Wellness

What is the best time of day to take your medication?

Overview of several classes of over-the-counter and prescription drugs. Before going into detail, note that it is important to always read the package insert carefully and to seek advice from your doctor or pharmacist. Indeed, exceptions may exist depending on each individual or drug.

Why are there differences in the time of taking?

Taking certain medications at a specific time of day may be more advisable than at another. The reason comes mainly from the circadian cycle, responsible for regulating the body, particularly in terms of hormones and sleep. Taking a drug at a specific time of the day can, for example, increase its effect or reduce certain side effects, as is the case with antidepressants. The science that studies these phenomena is called chronobiology. A catch in the evening is also called a catch in the evening.

Corticosteroids. The morning

As most cortisone is produced by the body in the morning, it is preferable to take corticosteroids also at this time of the day. The consequence of such an intake is a balance with the natural circadian cycle. It is advisable (unless there are medical exceptions) to take around 2/3 of the dose of corticosteroids in the morning after breakfast and the rest (1/3) at the beginning of the afternoon.

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Antidepressants. The morning

In general, the doctor who prescribes antidepressants recommends taking them in the morning, especially for serotonin reuptake inhibitors. These medications can lead to sleep-disrupting side effects.

Bisphosphonates. In the morning on an empty stomach

These drugs widely used in the treatment and prevention of osteoporosis should be taken in the morning on an empty stomach. Be careful, these drugs are often taken once a week and not daily or several times a day like most drugs. Ask your pharmacist or doctor for more information. You should know that bisphosphonates are often poorly absorbed at the gastrointestinal level. This is why they must be taken on an empty stomach. It is often advisable to consume them 1 hour before the meal.

Thyroid hormones. The morning

It is advisable to take levothyroxine, a thyroid hormone, in the morning. In addition, levothyroxine should be taken on an empty stomach (eg in the morning 30 minutes before breakfast), as this results in a significantly better bioavailability, as noted in October 2019 the scientific journal of the University of Basel.

Antiallergic. The evening

It is recommended to take antiallergics, especially antihistamines, in the evening. These drugs can lead to drowsiness, which increases the risk of an accident. Taken in the evening, for example to fight against hay fever (allergic rhinitis), also reinforces the effects of the drug in the early morning. Indeed, the symptoms of hay fever are the most intense in the morning. You should know that the maximum effect of these antiallergics is often obtained 8 to 12 hours after taking them.

Aspirin. The evening

To avoid possible side effects on the digestive tract, aspirin should be consumed in the evening and if possible with meals.

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Antihypertensives (hypotensives). The evening

According to a study published on October 22, 2019 in the European Heart Journal, it is preferable to take antihypertensives or hypotensives in the evening, that is to say in the evening. Many people with hypertension take their medication in the morning, but researchers have found that the blood pressure values ​​achieved when taken in the evening are better. Among the more than 19,000 participants in this study suffering from high blood pressure, half took their medication in the evening and the rest when they woke up. On average for more than 6 years, doctors checked the blood pressure of those tested at least once a year – with blood pressure monitors kept by patients on their bodies for 48 hours. The results showed that the group that took their medication in the evening performed better. Mean daytime and nighttime blood pressure was lower in this group, and values ​​fell more during sleep. Researchers also found that taking the drugs in the evening on average reduced the risk of serious secondary diseases, these include death from cardiovascular diseases like heart attacks (myocardial infarction), strokes ) and interventions due to obstruction of blood vessels.

Statins. In the evening, before going to bed

It is advisable to consume these drugs widely used among the population in the evening before going to bed. The reason is that the liver produces much more cholesterol at this time of day than during the afternoon. Statins are known to lower bad cholesterol (LDL) levels in the blood.

Analgesics. In the evening, before going to bed

Some pain medications such as codeine or tramadol have a sleeping effect, if possible it makes sense to consume them in the evening before going to bed to avoid drowsiness during the day.

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Antibiotics. Variable

Certain classes of antibiotics such as macrolides, fosfomycin or cefalexin are better absorbed if taken away from a meal. On the other hand, a molecule like amoxicillin should be taken with meals. For antibiotics, always ask your doctor or pharmacist for advice.

Antacids. After the meal, if possible in the evening

Antacids are often given 2 hours after a meal. Medicines for ulcers are usually taken 1 hour after a meal.

Consuming these drugs after meals or just before going to sleep is a good idea, because the stomach produces a significant amount of gastric acid between 10:00 p.m. and 2:00 a.m. Caution: antacids can lead to interactions with other medications such as iron and some antibiotics. It is necessary to leave an interval of at least 2 hours between taking antacids and other drugs at risk of interaction such as iron.

Anti-inflammatories. Usually with meals

Widely used nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often better tolerated when taken with a meal. NSAIDs can lead to digestive problems like ulcers.

Source:
Ramón C Hermida: Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. European Heart Journal, doi.org/10.1093/eurheartj/ehz754

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