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Why Must Some Medicines Be Taken Before, With, or After Food?

December 07, 2022 | Dr faisal

Medicines are prescribed in specific dosages to treat an illness or disease. Often, the medication dosage is specified, but it is not discussed whether to take them before or after meals. People often get confused about why some medicines must be taken on an empty stomach and others with a meal. For this reason, let’s begin to understand the influence of food on the efficacy of certain medicines.

How does food affect the absorption of medicines?

When you intake food, it travels down to your stomach, where the process of digestion begins. Your stomach releases gastric acid, which aids in the breakdown of food materials. This is why the pH of the stomach is in an acidic range, especially during and one hour after meals. 
This pH can affect the absorption of certain medicines. Some antibiotics like azithromycin or erythromycin will lose efficacy if they enter an acidic environment. This may also lower the absorption rate of these medicines. Hence the effects will be much delayed if taken with or right after food. 
Particular medications such as bisphosphonates or ciprofloxacin can bind themselves with mineral content obtained from food. This can diminish their properties and make them less effective. Therefore such medicines should be taken an hour before a meal. 
Similarly, some medicines such as digoxin can get adsorbed with the high fiber content of a meal. This can reduce the efficacy of these medicines. Therefore, they should not be taken with high fiber foods such as whole wheat, oats, bran rice, etc. 
On the contrary, some medicines are better to be taken with or after food. Aspirin, NSAIDs, and some corticosteroids can irritate the lining of your digestive tract if taken on an empty stomach.  It is recommended to take these medicines during or 30 minutes after a meal. 
Some antifungals, such as ketoconazole and itraconazole, are better absorbed when taken with food. Similarly, certain antiviral drugs such as ritonavir, saquinavir, nelfinavir, etc., are better absorbed into your bloodstream when taken with or after meals. 
Medicines taken for diabetes, such as metformin, gliclazide, etc., are recommended to be taken a little while before or after food. Taking them too early on an empty stomach may cause hypoglycemia, while taking them too long after a meal may lead to a high glucose level in the blood. Eating the medicine at the right time regarding your meals can stabilize your blood sugar level. 
Some medicines, such as bromocriptine and allopurinol, tend to cause nausea or vomiting as a side effect. It is better to take these medications 30 minutes or 1 hour after a meal to reduce the risk of these side effects.
If you have the issue of stomach acidity, it is recommended to take antacids after a meal to reduce its symptoms. However, medicines like omeprazole can be taken before meals to prevent gastric acid’s effects in patients with gastric or duodenal ulcers.

Things you should keep in mind before taking medicines

Before taking any medication, discuss its implications with your healthcare provider. Your doctor knows your history and will guide the use of medicines better. 
Read the label and directions given on the packaging of the medicine. Almost all medicines come with a small pamphlet which contains necessary information about that medicine. Read it carefully to ensure that the medicine is safe for you.
If you have any pre-existing allergies or underlying conditions, discuss them with your doctor beforehand. 
If you are unsure about taking medicine before or after food, always consult your doctor. Some medicines are taken on an empty stomach, while others are taken during or after meals.
It is best suggested to take oral medicines with water. Taking the medication with milk or other beverages may interrupt the absorption of that medicine. 
Do not take any medicine with alcoholic food or beverages. Alcohol is a depressant, and it will reduce the efficacy of drugs taken along with it. 
Avoid mixing medicine into hot drinks such as tea or coffee. The high temperature may ruin the active components of the medicine. 
Fatty foods can delay the emptying of the stomach into the small intestines. If you are taking medicines with fatty foods, the effects of these medicines might be delayed. 
Oral Medicines in topical form should be applied after you have had a meal. 
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