July 30, 2001

FOR RELEASE: Immediately

"Does it matter what time I take my medications?''
I am asked this question frequently. Often the answer is, "Yes, it does matter" for both prescription and over-the-counter medications.
Some medications can only be taken at a certain time of day or they will not work as expected. For example, your body makes the most cholesterol while you are sleeping. Cholesterol medications such as Mevacor® and Lipitor® work much better if you take them after dinner so the most medication is in your body the same time it is making the maximum amount of cholesterol.
Food can sometimes affect how much of a pill is absorbed from the stomach. Fosamax®, a medication for osteoporosis or brittle bones, must be taken on an absolutely empty stomach. It is recommended that it be taken at least a half hour before the first food or drink of the day with plain water only. Otherwise, more than half of the drug will not reach the bloodstream and the drug will not work as expected.
Diabetes medications such as Micronase®, Diabeta® or Glucotrol® must be taken a half hour before a meal. This allows enough time for the medications to start working before you begin eating. Blood sugar levels are kept under control instead of
increasing sharply after you eat. Other diabetes medications such as Glucophage® should be taken with a meal to prevent stomach upset.
Covera HS® is a pill designed to slowly release a drug for high blood pressure and heart problems. It should be taken at bedtime. After several hours the pill increases the amount of medication it releases. This increase is timed to happen in the early to mid-morning hours, which are the same hours heart attacks happen most frequently.
Many times people take medications just before they lie down or while lying down. They may be going to bed for the night or just resting. When you lie down, gravity doesn't help pills move down the esophagus, the food pipe from the mouth to the stomach. In fact, it can take up to ten minutes for pills to travel this short distance to the stomach. With some medications this can be long enough to cause irritation inside the esophagus. The antibiotic doxycycline, aspirin and ibuprofen (Motrin®, Advil®) are known to cause this. Some pills may get stuck on the way down the esophagus and cause ulcers inside it. After taking Fosamax® you should not lie down for at least 30 minutes or it can cause ulcers of the esophagus and stomach.
Taking medications without water also slows the pills down and increases the chances of them getting stuck. Always take medications with water.
There can be several problems that prevent a medication from working the way it is supposed to and wasting some of the medication or all of it. Many medications are expensive so money is lost. Side effects may occur. But most important, the condition you are taking the medication for is not being treated. You may continue to get worse or suffer unnecessarily.
Please continue to ask the question "When should I take my medication?" Your pharmacist and physician are prepared to answer it. And we want to answer it. Your health may depend on it.
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Todd A. Stevenson, PharmD is the Director of Pharmacy at Kent & Queen Anne's Hospital. He received his bachelor of science degree in pharmacy, after completing a five-year program, from Rutgers, the State University of New Jersey and received his doctor of pharmacy degree from Shenandoah University in Winchester, Virginia.

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