How long after a meal to take medicine. When is the best time to take medication? Method of drug use

Colds, flu, tonsillitis, whooping cough - in winter, and at any time of the year you can get sick without leaving the couch. And always, even at the first symptoms of the disease, we begin to stuff ourselves with pills. We want to warn you against the most common misconceptions associated with taking medications and tell you how to take them correctly.

Unless otherwise indicated in the instructions or in the doctor's prescription, it is better to take medications on an empty stomach 30 minutes before meals, since interaction with food and digestive juices can disrupt the absorption mechanism or lead to a change in the properties of drugs.

On an empty stomach take:

- all tinctures, infusions, decoctions and similar preparations made from plant materials. They contain the sum active substances, some of which, under the influence of hydrochloric acid of the stomach, can be digested and pass into inactive forms. In addition, under the influence of food, absorption of individual components of such drugs is possible and, as a result, insufficient or distorted exposure;

- all calcium preparations , although some of them (for example, calcium chloride) have a pronounced irritant effect. The fact is that calcium, binding with fatty and other acids, forms insoluble compounds. Therefore, taking drugs such as calcium glycerophosphate, calcium chloride, calcium gluconate and the like during or after meals is at least useless. To avoid irritating effects, it is better to drink such drugs with milk, jelly or rice water;

- drugs that, although absorbed with food, for some reason have an adverse effect on digestion or relax smooth muscles . An example is an agent that eliminates or weakens spasms of smooth muscles ( antispasmodic) drotaverine (known to everyone as No-shpa) and others.

-tetracycline because it is highly soluble in acids. But do not drink it (just like doxycycline, metacycline and other tetracycline antibiotics) with milk, as it binds to calcium, which is quite a lot in this product.

All multivitamin preparations are taken during meals or immediately after meals.

Immediately after eating, it is better to take drugs that irritate the gastric mucosa: indomethacin, acetylsalicylic acid, steroids, metronidazole, reserpine, cardiac glycosides (tincture of lily of the valley, digitoxin, digoxin, cordigit, celanid).

Diuretics(diacarb, hypotheazid, triampur, furosemide) - only after meals.

Antihypertensive drugs(adelfan, brinerdine, clonidine, renitek, papazol, raunatin, reserpine, triresit K, enalapril, enap) can be taken before and after meals, in the morning and in the evening.

Means that improve cerebral circulation(cavinton, instenon, tanakan, trental, stugeron (innarizin), nootropil) are taken regardless of when you sat down at the table.

Antiulcer drugs(denol, gastrofarm) should be taken half an hour before meals. They should be taken with water (not milk).

Laxatives(bisacodyl, senade, glaxena, regulax, gatalax, forlax) are taken at bedtime and half an hour before breakfast.

Antacids(almagel, phosphalugel, gastal, maalox) and antidiarrheals (imodium, intetrix, neointestopan, smecta) - half an hour before meals or 1.5-2 hours after.

Bronchodilators(berodual, broncholithin, ventolin, salbutamol) - regardless of food.

Take 10-15 minutes before meals choleretic drugs, for them to get into duodenum before food and stimulated the process of bile secretion by the time food enters the intestine.

All medicines that are not indicated in the instructions or in the prescription should be taken on an empty stomach (3-4 hours after a meal or 30-60 minutes before a meal).

Drink water while standing.

A special group consists of drugs that should act directly on the stomach or on the process of digestion itself. So, drugs that reduce the acidity of gastric juice (antacids), as well as drugs that weaken the irritating effect of food on a sick stomach and prevent abundant secretion of gastric juice, are usually taken 30 minutes before meals. 10-15 minutes before meals, it is recommended to take drugs that stimulate the secretion of digestive glands (bitterness), andcholeretic agents. Gastric juice substitutes are taken with meals, and bile substitutes (for example, Allochol) at the end or immediately after a meal. Preparations containing digestive enzymes and promoting the digestion of food (for example, Mezim forte) are usually taken before meals, during meals, or immediately after meals. Means that suppress the release of hydrochloric acid into the gastric juice, such as cimetidine, should be taken immediately or shortly after a meal, otherwise they block digestion at the very first stage.

Not only the presence of food masses in the stomach and intestines affects the absorption of drugs. The composition of food can also change this process. For example, with a diet rich in fats, the concentration of vitamin A in the blood plasma increases (the speed and completeness of its absorption in the intestine increase). Milk enhances the absorption of vitamin D, the excess of which is dangerous, primarily for the central nervous system.

Protein food or the use of pickled, sour and salty foods impairs the absorption of the anti-tuberculosis drug isoniazid, and protein-free, on the contrary, improves.

I hope that the above examples have given you a general idea of ​​how the properties of a drug can change depending on the diet and time of administration.

It is very important to take the drug at the time indicated by the doctor, or recommended in the instructions. Otherwise, the medicine may simply become useless, or even harmful.

Of course, there are drugs that work "regardless of food intake", and this is usually indicated in the instructions.

The method of taking the medicine is also important.

Remember that it is better to take the medicine orally while standing, in extreme cases, sitting, but not lying down! After taking it, you can’t lie down for 2-3 minutes, otherwise the medicine will “stick” to the inner surface of the esophagus and after 10 minutes it can completely collapse without reaching the stomach and intestines. When several drugs are prescribed at once, an interval of 10-15 minutes is required between taking each of them.

Drinking is supposed to warm water. Tea, especially strong tea, is not suitable for this, since the tannin contained in it forms insoluble, and therefore non-absorbable compounds with many medicinal substances. Especially active tannin binds papaverine, amidopyrine, cardiac glycosides, enzymes, active ingredients of herbal infusions and decoctions.

Whether we like it or not, our body depends on biological rhythms. He knows that in the morning you have to get up, and in the evening get ready for bed. For the same reason, there are seasonal exacerbations of diseases. But here, what is interesting, is there a dependence on biorhythms for each specific organ or system? It turns out that there is a lot.

If we know at what time the activity of a particular organ increases, we can influence the effectiveness of taking medications. That is, we will know when it is better to take medicines so that they are absorbed by the body more quickly. In addition, we will learn how to reduce the side effects of drug therapy.

There is a whole area in pharmacology (the science of drugs) dedicated to these issues - chronopharmacology. It originated several decades ago. The founder is Doctor of Medical Sciences, Professor R.M. Zaslavskaya. Although Avicenna spoke about annual (seasonal) biorhythms and related diseases. Chronopharmacology studies the biological rhythms of a person that affect the severity of the action of drugs, as well as the effect of drugs on the rhythmic fluctuations of the body.

What are the biorhythms that affect the body:

• Daily (circadian);
• Biorhythms of the month;
• Annual (seasonal);
• Hormonal (menstrual cycle);

It is from these rhythms that the body is most dependent. But in fact, there are about 500 of these rhythms. They affect different levels of the body - cellular, tissue, as well as organs and the body as a whole.

The periods of some biological rhythms are close to the time intervals familiar to us, but do not coincide with them. For this reason, in such names we often find the prefix " circa» (means around, about, about). For example, the circadian rhythm is called circadian ("circa" - about, "dies" - day). By the way, it is he who is the most important for the body, determining the activity and rest of all organs and systems, as well as cyclic metabolic processes.

Here we can guess why doctors insist on following the regime - we get up and go to bed at the same time, we eat at certain hours. Violation of the usual routine can lead to serious changes in the human body and even to illness.

One could continue to develop the topic, talking about what biorhythms are, about their high-, medium- and low-frequency effects on the body, but in this article we are pursuing completely different goals.

• Firstly, we are mainly interested in the change in activity in different areas of the human body depending on the time of day.
• Secondly at what hours it is most rational to take this or that pharmacological drug.

Biorhythms of the body

The approximate dependence of the activity of organs on the time of day is shown in the following diagram.

But this dependence can change quite widely under the influence of lifestyle, which sometimes leads to desynchronosis - violations of the normal functions of the body as a result of a shift in circadian biorhythms. Thus, each person has his own "biological clock", but their strong discrepancy with the natural rhythms of the body can seriously harm.

The dependence of the intake of certain drugs on biological rhythms

When is the best time to take medicines, for example, for hypertension and allergies? How to take vitamins and drugs from bronchial asthma? These questions are answered by chronotherapists.

