Thoughts on scheduling your medications

Most of us managing disabling conditions find ourselves also needing to take medications. I talk about medication management and drug interactions on other posts, but I wanted to take this moment to point out that your food needs and meal planning may have to take your medications into consideration as well. If you aren’t used to taking medications regularly, this might be something you never considered before!

Some medications work best if you take them while you’re eating. For example, fat-soluble vitamins and supplements are better absorbed if you take them with your meal, rather than on an empty stomach.

Any time you’re given a new medication, you want to research food and drug interactions.

Your pharmacist should also warn you about potential interactions, but that only works if you are buying all your medications through the same pharmacy and they also know what over-the-counter medications you are taking.

If they don’t, or if you aren’t in communication with your pharmacist, you want to be sure to check for interactions.

Since you are the one most affected, it’s important that you make sure you know.

Mixing food and medications

Generally, medications(especially antibiotics) can be hard on the stomach, so if there aren’t specific instructions related to food, it’s safer to eat around when you take your medications. Usually before is ideal.

Eating generally reduces your risk of an upset stomach or other negative reactions, as well as slowing down the digestive process, which in some cases improves absorption.

Some people have more or less sensitive stomachs, so I’m not saying that your medication will make your sick, just that it can.

There are, however, some medications with very specific rules about when you can take them in relation to food.

Some may help your digestion or absorption, others may be best absorbed when they are the only thing in your stomach, while they may not have found the mechanism, but have been observed to be more or less effective in relation to food.

There are some medications that are designed to interact with your digestive system when you eat.

Some medications can lower or increase stomach acid, for example, while others may help your body absorb nutrients or avoid an allergic or intolerant reaction.

For example, there are pills to help people who are lactose intolerant not have as severe a reaction to milk products. Taking it at days or times when you’re not eating milk products is a waste, but waiting until hours after you’ve eaten the milk products is likely too late to be helpful.

The medication will be most effective if you take it when instructed in relation to your meals, and may not be helpful at all if timed poorly.

Watch out for food-medication interactions

There are also some food and medication interactions that you need to be aware of and avoid. It’s almost always listed on the medication, generally in the form of a warning.

One of Al’s medications includes instructions not to have grapefruit juice due to interactions. Since Al has never held much interest in grapefruit juice it’s pretty much a nonissue, but you do want to be aware of these limitations. For somebody who would have grapefruit as part of breakfast every day, this would mean a severe change in their eating habits

It’s possible that one of your habitual foods is no longer an option – or simply cannot be eaten or drunk when you take certain medications.

When you take your medication

Al takes a medication that needs to be taken in the morning before he eats anything – he can’t eat anything until a half hour or more after he takes the medication. He only needs to take it once a week, but that does mean that on those mornings, he needs to follow that practice.

There are also some medications, like pain medications, that only last a certain amount of time, but need to constantly be in your system.

It also occasionally happens that two medications interact poorly, at least if you take them at the same time, so on occasion, you are instructed to take them at different times.

Many of those will have instructions to take them every x hours(usually between 4 and 12, depending on the strength of medication and length of effectiveness).

It’s very important to stay on or close to those schedules, as you otherwise increase your risk of overdose(if you take them too close together), reduced effectiveness(your body often builds up a tolerance over time), or increased symptoms(if you take them too far apart).

Plan a schedule that works with your life, and do your best not to deviate too much – if you do need to make an adjustment, you probably want to do it as gradually as you can.

Medication and fatigue

Also, some medications are known for either increasing your energy or for making you tired.

You often want to make sure that if the medication is going to put some extra pep in your step, you take it earlier in the day so you don’t end up having trouble sleeping.

As an example, Wellbutrin is an antidepressant that for many patients has the side effect of increasing their energy levels.

This is why it’s often recommended that you take it first thing in the morning, or early in the afternoon, rather than before you go to bed.

I did spend part of my childhood taking it, and since I was absolutely not a morning person at the time, my parents elected to have me take it after school, before dinner at the latest.

Medications that may make you tired can affect your ability to safely drive a car or other activities, so it’s important to know if that is an issue.

There are a fair number of pain medications and antidepressants(as well as others) that can have these effects.

The first few times you try a new medication that may make you tired, be sure that you don’t need to drive after taking it.

If it doesn’t appear to affect you that way after the first week or so, then you’re likely fine, but it is something you want to know for yourself.

Driving under the influence of heavy medications is just as risky as other forms of driving under the influence.

Alcohol and medications

There are a lot of interactions between medications and alcohol(which is considered a drug itself in this circumstance).

For many medications(often the same ones that may make you tired) the main effect is that the alcohol affects you much more quickly than it would otherwise.

I have experienced this a few times, as several medications I have taken at some point or another have that effect.

Antidepressants and anti-anxiety medications are often known for this, some people abuse them to get that associated high.

What I have learned over the years is that having a drink isn’t particularly risky for me.

This is something I re-evaluate every time my medication is adjusted, and a risk I don’t take if I’m fighting off a bug or infection.

I will often feel buzzed or even appear drunk off of one serving of alcohol, so my personal rule is to pace myself – I almost never have more than two drinks when out, and generally, only have one.

