Are You Getting the Most from Your Medications?

Are you getting the most effectiveness out of the supplements and medications you take? Did you know the time of day you take your medications and drug interactions may impact how well your supplements and medications work?  Today’s blog overviews the impact of time and drug interactions on your medications.

Time of day

Some prescription medications say what time of day they should be taken, but most don’t. Does the time of day impact how well the medication works?  Unfortunately, drug research is almost always done during the day and does not involve testing of new drugs at multiple times of the day. Yet many bodily functions vary throughout the day so that the impact of a drug may depend on circadian rhythms. A new field, chronobiology, hopes to change the way drug testing is done to include timing in drug tests. (1) 

There are some knowns, however. Aspirin is easier on the stomach if not taken in the morning.  Since certain diseases are worse at certain times of the day, taking your medication so it is active when symptoms are worse will give you the best benefit. So if your osteoarthritis gets worse at night, taking your anti-inflammatory around noon or in the afternoon might provide the most relief when the pain is at its peak.

Some older statin medications work better if taken at night. Asthma attacks are more frequent at night and the stomach secrets more acid at night, indicating the medications for these conditions should be taken a few hours before bedtime. (2)

Blood pressure medications are trickier. Most people’s blood pressure dips at night, so these people should take their blood pressure medication in the morning when blood pressure peaks. However, there are people whose blood pressure does not dip at night might do better by taking some of their blood pressure medication at night. (2)  

Interactions

With each medication you take, your chances of having a drug interaction increases. The interaction may either increase or decrease the effectiveness of a medication. Many times a prescription drug label will tell you about interactions (e.g., do not take alcohol while taking this medication), but many times it does not.

What are some of the common interactions?

Calcium can decrease the effectiveness of medications like antibiotics and ACE Inhibitors. To minimize the effects, take calcium at least 1 hour after or 4 hours before taking these medications. (3)  

Another common drug interaction is that medications to treat stomach disorders  can reduce the effectiveness of medications that rely on stomach acid to absorb the medication.  For example, a Canadian study of more than 60,000 people 50 and over found that those who took proton pump inhibitors for more than 5 years were 1.5 times as likely to have hip fractures. (4, 5)

Checking Interactions

Drugs.com has a Drug Interaction Checker where you enter your medications, including over the counter medications, and the website will tell you about the interactions.  This is really nice because it's customized specifically for the medications you take.

Common Drug Interactions - a Chart developed by a pharmacy graduate student.

Drug Interactions - a very nice site with a definition of drug interactions, how they occur, information on absorption and metabolism, the consequences of drug interactions and how drug interactions can be avoided.

References

1. Slate, The Best of Times, the Worst of Times. Nov 1, 2007
2. msnbc.com, What Time You Take Your Blood Pressure Pill Matters, December 17, 2007
3. WebMD.com, Calcium (click the interactions tab)
4. CBSNews.com, Acid Reflux Pills Linked To Hip Fractures, August 11, 2008
5. Everydayhealth,com, Nexium and Bone Loss?, May 7, 2007