What Your Prescription Label Is Really Telling You.
Have you ever wondered why sometimes the label on your prescription medicine is so specific about what time of day you should take your pills? Or why you shouldn’t take certain medications at the same time? You may have noticed warning labels on your bottle that say things like “avoid sun exposure” and “take with food”. Your doctor and pharmacist aren’t just being nit-picky and annoying; we have a good reason for giving you all these rules to follow. Each medication comes with its own set of directions depending on what it is being prescribed for and how it works in your body. We give you all those special directions because we want to make sure the medication works its absolute best for you.
Below are a few examples of instructions you may see on your prescription bottle and what they actually mean.
First things first…No matter what time you take any of your medications, you should always take them at the same time each day. I always feel the need to stress this point because it’s so important to remember. If you start off taking one of your daily meds at 9am every day, do your best to keep to that schedule. If you start taking that same medication whenever you feel like it on any given day, your either allowing too much or too little time to pass between each dose. The medication levels in your body are now all over the place instead of at a steady level and it’s not treating your condition or symptoms properly.
Take twice a day: This usually means that your doctor wants you to take your medication twice a day, as close to 12 hour apart as possible. Sometimes it’s not always possible to go exactly 12 hours in between doses but if you can get it in the 10-12 hour range you are doing it right.
Take three times a day: When you see these instructions, logic may tell you that since there’s 24 hours in a day, if I divide that by three then I should be taking one dose of medicine every 8 hours. While this is true, chances are your doctor does not want you waking up in the middle of the night to take your medication. Unless you are incredibly diligent and take your first dose the minute your eyes flap open in the morning and your last dose right before you close them at night, taking medicine exactly 8 hours apart is tough to do without interfering with your sleep. When I see dosing for three times a day, I tell my patients to aim for at least 6-8 hours apart.
Take on an empty stomach: If you see these instructions it means to take your medicine at least 1 hour before you eat a meal, or at least 2 hours after. Medications that need to be taken on an empty stomach are more sensitive to changes in your gut by food and drink. They may not be absorbed correctly when food is present, making them less effective. A common medication with directions like this is levothyroxine. Levothyroxine is used to treat people with low thyroid levels and it should always be taken by itself on an empty stomach. Take this medication when you first wake up in the morning, at least 1 hour before you eat or take any other medications.
Take with food: Some medications are known to be tough on your belly. One of the ways we can stop an upset stomach from happening is by making sure you eat a little bit of food before you take that medicine. This usually doesn’t mean you have to eat a full 3-course meal before you take your pills. Even a small bit of food to get the juices flowing is good enough. There are some medications that will go even farther and specify what kind of food you should or shouldn’t take your medication with. You may see a label that says take with a fatty meal or don’t take with milk or other dairy. It’s because these foods either enhance the absorption of medicine from your gut or make it more difficult. If the label gets specific about what food to take your medicine with, listen to it.
Avoid alcohol: This could mean different things depending on the medication you have been prescribed. The best things to do if you see this label is to have a conversation with your doctor or pharmacist so that you fully understand what it means. For some medications, if you drink any alcohol you can become pretty sick (think nausea, vomiting, rapid heart rate, flushing). Other medications may have side effects that will be exaggerated or dangerous if you drink while taking them. Getting clear directions on when and how often you can drink will help prevent any unintended interactions.
Avoid/limit sun exposure: If you see this label, don’t panic…I know that living on a boat often times means lots and lots of time spent outside in the sun. You don’t have to become a recluse and hide inside, only emerging by the light of the moon. There are some medications that may make you more sensitive to the sun, meaning you may get a more serious sunburn a lot easier than you’re used to. You just have to be more diligent about lathering up the sunscreen and wearing your SPF clothing.
What if the directions on my bottle don’t specify what time of day I should take my medication? Ask the pharmacist. That’s what we are here for. Just because the directions say to take once a day doesn’t always mean you should take that medicine any time you want. An example would be a class of medications called statins which are used to treat high cholesterol. These medications are best taken in the evening or at night. Your body makes cholesterol overnight while you sleep, so taking those medications in the evening makes sense. Will this medication work if you take it in the morning? Probably. But will it work better if you take it in the evening? Absolutely.
Can I take my medications all together at the same time? Again, this would be a great question for your pharmacist. Sometimes the answer is yes but often there are interactions that may happen if you take certain medications together. A good example of something that should be separated from pretty much anything else you may be taking is your daily multivitamin. Multivitamins contain both vitamins and minerals which can bind to other medications in your stomach and prevent them from being absorbed all the way. It’s best to separate your multivitamin from your other medications by at least 2 hours if you can.
Following the directions on your prescription label can really change how effective any given therapy will be. If you are unsure about any directions you see or don’t understand or remember what the doctor told you, don’t hesitate to ask for help. Your doctor and pharmacist are there to answer any questions. What you take and how you take it are all part of the path to keeping you healthy.
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