Taking pills three times a day. When to take medication. Time of day and interval of medication
Who has just prescribed you a course of treatment that includes several drugs, do you completely forget about how and when to take them? If you forgot, you are not alone. Most of them are. Result: drugs do not help and even harm. If you want the pills to bring health benefits, take them correctly.
1. Take different tablets separately, and not all at once at one time. This way you will avoid many side effects.
2. Check drugs for compatibility. For example, if a general practitioner prescribed one drug for you, a urologist prescribed another, a cardiologist a third, and a gastroenterologist a fourth, be sure to return to the therapist again or seek the advice of a pharmacist. So you prevent their contradictory interaction by replacing the medicine with a safe analogue.
3. Do not expect instant results from drugs and do not take a double dose without waiting. Most tablets begin to work in 40-60 minutes.
4. Do not swallow medicines lying down. Otherwise, they may begin to decompose in the esophagus, leading to heartburn, nausea, and vomiting.
5. Do not chew or twist capsule preparations. The gelatin shell ensures the "delivery" of the drug to its intended purpose - to the gastrointestinal tract. In addition, many of the capsules are so-called prolonged action agents that no longer need to be taken several times a day. The shell provides a slow release of the drug, and it must not be damaged.
Precautions for each drug
Aspirin. This medicine should only be taken after meals. Dip a soluble tablet 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 and will not unnecessarily irritate the mucous membranes of the gastrointestinal tract.
Sulfonamides. They should be washed down with a glass of mineral water. These drugs often cause problems with the kidneys, and drinking plenty of alkaline water will get rid of the problems.
Oral contraceptives. These pills can not be washed down with tea, coffee, Coca-Cola. If this recommendation is not followed, hyperactivity and insomnia appear, since contraceptives reduce the body's ability to break down caffeine.
Antibiotics. They should be taken half an hour before meals. And it is better to drink them with water, and not with milk, since the milk contained in it reacts with antibiotics (especially with tetracycline) and forms sparingly soluble compounds.
Nitroglycerin, glycine. They must be dissolved without drinking anything.
How to take pills
Boiled water at room temperature is the best drink for most tablets.
Grapefruit juice. It cannot be combined with cholesterol-lowering drugs, immunosuppressants, erythromycin, oral contraceptives, some anticancer drugs, Viagra (and its analogues). Grapefruit juice does not remove drugs from the body. The result is an overdose.
Cranberry juice. It is not compatible with anticoagulants - drugs that reduce blood clotting. Otherwise, bleeding in the gastrointestinal tract may open.
Alcohol. In the annotation to many tablets, a warning is given about incompatibility with alcohol. Thus, the combination of alcohol with antihistamines, insulin, tranquilizers and blood pressure pills will lead to increased drowsiness, which is especially dangerous for motorists. Antibiotics, when mixed with alcohol, will cause flushing of the head, dizziness, and nausea. Nitroglycerin under the influence of alcohol changes its effect and will not bring much-needed relief to the heart. Antipyretic tablets, coupled with alcohol, will cause a massive blow to the mucous membranes of the stomach.
How to take medication
Enzyme preparations that improve digestion should be swallowed directly with meals.
Do not mix aspirin with spicy foods and citrus fruits an hour before and after taking the tablets, so as not to irritate the stomach and intestines.
Antidepressants are best taken with a diet that excludes foods such as: cheese, yeast, soy sauce, fish caviar, avocado. Otherwise, severe drowsiness and high blood pressure will ruin your day.
Hormonal preparations require mandatory neighborhood with protein foods. Vitamins require fats for good absorption.
Drugs that regulate digestion, on the contrary, are not combined with fatty foods.
Medication time
Heart remedies and asthma medications are taken closer to midnight.
Ulcer medicine early in the morning and late in the evening to prevent hunger pains.
Of course, you yourself are well aware of all this. But ... forgot. Print this leaflet if you are constantly taking any medication for a medical condition. And don't bother remembering.
Many sick people do not attach much importance to the rules for taking medications, do not follow the instructions. Meanwhile, this is a big misconception. After all, an incorrectly taken medicine, at a minimum, will not bring the desired effect and, at a maximum, will lead to sad results. Therefore, it is necessary to strictly adhere to the rules for taking medications.
