap = next.getTime() - prev.getTime();
     if (gap <= gapToleranceMs) continue;
     // Number of whole cycles the user skipped: floor(gap/N) − 1 missed
-    // cycles sit strictly between the two intakes.
-    const cyclesInGap = Math.floor(gap / cycleMs);
+    // cycles sit strictly between the two intakes. Counted in calendar
+    // days, so a gap spanning a DST change (one hour short) still counts
+    // its last cycle.
+    const prevDay = civilDayOfInstant(prev, ctx.timeZone);
+    const gapDays = Math.round(
+      (civilDayOfInstant(next, ctx.timeZone).getTime() - prevDay.getTime()) /
+        DAY_MS,
+    );
+    const cyclesInGap = Math.floor(gapDays / n);
     for (let k = 1; k < cyclesInGap; k++) {
-      const anchor = new Date(prev.getTime() + k * cycleMs);
-      const at = applyTimeOfDayToDate(anchor, time, ctx.timeZone);
+      const at = applyTimeOfDayToCivilDay(
+        addCivilDays(prevDay, k * n),
+        time,
+        ctx.timeZone,
+      );
       if (inWindow(at)) {
         slots.push(buildOccurrence(at, time, schedule));
       }
@@ -639,12 +664,16 @@ export function expandRollingRetrospective(
   const forwardToleranceMs = cycleMs / 2;
   const lastInstant =
     sorted.length > 0 ? sorted[sorted.length - 1] : ctx.lastIntakeAt;
+  const nextDueDay =
+    lastInstant !== null
+      ? addCivilDays(civilDayOfInstant(lastInstant, ctx.timeZone), n)
+      : anchorCivilDay(ctx);
   const nextDue =
     lastInstant !== null
       ? new Date(lastInstant.getTime() + cycleMs)
-      : (ctx.medication.startsOn ?? ctx.medication.createdAt);
+      : startOfCivilDayInstant(nextDueDay, ctx.timeZone);
   if (now.getTime() - nextDue.getTime() > forwardToleranceMs) {
-    const at = applyTimeOfDayToDate(nextDue, time, ctx.timeZone);
+    const at = applyTimeOfDayToCivilDay(nextDueDay, time, ctx.timeZone);
     // Dedupe: a forward slot already represented by a logged intake (the
     // intake re-anchored exactly N days out) must not double-count.
     const alreadyPresent = slots.some(
@@ -671,16 +700,21 @@ function expandRrule(
   const rruleStr = schedule.rrule;
   if (!rruleStr) return [];
 
-  const dtstart = ctx.medication.startsOn ?? ctx.medication.createdAt;
-  const dtstartLine = `DTSTART:${formatUtcBasic(startOfUtcDay(dtstart))}`;
+  // The rrule library works in "floating" UTC: DTSTART and every emitted
+  // anchor are calendar days carried as UTC midnight. Keep them that way end
+  // to end — the anchor's day is read from its UTC fields and only then is
+  // the HH:mm materialised in the user's zone. Reading the anchor in the
+  // user's zone instead turned Monday 00:00Z into Sunday evening west of UTC.
+  const dtstartLine = `DTSTART:${formatUtcBasic(anchorCivilDay(ctx))}`;
   // Skip the engine-side UNTIL suffix when the user's RRULE already
   // bounds the recurrence with COUNT or UNTIL — RFC 5545 forbids both
   // (and any two-UNTIL collision), and RRule.fromString throws on the
   // duplicate, silently collapsing the schedule to zero slots.
   const userBoundsRecurrence = /(?:^|;)(?:COUNT|UNTIL)=/.test(rruleStr);
+  const endsOnDay = endsOnCivilDay(ctx);
   const untilSuffix =
-    ctx.medication.endsOn && !userBoundsRecurrence
-      ? `;UNTIL=${formatUtcBasic(endOfUtcDay(ctx.medication.endsOn))}`
+    endsOnDay && !userBoundsRecurrence
+      ? `;UNTIL=${formatUtcBasic(endOfUtcDay(endsOnDay))}`
       : "";
   const full = `${dtstartLine}\nRRULE:${rruleStr}${untilSuffix}`;
 