1. Non-steroidal anti-inflammatory drugs (NSAIDs) accept at various diseases, such as rheumatoid arthritis, radiculitis pains, headaches, etc. From the point of view of chronotherapists, NSAIDs are most effective when taken in the evening after dinner. On the one hand, this reduces the severity of side effects of these drugs, such as stomach pain, intestinal irritation. On the other hand, if we consider rheumatoid arthritis, in which the pain intensifies in the morning, then the effectiveness of the drugs increases. Chronopharmacologists are sure that taking NSAIDs a few hours (1.5-2 hours) before the maximum pain gives a 2x increase.
2. A similar picture for treatment. Chronotherapy is the most widespread here. The body of each hypertensive individual is individual, therefore, for the use of chronotherapy, daily monitoring of blood pressure (BP) is required, which determines the time at which the peaks of blood pressure increase occur. The use of drugs for the treatment of hypertension is most appropriate 1.5-2 hours before the onset of the maximum blood pressure detected during monitoring. This allows you to achieve a decrease in blood pressure in a shorter time.
3. Sick use bronchodilators, incl. prolonged (prolonged) action. At night, bronchial patency decreases, which is why asthma attacks most often occur in the wee hours (around 4 am). In this case, it is rational to take bronchodilators in the evening at 20-22 hours, and prolonged-acting drugs even earlier, because. the peak of their activity occurs 12 hours after ingestion.
4. Allergy medications (antihistamines) chronotherapists advise taking it in the evening or in the afternoon, due to the maximum activity of histamine in the evening and at night (histamine content is maximum at 21-24 hours). Those. we again adhere to the principle of taking the drug a few hours before the onset of the maximum manifestation of a chronic disease.
5. Taking vitamins also depends on biological rhythms associated with biochemical processes in the body. It is known, for example, that vitamin B6 (pyridoxine) often causes allergic reactions. It turns out that this is due to the fact that in the evening it promotes the release of histamine. However, when taken in the morning, it activates an enzyme that destroys histamine. In this way, this drug best taken early in the morning. Similar studies were carried out with other vitamins (B1, C, A, E, etc.). Probably, on the basis of these data, some doctors form the opinion that it is inappropriate to take vitamin-mineral complexes, since their individual components must be taken at different hours of the day.

Conclusion

One of the positive aspects of the use of chronopharmacology is the reduction of therapeutic, daily and course doses of drugs, because. their intake in certain phases of the body's activity increases the efficiency by 2 times. If the dose of the drug is reduced, then the side effects.

But! The use of chronotherapy should take place under the clear guidance of an experienced chronopharmacologist. He will analyze the individual characteristics of the body and give recommendations at what time is best to take medication.

In addition, the principles of chronotherapy are not applicable to all diseases and drugs. Such diseases, for example, include infectious diseases. Antibiotics must be supplied in a strictly defined concentration and regularly in order to avoid the formation in your body of strains of microorganisms insensitive to them.

When prescribing pills several times a day, most doctors mean by this a day, i.e. 24 hours. Internal organs work around the clock, bacteria in the same way work without rest and sleep. Therefore, medication should be divided at regular intervals, especially for antimicrobial agents.

With short-term courses of drugs, it is easier, because for a couple of days you can follow all the rules, and with long-term courses, certain difficulties often arise. A person takes a pill, and then forgets and drinks a second one “just in case”. Well, if the medicine is not potent. There are a lot of methods of dealing with such forgetfulness, everyone chooses for themselves: checkmarks on the calendar help someone, others put medicines in a conspicuous place, someone starts alarms and puts reminders on their mobile, etc. Pharmacological firms produce special calendars in which you can mark each appointment.

Before or after meals

All medications are divided into groups according to their connection with meals: "do not care", "before", "after" and "during meals". At the same time, in the mind of the doctor, the patient eats according to the schedule, without snacking during breaks, and the patient is sure that the eaten apple or pie has nothing to do with food.

A medicine prescribed to be taken “before meals” assumes that a person has not eaten anything before taking it and will not eat anything for at least a specified period after eating. The tablet must be taken in an empty stomach so as not to be exposed to gastric juices, food components, etc. in this case, a glass of juice or candy two hours or an hour before taking the medicine can drastically affect the result of treatment. There are cases when you need to eat exactly at the indicated time of admission, so it is advisable to clarify what exactly the doctor has in mind.

"With Meals" is the easiest way to take it, but if your diet is far from ideal, it's best to ask your doctor which foods are best when taking one or the other. medicinal product.

Drugs that are prescribed "after eating" include drugs that irritate the gastric mucosa or help normalize digestion. In this case, a small amount of food will be enough.

Medication Rules

Most drugs must be taken separately. This is not very convenient, but swallowing the pills with a “handful”, you can get an unpredictable effect, at least half an hour should pass between doses.

Also, keep in mind that vitamins, combined means from colds, herbs and hepatorrotors during treatment should be taken only after consulting your doctor.

Not every tablet can be divided into several doses, some drugs are coated, damage to which can significantly affect the properties of the drug. The absence of a dividing strip on a tablet most often indicates that it is forbidden to divide it.

With rare exceptions, drugs are washed down only with water, plain and not carbonated. The exception is certain drugs that need to be washed down with acidic drinks, milk, mineral water or other separately specified liquids, the rules for admission are most often specified in the instructions.

Methods of drug use also have great importance, for example, a chewable tablet that you swallowed whole will take a very different time to work or will not produce any healing effect at all.

The form of release of the drug should also be taken into account. If the tablet has a special shell, then it cannot be crushed or cracked, because. its main function of the coating is to protect, for example, the stomach, esophagus or tooth enamel from the active substance. The capsule form indicates that the main medicinal substance should be absorbed into the body only in the intestine after a certain period of time, so they should not be opened.

Why do drugs sometimes not work as quickly as expected, and sometimes they don't work at all? It is possible that this is due to improper medication.
Most of us take drugs according to one scheme: drink and forget. But the body remembers for a long time what and how it was taken, punishing for the wrong attitude towards itself.

Chew or swallow?

Medication does not tolerate self-activity. On most drugs there is an inscription: "For oral administration." However, it is not always indicated which way to take the medicine inside.

Some medicines that are coated or contained in a capsule must be swallowed without chewing. This is usually specified in the instructions.

Some of the tablets can be chewed (citramon, analgin). Since there are many in the oral cavity blood vessels, the medicinal substance is easily absorbed into the bloodstream and acts faster than when the tablet is swallowed whole.

There is emergency conditions when you need emergency help. Then the tablet is placed under the tongue, such as validol or nitroglycerin. There are pills that are very bitter in taste, it is preferable to take them whole.

Water or juice?

Pharmacologists are convinced: pills should be taken with water room temperature. All other drinks may not be combined with drugs. Therefore, the patient will not make a mistake with the choice if he drinks the medicine with plain water. If he chooses another liquid, various surprises are possible.

Cranberry juice should never be taken with blood thinners. This can lead to internal bleeding. Grapefruit juice reduces the effectiveness of hormonal contraceptives.

Some antibiotics, such as tetracycline, and enzymes such as mezim and pancreatin are incompatible with milk. Do not drink tablets with tea, the tannin contained in the tea contributes to the precipitation of many active substances. Coffee is also contraindicated - why does a sick body need an extra load on the heart?

It is forbidden to drink medicines with decoctions of herbs, since herbs are also medicines, and it is not known how such a mixture will behave in the body.

You should forget about alcohol during treatment. Joint reception, for example, alcohol with nitroglycerin leads to sharp decline blood pressure up to loss of consciousness. Against the background of treatment with diuretic drugs, alcohol leads to a violation of the heart rhythm. Fainting is also threatened by the interaction of alcohol with drugs for the treatment of diabetes, sleeping pills and antiallergic drugs. For the duration of antibiotic treatment, you need to forget even about beer.

There is a deviation from the iron rule "water and only water". Vitamins A, D, E, K, iodine preparations and hormonal preparations are well perceived by the body with milk. The antibiotic erythromycin is washed down with any alkaline mineral water. Aspirin or other drugs containing acetylsalicylic acid “soften” with kissel. But such tablets as pharyngosept, in general, do not tolerate any neighborhood with them for several hours.

Medicines and products

Sometimes drugs are incompatible with products. For example, oily fish with aspirin provokes bleeding. If you take bananas and chocolate with psychostimulants together, it rises blood pressure increase the side effects of medications. Cabbage removes barbiturates from the body too quickly. Dairy products slow down the absorption of some antibiotics (tetracycline, doxycycline, ampicillin).

Before meals or after?