Medication Rules
1. You must strictly follow the instructions. This is especially true of the ratio of medication and food. If it is recommended to take medication 30 minutes before a meal, or 30 minutes after, just before, during or after a meal, then this must be done carefully. Not only the effectiveness of treatment, but also the state of the digestive and excretory systems will depend on strict adherence to this requirement. After all, there are practically no drugs that need to be taken on an empty stomach.
2. Self-medication is not allowed. Most patients consider themselves the best doctor. And of course, they are treated themselves, taking medications on the recommendation of friends. Such medication is not allowed, because the interaction of drugs is not taken into account: some drugs mutually enhance the effect, causing significant side effects, while others, on the contrary, completely inactivate.
3. Take your medicines at regular intervals. It is known that the concentration of drugs in the blood is the highest after taking the drug, then, every hour, it gradually decreases. If you arrange long intervals between doses of drugs, then there will come a period when the concentration of the drug in the blood will be very low. When taking antibiotics, this should not be allowed, since the microorganisms adapt and then, in order to destroy them, a much larger dose is needed. And this is no longer indifferent to the body. Therefore, drugs should be taken 2, 4, 6 times a day, and the intervals between doses should be even. Even at night it is necessary to take medicines.
4. What is the best time of day to take medication?
Pain is most felt at night, so it is very important to take painkillers in the evening. However, at approximately 3 pm, the dose of these drugs can be reduced without reducing the effect, since painkillers are most effective during this period of the day.
But oncological drugs most effectively act on cancer cells at about 6 o'clock in the morning, therefore it is most advisable to take them at this time of day.
It is advisable to take vasodilator drugs in the morning. Indeed, during this period, the risk of myocardial infarction reaches a peak. But in the evening, the doses of these drugs can be reduced without health consequences.
Anti-asthma drugs are recommended to be taken in the evening, this is to prevent nocturnal asthma attacks, because they occur mainly at night or in the early morning.
Antirheumatic drugs should also be taken in the evening. This will reduce joint pain and improve their mobility after sleep.
Also in the evening, but late, it is necessary to take anti-allergic drugs, since it is at night that the body produces the smallest amount of a hormone that inhibits allergic reactions.
Considering that gastric juices are very aggressive at night, it is most advisable to take medicines against gastric ulcer and 12-collapsed intestine in large doses shortly before bedtime.
5. Treatment must be completed. Especially it concerns . In no case should you stop taking antibiotics, even if the symptoms of the disease have decreased or disappeared. After all, during the treatment with these drugs, the weakest microorganisms die first, then the more resistant ones, and at the very end, all the rest. If the full course of treatment is not carried out, then the most resistant microorganisms will survive, adapt to these drugs, and in subsequent diseases they will no longer be sensitive to this antibiotic, or sensitive, but to a higher, not harmless to the body, dose.
6. If several medications are prescribed, they must be taken separately. Even the most harmless drugs for the body when taken in one gulp, i.e., the simultaneous intake of several drugs, will put a heavy burden on the stomach and liver. In addition, no one will ever say how, under the influence of the individual environment of the stomach of each person, several medications taken at the same time will behave. Will they cause the formation of toxic agents in the stomach. And therefore, the intake of medicines must be diluted in time so that the interval between doses is at least 30 minutes.
7. When using tablet preparations, it is necessary to chew them. An exception to this rule is tableted and powder medicines that are in gelatin capsules, shells, cachets, the purpose of which is to protect the digestive tract from irritation. The rest of the tablets, even if they are very bitter, are recommended to be chewed, then they will begin to be absorbed in the mouth and continue to be rapidly absorbed in the stomach without losing their medicinal properties, which will allow them to quickly achieve a therapeutic effect.
8. Medicines must be washed down. Even miniature pills need to be washed down, since a high concentration of the active substance can harm the stomach. It is best to drink medicines with warm boiled water. It is not allowed to drink juices, carbonated water, milk (unless it is provided for by the instructions), kefir, etc. Indeed, in milk and kefir, even fat-free, there is fat that envelops the tablets, not allowing to be absorbed completely and without delay.
9. Do not drink alcohol while taking medication. A very large number of medicines, primarily antibiotics, when taken with alcohol, not only lose half of their medicinal properties, but can also form, and not only in the stomach, compounds harmful to the body.
10. It is not allowed to take expired medicines. The least that will come from this is the ineffectiveness of treatment, and the biggest is irreparable harm to health. After all, when the expiration date expires, the reaction of drugs, when they enter the human body, may differ for the worse from that provided for by the instructions. The same equally applies to preparations that were stored incorrectly (temperature, humidity, light warnings were not respected). About that, we already wrote on the site, we will not repeat ourselves.
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When is it better to drink it - in the evening or should it have been done in the morning? How to combine it with food: take it on an empty stomach, during meals or after?
How does it combine with the juice drunk half an hour ago, and how will it be combined with the aspirin taken earlier?
Surprisingly, neither long instructions for medicines, nor the doctors who prescribed them often give clear answers to these fatal questions. Moreover, this often remains a mystery for drug manufacturers. Pharmaceutical companies are not required to conduct such tests. They study safety and effectiveness, but these nuances are not. Therefore, we draw most of the knowledge from the results of various emergencies that have occurred with people who have previously taken the same pill. For example, in a patient who took statins to lower cholesterol, the liver collapsed. During the investigation, it turned out that he always washed them down with grapefruit juice. Then it was found that this juice causes an overdose of statins and, by the way, many other drugs. And now all new products in some countries require mandatory testing for compatibility with this juice. And we should learn: if you drink medicines, you better forget about grapefruit juice. By the way, in the same way, the liver can be destroyed when paracetamol is combined with alcohol.
The question of whether to take it in the morning or in the evening is important primarily for the cores. As scientists from the influential Cochrane Collaboration Institute recently proved, antihypertensive drugs are better at lowering blood pressure if they are swallowed at night before bedtime. In the same way, it is better for cores to take aspirin - the likelihood of blood clots at night is higher. But for most other drugs, this is not so important. When you have to be treated with several drugs at once (some prescribed by a therapist, others by a neuropathologist, etc.), the risk of side effects increases dramatically. Therefore, it is imperative to audit all prescribed drugs for compatibility. Among them there should not be funds not only with the same active ingredients (taking them together, you double the dose), but also with the same mechanism of action. To determine this, look in the instructions for which group the drug belongs to - there should not be two drugs from the same group. A typical example: a cardiologist prescribed aspirin, and a rheumatologist prescribed ibuprofen for joints. Both drugs belong to the same group, the so-called. NSAIDs and ibuprofen will negate the protective effect of aspirin. And be sure to study the section that is usually called "drug interactions." They usually indicate how some drugs affect each other. It is possible that such “warring” drugs were prescribed by different doctors together due to an oversight.
What you need to know before taking medication
If the package insert does not contain clear information about the rules for taking medications, then it is better to follow the following rules:
The most unpredictable drugs
Antibiotics, many antiallergic and antifungal drugs, sleeping pills (especially oxazepam and diazepam), antidepressants (especially tricyclic and from the group of MAO inhibitors), paracetamol, statins (lower cholesterol), cimetidine (used for ulcers), omeprazole and other so-called. proton pump inhibitors (reduce acidity in ulcers), cyclosporine (used for transplantation, rheumatoid arthritis and other systemic diseases), cisapride (stomach weakness, reflux esophagitis), warfarin (prevents the formation of blood clots).
Often in the annotation to the medicine you can read “take after meals” or “half an hour before meals”, or there are no recommendations at all in the instructions. In addition, the doctor gives advice when he prescribes the drug - drink it twice or thrice a day, or once, at night, etc. Why do these instructions, what do they change in the action of the tablets, do they need to be strictly observed or is it not important ? Does food, time of day, and sleep affect how drugs work? Let's figure it out.
The basic rule for taking any pills is the frequency of their use. When a doctor prescribes medication several times a day, most specialists mean the whole day as a whole, and not the waking time, which is approximately 15-16 hours (minus the time that the patient spends in sleep from the day).
This is due to the fact that, despite the patient's sleep, his body continues to work - the heart contracts, the liver actively processes drugs, and the kidneys excrete their residues in the urine. Accordingly, microbes or viruses also attack the body around the clock, and diseases do not go to sleep with their host. Therefore, it is important to evenly distribute the intake of tablets at equal time intervals (if possible), especially if they are antiviral drugs, antibiotics, or some other means.
Accordingly, if the tablets need to be taken twice a day, the interval between their use should be approximately equal to 12 hours. That is, they can be accepted, for example, at 8.00 and 20.00. If this is a three-time appointment, the interval is reduced to 8 hours, you can make a schedule like this - 6.00, 14.00 and 20.00.
Fluctuations in the interval of taking the drug at 1-2 hours are acceptable, and it is not necessary to jump up on the alarm clock an hour earlier than expected to take the pill, you can adjust the schedule for yourself. However, taking three times a day does not mean chaotic use - without observing time intervals, as it is convenient for the patient if he forgot to take the drug on time. That is, you can not take the drug in the morning, then in the evening and two pills at once, after waiting 2-3 hours, because there was no time at work during the day. To avoid confusion, many experts indicate the approximate time of taking the medicine when prescribing it.
It is often easier to follow short courses of drugs. Usually the first few days the patient is more pedantic about his treatment, especially if he is not feeling well. But, as it becomes easier, or if the course is long, the pills are drunk less and less responsibly - and this is very bad! Often, rush, stress, or forgetfulness is the reason for missing or stopping medications. This leads to the fact that the treatment does not give the expected effect due to its incomplete course. There is another option: people take pills half asleep or forget that they have already taken them, and then repeat the dose, already superfluous. If the drug has strong effects, this can end sadly.
To combat this problem, various options are offered: placing the pills in a conspicuous place, a schedule on the wall with checkmarks when taking pills, reminders on the phone or alarm clocks. So, for oral contraceptives, manufacturers have long begun to mark the days of the week or the dates of the month on the blister itself so that women do not forget to take the pill. There are also mobile applications that help to follow the treatment schedule. And recently hybrids have appeared - an alarm clock-a first-aid kit, programmable and giving out a portion of the drug on a bell.
Human nutrition can significantly affect the activity of drugs and the rate of their absorption from the intestine into the blood. If we divide all drugs in relation to their relationship with nutrition, there are several groups:
- Means that do not depend on meals,
- Drugs that must be taken strictly before meals,
- Medicines taken after meals
- Drugs taken with food.
In addition, according to the patient's assumption, nutrition refers to regular meals in the form of breakfast, which is then followed by a full lunch and the same dinner. However, doctors say that frequent and incomplete snacking is also a meal, even a banana, tea with biscuits or yogurt eaten is nutrition. But, according to the patient, they are not considered normal meals. This means that taking medications without taking into account these snacks, but only the main meals, will be wrong from the point of view of the full assimilation of drugs.
Preparations that require taking “before meals” suggest that when you take the pill you are hungry, you have not eaten anything at all, and you will not eat anything for the period specified in the instructions (usually 30 minutes). Thus, the drug enters the empty stomach, in which it will not interfere with food components mixed with gastric juice. This is due to the fact that the activity of drugs, if the patient allows himself just one candy or a glass of juice, can be disturbed almost to zero, absorption in the intestine will suffer or the drug will simply collapse.
There are exceptions to the rule, especially in the treatment of digestive disorders or endocrine pathologies. Therefore, you always need to check with the doctor how the remedy is taken correctly - strictly on an empty stomach or after waiting a couple of hours after you have eaten.
With drugs from the “during meals” group, it is most understandable, although it is worth checking with the doctor how dense the meal should be and what components the meal should consist of, especially if you have it extremely irregular.
Taking drugs "after a meal" is rare. Usually these are means for the normalization of digestive functions, stimulating the separation of gastric juice or some others. It is also important to clarify with the doctor what is meant by nutrition in this case - any snacks or a plentiful, hearty meal.
The easiest way is with drugs that do not depend on food intake in any way, for them only the time interval for taking is set.
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, pronounced side effects can be avoided if you take different pills separately, and not all at once at one time.
Secondly, it is extremely dangerous to use the medicine after the expiration date, since the chemical composition of the drug could change.
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 drugs, 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?
Emergency funds, of course, are accepted 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 medicines 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 exclude foods containing tyramine: cheese, yeast, soy sauce, fish caviar, avocado. Otherwise, severe drowsiness and high blood pressure will ruin your day.
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 not gnaw or unwind the capsules: the gelatin shell was invented not for beauty, but to ensure the "delivery" of the drug to its intended purpose - to the gastrointestinal tract. There is another reason why the pill shell should not be damaged: in recent years, doctors are increasingly prescribing so-called prolonged (prolonged) action agents that no longer need to be taken 5 times a day - the shell in such cases provides a slow release of the drug, and damage she can't.
Never swallow tablets while lying down: they can start 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.
