Timing your medication appropriately can be crucial to the success of any treatment regime whether it be to cure a life-threatening condition or simply to alleviate troublesome symptoms.
When best to take a medication depends on the active ingredient, what product form the medication is in, the nature and severity of the condition to be diagnosed, prevented or treated, as well as individual diet and lifestyle. The detailing that your doctor or pharmacist provides often centers on maximizing the effectiveness and safety of the medication.
Getting as much of the active ingredient to be absorbed into the body can be an important goal of correctly timing your medication. Some medication is better absorbed when taken with meals or specific foods while the absorption of others is inhibited when taken in the same way. Extremely little of an osteoporosis medication like Fosamax (alendronate) already ever gets into the body, let alone reaches the bones, under fasting conditions from a single dose. This medication needs to be taken with plain water and without food or other drink, weekly on the same day in an upright position upon first rising. Already more than 99% of a single dose will be excreted out of the body under such conditions and if the medication is taken with food or at other times during the day, the amount absorbed can be further reduced by half or more.
Some medications may be safer to take with food rather than on an empty stomach. In better assuring the long-term safety of a painkiller class of medications known as NSAIDs, it may be advisable to avoid taking the medication aspirin for instance, on an empty stomach and to either take the medication with or after food or together with an antacid.
Active ingredients can require a specific dose and timing strategy to be most effective. This is especially so for different types of antibiotics in treating infections. An antibiotic medication like cloxacillin may require four times a day dosing to maintain effective blood levels in treating a skin infection while ciprofloxacin, an antibiotic of a another class that acts differently, may only require once or twice a day dosing to treat a urinary tract infection.
The product form can play an important role in when and how often a medication is taken. Long-acting, delayed or sustained release preparations can work to release the active ingredients of a medication product differently or consistently throughout a day allowing the medication to be therapeutic despite being dosed only once instead of multiple times in a day. In managing blood pressure for instance, chronotherapeutic medication has been developed to work in tandem with the body’s natural circadian rhythms and in effect, to best tackle the peak blood pressure that tends to occur upon awakening. Innopran XL (propranolol) can be taken just once at night before sleeping. Technology allows the release of the medication’s active ingredient four hours after taking it, with resulting peak blood levels that coincide with the morning spike in blood pressure.
The nature of a medical condition can also help to determine when it is best to take a particular medication. Cholesterol is synthesized by the body, often during sleep in the night hence the arising notion that it may be most advantageous to dose cholesterol-lowering medication like Zocor (simvastatin) or Mevacor (lovastatin) in the evenings. Conditions like migraine, fever and gout may have acute symptoms that occur unpredictably and can often require medicating regardless of the time of day.
Incorporating individual diet and lifestyle patterns often facilitates compliance with taking medication and can be crucial to effectively treating a chronic condition like diabetes without unduly reducing quality of life. To best control the condition, insulin injections may be administered as well as oral medication taken before, with or after food to coincide with specific anticipated spikes in blood sugar levels. In consultation with the treating doctor, oral medication may be timed with meals or scheduled for consumption either consistently in the morning or the night to facilitate lifestyle and compliance.
When specific medications are used to moderate elements of diet and nutrition, taking these consistently with meals can be important to treatment success. A weight-loss medication like Xenical (orlistat) is often best taken with meals or times of food intake that involve the most consumption of fats as these get bound by the medication and are passed out from the body. The cholesterol-reducing medications colestipol and cholestyramine also act in a similar way and are best taken with meals.
Timing medication for best outcomes can be especially important when having to take five or more medications consistently. In such cases known as polypharmacy, it becomes increasingly important not just to match medicating with specific time slots before, with or after food, but also to space out the different medications appropriately so as to avoid negative interactions that could lead to ineffective medicating or even direct harm to health.
In timing your medication, discuss the various considerations with both your treating doctor and pharmacist. This will optimize a safe and effective medication regime and better your treatment outcomes.
Sudesh Samuel is president and founder of the Institute for Medication Management. He is both a pharmacist and author specializing in the development of informational tools that center around patients being able to rely on safe, effective and low-cost medicines where necessary to manage health and well being.