I am reasonably certain that most of you have, at least once, wondered when is the right time to take your medicines. It happens to be the most common question asked to the doctors. While the answer is not quite straight-forward, there are certain thumb rules one can apply which works in majority of the situations. This article addresses few of those basic rules. The write-up is intended to provide you with basic insight and by no means replaces instructions written on medication strip/box, or advice of a medical practitioner. Its always good to discuss with your doctor the type of medicines prescribed to you, its role, and best way/time to consume it.
Morning vs Evening:
For a lot of medicines it really doesn't matter. Examples are: once a day antibiotic, vitamin tablets, certain heart medications like aspirin, clopidogrel etc. For others, it depends on what is being treated.
Here is a list of certain medications and ideal time:
- Levothyroxine: This should be taken empty stomach with no food/drink for next 1 hour.
- Acid reducing drugs: They come by various names: omeprazole, pantoprazole, rabeprazole, ranitidine etc. These medicines should be taken at least 30 minutes before breakfast. For people whose acidity symptoms are mostly at night should take this 30 minutes before dinner.
- Hypertension medications: Since our blood pressure is typically a few points higher during the daytime, medications taken in the morning will help controlling daytime blood pressure. Few medications like Prazosin can cause dizziness upon standing, and are best taken at bedtime.
- Asthma/allergy medications if taken in the morning, may control day-time symptoms better. Obviously, if majority of the symptoms are during night, then adjustments need to be made accordingly.
- Diuretics (water pill): These medications take excess water out of the body by increasing urination frequency. Taken in the morning, these are better tolerated (as compared to evening dose which will interrupt sleep by need for frequent bathroom trips).
- Sedatives: Sleeping aids should obviously be taken before bedtime.
- Laxatives: Medications for constipation typically take 4-6 hours to show its effect. So, it should be timed accordingly.
- Cholesterol medications: Studies suggest these medications might work better if taken at night, also are better tolerated.
Before vs After Food:
Food typically interferes with drug absorption, making them less efficacious. So, in theory, most of the medications should be taken before food (or empty stomach) with no food consumed at least 1 hour after that. Practically, medications are better tolerated with less nausea or stomach upset if taken after food. Also, except a few, effect of food on drug absorption is not very significant.
Medications recommended to be taken empty stomach include:
- Levothyroxine (as mentioned above)
- Acid reducing medications
- Certain antibiotics: like Amoxicillin, Ampicillin
- Short acting insulin (pre-meal insulin): this should be taken once the food is already served and good to go.
- Oral diabetes medications should be taken with food (can be take JUST before or after food).
Medications recommended to be taken after food:
- Pain medications (analgesics)
- Aspirin
- Iron supplement tablets/syrup
- Potassium supplements
- Newer blood thinners like Dabigatran, Rivaroxaban
- Steroids like prednisone, dexamethasone etc.
- Oral therapies like mouthwash or oral antibiotic paint. If applied before food, these drugs will be swallowed prematurely.
Please note that while the above write-up can be a general guide, every drug therapy is tailored for a particular individual and should be used as per professional guidance. The idea of this article is to give you an overview of how medications interact with time and food. Also, the information provided here is mostly for common medications. Specific treatment modalities require more comprehensive assessment and should be discussed with the treating provider.
Here are certain myths that should be addressed as well:
- Consuming medicines with warm or cold water doesn't make any difference.
- There is no compelling reason to take any medicine with milk or any other liquid other than water.
- Lying down on bed immediately after taking medicine may actually hurt your food pipe (esophagus). It's recommended to stay upright for sometime, ideally for an hour at least, to minimize the risk.
- Asthma inhalers, blood pressure medications, diabetes medicines including insulin etc. do not make your body addicted to it. If you are prescribed these medications, that's because your body needs it, and you are not able to get rid of these medicines because the disease for which these medicines were prescribed in the first place is still present.
I am sure I didn't answer all your questions on this topic. Feel free to message me your queries and I will be happy to answer those.
Medical disclaimer: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. You are encouraged to confirm any information obtained from or through this web site with other sources, and review all information regarding any medical condition or treatment with your physician. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE.