Timing and Pill Popping: What to consider when scheduling your medications.

Diet and timing of our meals can influence how some of our medications work. 

For example, people taking a statin medication for their cholesterol should not drink large amounts of grapefruit juice as it can lead to higher blood levels of the statin medication. Small amounts are probably just fine. My parents were both on statins too but luckily they didn’t like or drink grapefruit juice! 

Some medications are best taken on an empty stomach. Requiring an empty stomach usually means that a medicine won’t get absorbed and work as well if it is mixed with food. That means waiting 1 hour or so after a meal for the stomach to be empty of food to take the medication. The osteoporosis medications called bisphosphonates and iron tablets fall into this category. Unfortunately that also means waiting about 2 hours after the medication to eat again. 

Some medications are best taken with food to minimize their irritation to the stomach. 

Medications taken only occasionally such as aspirin and non-steroidal anti-inflammatory drugs (NSAID’s) such as ibuprofen are two such examples. Drinking a glass of milk or a small sandwich or a snack may be enough to minimize stomach upset or irritation.

On the other hand, don’t assume that by taking aspirin or ibuprofen with a small amount of food you can always avoid serious gastric problems. Over-the-counter NSAID’s and aspirin, even in small doses, can cause serious gastric irritation and even bleeding ulcers if taken on a daily basis for long periods of time.

The timing of a medicine can be important too.

Some medications should be taken in the morning. Diuretics are a great example. Most diuretics work by removing sodium (salt) and water from the body. As a result diuretics will make you go to the bathroom to urinate more often. The potent diuretic my mom was taking, Lasix (furosemide), caused her to urinate a lot within a few hours after she took the pill. Once she was aware how important the Lasix was to prevent heart failure and repeated hospitalizations, she figured out how to time the medication so she could take the Lasix and still go outdoors.

Finally, some medications are best taken at night. For example, some of the popular blood pressure medications are best taken at bedtime (the ACE inhibitors such as lisinopril for example). 

ACE inhibitors not only control your blood pressure better if taken at night, taking them at bedtime may also help reduce heart attacks and strokes.

Many people take a diuretic to treat their blood pressure too but as I just pointed out, a diuretic is usually best taken in the morning or earlier in the day so getting up more than usual to urinate doesn’t interfere with your sleep. 

I will talk lots more about the best ways to treat high blood pressure and optimal timing of medications in future blog posts so make sure to check back if this topic is relevant to you or your loved one.

How challenging does all of this information on timing of medicines and whether to take medicine on empty of full stomach must seem to the daily routines of two seniors such as my parents? What about diet changes while on medication? Are your parents or loved ones on different diets? How have you handled this?

Do you know of someone taking more and more medication as they fall into the prescribing cascade dark hole?