I’ll have a second if the first did not seem to have any effect(in my case, it has been inconsistent), or if I know that I can be safely escorted home by the friends I am out with if the second drink has more effect than I anticipated.

Getting drunk faster may be cheaper, but you want to be aware of this so you can pace yourself appropriately.

If you’re going out with friends or family, it’s good to know if that glass of wine is going to have minimal effect, or would leave you slurring your words or falling over.

There are some medications that have worse interactions with alcohol, including immediately making you nauseous or increasing your potential for death, so you do want to do a little research so you know what to watch out for.

The warning labels generally just say there’s a risk of interaction, so you want to do your research!

Be extremely cautious about drinking right after getting a new medication – not only may it have interactions with your alcohol, but it also may interact with your other medications in unfortunate ways.

It also can totally change your tolerance level, as a lot of medications will multiply, not add to, the effects of alcohol.

Risks of medication addiction

This country is currently going through an opioid epidemic – there are way too many people out there taking powerful pain medications to get high, and then turning to heroin as a cheaper alternative.

This in turn has led to increased pressure on doctors to not prescribe these medications or to lower offered dosages.

This can severely impact the quality of life for people with pain issues, especially those for whom opioids have proven most effective.

The risk of addiction is relatively low as long as you, as the patient, take the medications as directed.

If you find yourself craving your next dose, or consistently running low or out near the end of your prescription, you may need to worry about addictive issues. Talk with your doctor about these concerns.

As a side note, potentially addictive medications also can cause withdrawal symptoms if the medications are abruptly stopped, leading to severe discomfort, cold sweats, nausea and other unpleasant symptoms – in really severe cases, this can cause or lead to death. Do not stop taking a medication without understanding all the potential impacts(ideally discussing with your doctor).

Al had a brush with opioids when he broke his hip.

The initial pain medications they gave him had no effect, so they had to keep trying stronger stuff.

In the hospital, he was getting a strong opioid through IV for the first several days.

When he was transferred to The Hospital for Special Surgery, they switched him to taking the medication orally.

He needed to continue that treatment the first few weeks outside the hospital, and being aware of the potential for an addiction he very much wanted to stop taking them as soon as possible.

At his follow-up appointment, his doctor agreed that he could stop taking it, and he immediately stopped cold turkey, instead of reducing his dosage more slowly.

I don’t recommend this approach.

Due to this, he spent the first couple of days after he stopped the medication experiencing nausea and having the first and only cold sweats of his life.

It would have been better for him to taper off it more slowly, but there was no long-term harm done by stopping that treatment.

How long before the medication is effective?

Generally, medications are effective anywhere from minutes to weeks after they are taken.

Often, liquids are absorbed faster, and the structure of the medication does make a difference(powder in a capsule isn’t useful until the capsule is broken, but solid pills may take longer to digest.)

Many medications are effective as soon as they are absorbed – such as anti-inflammatories(ibuprofen and related medications), pain relievers(like aspirin), and many digestive aids(like lactase and antacids).

Generally, these medications are effective for a given amount of time(usually hours), and then leave the system and are no longer noticeable.

Other medications can take considerably longer to make changes, such as antidepressants often taking weeks to be effective.

With those medications, you need to have a consistent amount constantly in your body for it to be effective.

It takes longer to build up, but once it is, you can usually be unaffected by skipping a dose here and there as it takes much longer for your body to process it.

There is a similar effect with certain medications, which can take even longer, such as most cholesterol medications and bone-strengthening medications.

These are designed to change your body chemistry in some fundamental way to help the body slow down or speed up a process. For example, statins reduce the production of LDL(bad) cholesterol. These changes can take months to years to have a noticeable impact.

Personal experience

I feel lucky, after listing off all of these potential issues, that I can take everything I need to for the day at once. I do so in the morning, taking my medication and vitamins just before I finish breakfast(so I can have a reasonably full stomach, but not end up with the medicine being the last flavor I taste for a bit).

I do need to be very aware of my alcohol intake, but that is second nature to me as I grew up profoundly aware of my family’s history with alcohol addiction. I do not appear to have inherited that trait, but I have always tried not to develop habits around alcohol all the same.

I have spent much of my life on one antidepressant or another, so am used to the idea of that long-term change in brain chemistry and the challenging process of adjusting medications like that.

I try to research everything I take, even if it is sometimes difficult. I like understanding how and why it works, so I can be sure not to work against the process.

Conclusion: taking your medications

While the top priority is making sure that you take your medications, there is definitely some planning that you can do to make it as simple and comfortable as possible.

You want to know what, if any, drug interaction(including with alcohol) you need to be aware of for each medication you take.

It’s also necessary to know if your medication interacts with foods or drinks, and to plan accordingly.

Whether it’s taking your Lactaid with milk products, waiting a half-hour after taking your meds to eat, or making sure that you eat something before you take your vitamins, planning ahead and thinking through your day can really help your medication be most effective and for you to feel the most comfortable with taking it.

Space your medications out so that you’re taking them at the appropriate times and are keeping the right amount of your drug in your system at all times.

The better you understand how and why your medications work, the easier it is to understand and maintain your personal medication schedule.

What other concerns have you had over your medication? Please let me know if you have extra information or tips to share!