Another important point- when to take the medicine. Punctuality in this is simply necessary, since the effect of treatment depends on it. Strictly by the hour, contraceptives, antiallergic pills and painkillers with a prolonged duration of action are taken. If you accidentally miss a dose, do not take a double dose next time. The consequences for the body are dangerous.

30 minutes before meals, drugs are usually taken that affect the secretion of gastric juice, containing live bacteria, some homeopathic remedies. Choleretic drugs drunk 15-20 minutes before a meal, drugs that reduce the secretion of gastric juice, herbal decoctions are best absorbed.

During meals, enzymes are taken that improve the digestion of food. In order for vitamins to be better absorbed, they should also be drunk after meals or during it.

Non-steroidal anti-inflammatory drugs are best taken one hour after a meal.

Can nicotine?

If you're on medication and smoking at the same time, don't be surprised why you're not getting better. Substances contained in cigarettes reduce the therapeutic effect of cardiovascular, psychotropic, bronchial and even contraceptives.

Alcohol enhances the effect medicines containing paracetamol, and antihypertensive drugs. If you drink a phenobarbital tablet with an alcoholic drink, then there is a risk of dying from respiratory arrest.

If you combine aspirin and alcohol, then a stomach ulcer may develop and stomach bleeding. Alcoholic beverages combined with nitroglycerin can lower blood pressure dramatically, leading to fainting. Insulin and other anti-diabetic drugs, combined with alcoholic beverages, greatly reduce blood sugar, which often causes fainting. Alcoholic beverages, along with diuretics and digoxin, disturb the heart rhythm, as potassium balance changes.

Rules for taking medicines

Medicines must be taken regularly.

When taking certain medications, one should take into account the state of health, age, and sometimes even gender. Very carefully and carefully you need to take pills for children and pregnant women, the elderly, drivers, athletes. For example, pills such as erythromycin, verapamil, diazepam are more suitable for men, but are ineffective for women. And tazepam and anaprilin on women are more beneficial.

It is undesirable to take several different pills at once. If this is necessary, then you need to drink medicines with a break of 30 minutes to 1 hour.

Antibiotics do not need to be combined with antipyretic, antihistamine, sleeping pills.

Iron preparations should not be taken with antacids (Maalox, Almagel, Rennie).

Oral contraceptives (Non-ovlon, Marvelon, Trimerci, Jeanine) should not be mixed with analgin, sulfonamides (biseptol, streptocide), antibiotics.

When taking enterosorbents ( Activated carbon, smecta, polysorb) and any other tablets, the interval between taking them should be at least 2 hours.

At the same time, you can not take papaverine and aspirin, penicillin and vitamin C, tetracycline and dibazol.

At first glance, this question seems silly. But it turns out that only 20% of patients follow the recommendations of doctors. 60%, leaving the office, completely forget when and how to take pills. And another 20% consider such subtleties unprincipled. The result is predictable: drugs do not work as expected. In fact, a person taking pills needs to learn some wisdom. Only then will he extract the maximum from the medicine. Firstly, it is possible to avoid pronounced side effects if accepted different pills individually, not all at once.
Secondly, it is extremely dangerous to use the medicine after the expiration date, because chemical composition drug may have changed.
Thirdly, never take doctor's prescriptions thoughtlessly. If the therapist prescribed you one medicine, the optometrist another, the dentist a third, and the cardiologist a fourth, be sure to return to the therapist again or seek the advice of a pharmacist. Have them analyze the drugs for compatibility to prevent their conflicting interactions, and replace some medicine with a safe analogue. There are other very important rules.

What to drink?

One example: recent studies have shown that oral contraceptives Do not mix with drinks containing caffeine. With this combination, contraceptives reduce the body's ability to break down caffeine, hyperactivity and insomnia appear. Therefore, in most cases, it is important than to take a pill.

Aspirin strongly irritates the mucous membranes of the gastrointestinal tract. Therefore, this medicine should be taken only after meals. A soluble tablet should be dipped in exactly the amount of water indicated in the insert, and it is better to crush or chew an ordinary tablet and drink it with milk or mineral water, then it will quickly enter the bloodstream.

If etazol, norsulfazol, sulgin, sulfadimethoxine are prescribed, you will need a glass of mineral water. The fact is that sulfonamides often cause kidney problems, and drinking plenty of alkaline water will help get rid of unnecessary problems.

