These days, your doctor often sends your prescription straight to a local or mail-order pharmacy. Before you know it, you’re grabbing it at the pharmacy’s drive-thru window or opening it along with your other mail. And that often means you may only glance at the instructions before you take your first dose.
Taking your medicine at the right time of day can be essential for making sure it works the right way. The importance of timing is already well known for many common drugs. And researchers are continuing to study how the specific time that a certain drug is taken may improve the drug’s ability to control disease and lessen side effects.
The Good Patient
Medication adherence (or taking your medicine as directed) is key to treating illnesses and preventing complications. For example, you must finish antibiotics completely. That’s true even if you feel better before you complete your dose because the bacteria can still be alive in your body. If those germs multiply and spread, a new strain of resistant germs may make you sick again.
Not properly taking medicine for chronic health problems is even more unsafe. If you have high blood pressure, for instance, taking your meds in the wrong way puts you at risk for stroke, heart disease and kidney failure.
On the Clock
Why does it matter when you take your medicine? “Some drugs don’t work as well at different times in the day because they interfere with other processes or reactions in the body,” said Dr. Susan Echiverri, a Blue Cross and Blue Shield Plan medical director.
The following are some conditions treated with drugs that need to be taken at specific times. Please note that you should always follow your doctor’s instructions when taking any medicine.
Allergies: Most people take once-a-day antihistamines in the evening, around dinner, to combat allergies. Some people need a morning and an evening dose.
Heartburn/acid reflux: Traditionally, doctors have told patients who take drugs that curb the production of stomach acid to take them before the first meal of the day. However, a study from the University of Kansas found that taking them at night may be more effective. More than 70 percent of patients who took the drug in the afternoon or evening had symptom relief, while just 42 percent of patients who took it in the morning said the same.
Depression: Some doctors advise taking antidepressants in the morning. They can cause insomnia if taken at night.
Asthma: Doctors often want asthma patients who take a steroid medicine once a day to take it between 3 p.m. and 5 p.m. Asthma can be worst from midnight to early morning. Taking the steroid in the late afternoon allows it to be more effective during that critical time.
Blood pressure: Those who use medicines to control high blood pressure usually take them in the morning to help keep their levels steady during the day. Blood pressure often goes down at night as you sleep.
Cholesterol: Statins for managing cholesterol work best when taken before bedtime. The liver produces the most cholesterol after midnight.
Diuretics: Most people take them during the day, often in the morning. Taking them before bed could cause frequent bathroom visits that disrupt sleep.
Osteoarthritis: Many people have the pain, swelling and soreness of osteoarthritis at different times of the day. They often use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to ease their symptoms. NSAIDs are more effective when taken four to eight hours before the most intense pain. That ensures that the highest levels of the drug coincide with peak pain.
So when should you take NSAIDs?
- Around mid-morning to noon for afternoon pain
- Mid-afternoon for evening pain
- With an evening meal for nighttime pain
Rheumatoid arthritis: The stiffness, swelling and pain of rheumatoid arthritis is usually worst in the morning. Taking over-the-counter pain medication like ibuprofen or aspirin during the late evening may be the most effective way to prevent pain from developing overnight. But some people are prescribed multiple doses per day.
Thyroid conditions: You should take your thyroid medicine in the morning before meals. If you take it with food or drinks, it can interact with the ingredients in some foods. In some cases, your body may not absorb the medicine correctly. Making these medicines part of your waking routine can give them time to work before you have your morning coffee and breakfast.
If you are getting a new prescription at a doctor’s visit, ask a few questions to make sure you are taking your new medicine the right way.
- How often should I take it, at what dose and when?
- How long should I take it?
- What side effects are possible? What should I do if they happen?
- What foods, drinks or other medicines should I avoid while I take the medicine?
- What should I do if I forget a dose?
Whatever medicine you take, it is important to read and follow all the directions. Taking your medicines with everyday foods like dairy products or even grapefruit juice can prevent your body from absorbing the medications or even cause a reaction. Some medicines call for an empty stomach, while you should take others with food.
If you have questions about your medicine, talk to your pharmacist or your doctor.
Learn more about drug interactions.
Read our LifeTimes article All Mixed Up: Dangers of Combining Medicines, Foods and Drinks to learn more about potential food and beverage interactions with your medicine.
Sources: Chronobiology and Chronotherapy of Arthritic Diseases, American Association for Medical Chronobiology and Chronotherapeutics; Comparison of morning and evening administration of rabeprazole for gastro-oesophageal reflux and nocturnal gastric acid breakthrough in patients with reflux disease: a double-blind, cross-over study, Alimentary Pharmacology & Therapeutics, 2003; OTC Drug Facts Label, U.S. Food and Drug Administration, 2015