@@ -697,20 +731,25 @@ function expandRrule(
 
   // Walk a generously padded day-anchor window so a per-day timesOfDay
   // expansion still hits the requested [from, to] after the time-of-day
-  // is applied. The rrule lib's day-anchored dates land at midnight UTC
-  // of the BYDAY/BYMONTHDAY day; the time-of-day might push back across
-  // a day boundary in some timezones, so widen the window by 2 days on
-  // each side.
+  // is applied: a calendar day spans instants up to 14 h either side of
+  // its UTC midnight, so widen the window by 2 days on each side.
   const padded = 2 * DAY_MS;
   const after = new Date(from.getTime() - padded);
   const before = new Date(to.getTime() + padded);
-  const dayAnchors = rule.between(after, before, true);
+  // An RRULE with BYHOUR (the measurement-reminder protocols) emits several
+  // anchors per day; the times of day are expanded per calendar day, so
+  // collapse the anchors to their days first.
+  const dayKeys = new Set<number>();
+  for (const anchor of rule.between(after, before, true)) {
+    dayKeys.add(startOfUtcDay(anchor).getTime());
+  }
 
   const times = effectiveTimesOfDay(schedule);
   const slots: Occurrence[] = [];
-  for (const anchor of dayAnchors) {
+  for (const dayKey of dayKeys) {
+    const day = new Date(dayKey);
     for (const time of times) {
-      const at = applyTimeOfDayToDate(anchor, time, ctx.timeZone);
+      const at = applyTimeOfDayToCivilDay(day, time, ctx.timeZone);
       if (at.getTime() < from.getTime()) continue;
       if (at.getTime() > to.getTime()) continue;
       slots.push(buildOccurrence(at, time, schedule));
@@ -730,17 +769,19 @@ function expandLegacy(
   to: Date,
 ): Occurrence[] {
   const recurrence = parseScheduleRecurrence(schedule.daysOfWeek);
-  const anchor = ctx.medication.startsOn ?? ctx.medication.createdAt;
-  const anchorWeekStartUtc = startOfUtcWeek(anchor).getTime();
+  const anchorWeekStart = startOfCivilWeek(anchorCivilDay(ctx)).getTime();
   const times = effectiveTimesOfDay(schedule);
+  const endsOnDay = endsOnCivilDay(ctx);
 
   const slots: Occurrence[] = [];
-  // Iterate every UTC day in [from-1, to+1] to cover any time-of-day
-  // that might land in [from, to] after applying the local-tz HH:mm.
+  // Iterate every calendar day (carried as UTC midnight) in [from-1, to+1]
+  // to cover any time-of-day that might land in [from, to] once the HH:mm
+  // is materialised in the user's zone. Every comparison below is between
+  // calendar days; only `applyTimeOfDayToCivilDay` touches the zone.
   const start = startOfUtcDay(new Date(from.getTime() - DAY_MS));
   const end = startOfUtcDay(new Date(to.getTime() + DAY_MS));
   const startsOnFloor = ctx.medication.startsOn
-    ? startOfUtcDay(ctx.medication.startsOn).getTime()
+    ? civilDayOfDate(ctx.medication.startsOn).getTime()
     : null;
   for (
     let day = start;
@@ -754,13 +795,12 @@ function expandLegacy(
     if (startsOnFloor !== null && day.getTime() < startsOnFloor) {
       continue;
     }
-    // Day-of-week filter (empty = every day). Use the user's
-    // timezone weekday so the legacy "Mon = 1" encoding aligns with
-    // the user's local-Mon, not UTC-Mon.
-    const localWeekday = wallClockInTz(day, ctx.timeZone).weekday;
+    // Day-of-week filter (empty = every day). `day` IS the user's
+    // calendar day, so its UTC weekday is the local weekday.
+    const weekday = day.getUTCDay();
     if (
       recurrence.daysOfWeek.length > 0 &&
-      !recurrence.daysOfWeek.includes(localWeekday)
+      !recurrence.daysOfWeek.includes(weekday)
     ) {
       continue;
     }
@@ -768,9 +808,9 @@ function expandLegacy(
     // Multi-week interval — the fix vs the legacy worker, which
     // silently ignored intervalWeeks.
     if (recurrence.intervalWeeks > 1) {
-      const dayWeekStart = startOfUtcWeek(day).getTime();
+      const dayWeekStart = startOfCivilWeek(day).getTime();
       const weeksFromAnchor = Math.round(
-        (dayWeekStart - anchorWeekStartUtc) / WEEK_MS,
+        (dayWeekStart - anchorWeekStart) / WEEK_MS,
       );
       const phase =
         ((weeksFromAnchor % recurrence.intervalWeeks) +
@@ -780,15 +820,12 @@ function expandLegacy(
     }
 