Antibiotics. After all, calcium contained in milk reacts with antibiotics (especially tetracycline) and forms sparingly soluble compounds. By the way, boiled water at room temperature is the best drink for most tablets.

Special conversation - grapefruit juice. It cannot be combined with cholesterol-lowering agents, immunosuppressants, erythromycin, oral contraceptives, tamoxifen, anticancer drugs, Viagra and its analogues. Grapefruit juice does not remove drugs from the body. The result is an overdose.

But with cranberry juice is not compatible anticoagulants- drugs that reduce blood clotting. If this rule is not observed, bleeding in the gastrointestinal tract may open.

Do not drink alcohol while taking medication. Combining alcohol with antihistamines, insulin, tranquilizers, and blood pressure pills can lead to increased drowsiness, which is especially dangerous if you drive.
Antibiotics should also not be mixed with alcohol, otherwise you will suffer from rushes of blood to the head, dizziness and nausea.
In old age, when alcohol stays in the blood longer, the consequences of such a combination can be even more unpleasant. For example, nitroglycerin under the influence of alcohol changes its effect and does not bring much-needed relief to the heart.

Antipyretic tablets, coupled with a glass or two of alcohol, will cause a massive blow to the mucous membranes of the stomach. Alcohol is especially dangerous for diabetics, because under its influence, blood sugar levels first rise and then fall.

When to take the tablets?

Funds emergency assistance, of course, they take it regardless of the time of day - if the temperature has risen or colic has begun, it is no longer up to the schedules. But the effectiveness of drugs, as doctors have long noticed, also depends on the time of administration. Heart remedies and asthma medications are taken around midnight, and for ulcers early in the morning and late in the evening to prevent hunger pains. Do not expect instant results from medicines and do not take a double dose without waiting. Most tablets take effect within 40 to 60 minutes. The exception is those that are placed under the tongue for quick absorption (for example, nitroglycerin, glycine).

Seize?

Taking pills, you must follow a certain diet. Festal, mezim-forte and other enzyme preparations that improve digestion are best taken directly with meals. Do not mix aspirin with spicy foods and citrus fruits one hour before and one hour after taking the tablets. If you do not follow this rule, irritation of the gastric mucosa is guaranteed to you.
When taking antidepressants, it is better to avoid foods containing tyramine: cheese, yeast, soy sauce, fish caviar, avocado. Otherwise, your day will be ruined by severe drowsiness and high pressure.
Tetracycline tablets, as we have already warned, do not tolerate proximity to dairy products. An hour or two before and after taking the medicine, give up milk in any form, cottage cheese, yogurt.
If a person takes hormonal drugs, it is important for him to provide the body with protein food.
Vitamins require fats, and drugs that regulate digestion, on the contrary, are not combined with fatty foods. Spinach, rhubarb, tea and bran bread combine with the calcium found in many vitamins to prevent the body from absorbing it.

How to swallow?

In order for the medicine to get into the bloodstream more quickly and fulfill its task, the American Medical Association suggests the following way of taking pills. Fill your mouth with some water and tilt your head back. Tilt your head forward while swallowing. Then drink the medicine with a full glass of water, unless otherwise indicated in the annotation for the medicine.

You can’t gnaw or unwind the capsules: the gelatin shell was invented not for beauty, but to ensure the “delivery” of the medicine to its intended purpose - in gastrointestinal tract. There is another reason why you should not damage the shell of the pill: in last years doctors are increasingly prescribing means of the so-called prolonged (prolonged) action, which no longer need to be taken 5 times a day - the shell in such cases provides a slow release of the drug, and it cannot be damaged.

Never swallow tablets while lying down: they may begin to decompose in the esophagus, leading to heartburn, nausea, and vomiting.

Where to take?

It is necessary to take tablets very carefully in the summer, especially if you are sunbathing under the hot sun. Some medications can increase sensitivity to light and change skin pigmentation. After taking the drugs, you will burn faster in the sun. To return from vacation with a “chocolate” and not a spotted panther, refrain from taking hormonal drugs, antibiotics, tranquilizers, analgesics and skin antiseptics for a while. If the course of treatment cannot be postponed, then tanning is contraindicated for you, so you should refuse to travel to the sea or stay in the shade most of the time.

One more thing. Taking medication in front of guests and colleagues is considered bad manners.