     // endsOn cap.
-    if (
-      ctx.medication.endsOn &&
-      day.getTime() > endOfUtcDay(ctx.medication.endsOn).getTime()
-    ) {
+    if (endsOnDay && day.getTime() > endsOnDay.getTime()) {
       continue;
     }
 
     for (const time of times) {
-      const at = applyTimeOfDayToDate(day, time, ctx.timeZone);
+      const at = applyTimeOfDayToCivilDay(day, time, ctx.timeZone);
       if (at.getTime() < from.getTime()) continue;
       if (at.getTime() > to.getTime()) continue;
       slots.push(buildOccurrence(at, time, schedule));
@@ -807,37 +844,115 @@ function effectiveTimesOfDay(schedule: CanonicalSchedule): string[] {
     : [schedule.windowStart];
 }
 
+// ────────────────────────────────────────────────────────────────────
+// Calendar days
+//
+// A "civil day" is a calendar date carried as UTC midnight of its
+// Y/M/D, the same shape Prisma returns for a `@db.Date` column and the
+// rrule library works in. Its UTC fields ARE the calendar date; it is
+// never read in the user's zone. Instants (createdAt, intake times,
+// slot instants) become civil days through `civilDayOfInstant`, which
+// reads them on the user's wall clock. Only `applyTimeOfDayToCivilDay`
+// turns a civil day back into an instant.
+// ────────────────────────────────────────────────────────────────────
+
+/** A `@db.Date` value (UTC midnight of the calendar date) as a civil day. */
+function civilDayOfDate(d: Date): Date {
+  return startOfUtcDay(d);
+}
+
+/** The calendar day an instant falls on in `tz`, as a civil day. */
+function civilDayOfInstant(instant: Date, tz: string): Date {
+  const p = wallClockInTz(instant, tz);
+  return new Date(Date.UTC(p.year, p.month - 1, p.day));
+}
+
+function addCivilDays(day: Date, n: number): Date {
+  return new Date(
+    Date.UTC(day.getUTCFullYear(), day.getUTCMonth(), day.getUTCDate() + n),
+  );
+}
+
 /**
- * Apply an "HH:mm" time-of-day to `day` in the user's IANA timezone,
- * returning the corresponding UTC instant. DST-aware via the two-pass
- * solver pattern from `medication-schedule.ts`.
- *
- * `day` is interpreted as "the day in the user's timezone at which
- * the time-of-day should land" — we read its wall-clock Y/M/D in the
- * target zone, then materialise the instant for that Y/M/D + H/M in
- * that zone. So passing midnight-UTC on the spring-forward day with
- * Europe/Berlin gives the local-Berlin day, not the previous-Berlin
- * day even if the UTC midnight technically falls before the local
- * day boundary.
+ * The schedule's first calendar day: `startsOn` is a calendar date; the
+ * `createdAt` fallback is an instant and so is read on the user's clock.
  */
-function applyTimeOfDayToDate(day: Date, hhmm: string, tz: string): Date {
+function anchorCivilDay(ctx: RecurrenceContext): Date {
+  return ctx.medication.startsOn
+    ? civilDayOfDate(ctx.medication.startsOn)
+    : civilDayOfInstant(ctx.medication.createdAt, ctx.timeZone);
+}
+
+function endsOnCivilDay(ctx: RecurrenceContext): Date | null {
+  return ctx.medication.endsOn ? civilDayOfDate(ctx.medication.endsOn) : null;
+}
+
+/** Local midnight of a civil day (DST-safe, via its local noon). */
+function startOfCivilDayInstant(day: Date, tz: string): Date {
+  return startOfLocalDayInTz(applyTimeOfDayToCivilDay(day, "12:00", tz), tz);
+}
+
+/** The last millisecond of a civil day on the user's clock. */
+function endOfCivilDayInstant(day: Date, tz: string): Date {
+  return new Date(
+    startOfCivilDayInstant(addCivilDays(day, 1), tz).getTime() - 1,
+  );
+}
+
+/** The Sunday that starts the calendar week of a civil day. */
+function startOfCivilWeek(day: Date): Date {
+  return addCivilDays(day, -day.getUTCDay());
+}
+
+/**
+ * Materialise an "HH:mm" on a civil day in the user's IANA timezone,
+ * returning the corresponding UTC instant. DST-aware via the two-pass
+ * solver pattern from `medication-schedule.ts`: a wall-clock time that
+ * does not exist on a spring-forward day resolves forward (02:30 in
+ * Europe/Berlin on 2026-03-29 becomes 03:30).
+ *
+ * The calendar date comes from the civil day's UTC fields and is never
+ * re-read in `tz` — see the section comment above.
+ */
+function applyTimeOfDayToCivilDay(day: Date, hhmm: string, tz: string): Date {
   const [hStr, mStr] = hhmm.split(":");
   const h = Number(hStr);
   const m = Number(mStr);
   if (!Number.isFinite(h) || !Number.isFinite(m)) return day;
 
-  const parts = wallClockInTz(day, tz);
-  let guess = new Date(
-    Date.UTC(parts.year, parts.month - 1, parts.day, h, m, 0, 0),
+  const wall = Date.UTC(
+    day.getUTCFullYear(),
+    day.getUTCMonth(),
+    day.getUTCDate(),
+    h,
+    m,
+    0,
+    0,
   );
-  for (let i = 0; i < 2; i++) {
-    const offsetMin = tzOffsetMinutes(guess, tz);
-    guess = new Date(
-      Date.UTC(parts.year, parts.month - 1, parts.day, h, m, 0, 0) -
-        offsetMin * 60_000,
-    );
+  // Try the zone offset in force a day before and a day after. A candidate
+  // is valid when it reads back as the requested wall clock. On a
+  // fall-back day both are valid and the earlier one wins; on a
+  // spring-forward day neither is, and the pre-transition offset moves the
+  // time forward past the gap. That also covers zones whose clocks skip
+  // midnight itself (America/Santiago), where an iterative solver settled
+  // on the previous evening.
+  const before = new Date(
+    wall - tzOffsetMinutes(new Date(wall - DAY_MS), tz) * 60_000,
+  );
+  const after = new Date(
+    wall - tzOffsetMinutes(new Date(wall + DAY_MS), tz) * 60_000,
+  );
+  const readsBack = (c: Date): boolean => {
+    const p = wallClockInTz(c, tz);
+    return Date.UTC(p.year, p.month - 1, p.day, p.hour, p.minute) === wall;
+  };
+  const validBefore = readsBack(before);
+  const validAfter = readsBack(after);
+  if (validBefore && validAfter) {
+    return before.getTime() <= after.getTime() ? before : after;
   }
-  return guess;
+  if (validAfter) return after;
+  return before;
 }
 
 function tzOffsetMinutes(date: Date, tz: string): number {
@@ -916,12 +1031,6 @@ function endOfUtcDay(d: Date): Date {
   );
 }
 
-function startOfUtcWeek(d: Date): Date {
-  const midnight = startOfUtcDay(d);
-  const weekday = midnight.getUTCDay(); // 0 = Sun
-  return new Date(midnight.getTime() - weekday * DAY_MS);
-}
-
 /** RFC 5545 basic-format UTC instant: `YYYYMMDDTHHMMSSZ`. */
 function formatUtcBasic(d: Date): string {
   const pad = (n: number, w = 2): string => String(n).padStart(w, "0");
diff --git a/src/lib/medications/units-per-dose.ts b/src/lib/medications/units-per-dose.ts
index ba7d012f4..1c26a5af1 100644
--- a/src/lib/medications/units-per-dose.ts
+++ b/src/lib/medications/units-per-dose.ts
@@ -136,3 +136,16 @@ export function formatUnitsPerDose(value: number, locale?: string): string {
     useGrouping: false,
   }).format(rounded);
 }
+
+/**
+ * `Math.floor` for the supply arithmetic, tolerant of binary floating point.
+ * 2.4 / 0.8 is 2.9999999999999996 in IEEE 754, so a plain floor reports two
+ * doses left where there are three. Units and units per dose carry at most
+ * four decimals (per dose at most 100), so a quotient that is not a whole
+ * number sits at least 1e-6 below the next one; a rounding error sits
+ * orders of magnitude closer. Anything within 1e-9 of the next whole
+ * number is that number.
+ */
+export function floorWhole(value: number): number {
+  return Math.floor(value + 1e-9);
+}