What does it mean to take medicine after eating. How to take medications correctly. Simple tips

They should be washed down with water (not milk).

You should also take it half an hour before meals. antacids (ALMAGEL, PHOSPHALUGEL, etc.) and choleretic agents .

TAKEN WITH MEALS
During meals, the acidity of the gastric eye is very high, and therefore significantly affects the stability of drugs and their absorption into the blood. IN acidic environment the effect of ERYTHROMYCIN, LINCOMYCIN HYDROCHLORIDE and others is partially reduced antibiotics.

Should be taken with food gastric juice preparations or digestive enzymes , as they help the stomach digest food. These include PEPSIN, FESTAL, DIGESTAL, ENZISTAL, PANZINORM.

It is advisable to take with food laxatives to be digested. These are Senna, buckthorn bark, rhubarb ROOT and JOSTER FRUITS.

During meals you have to take some diuretics , QUINIDINE (antiarrhythmic and antimalarial), EUPHYLLINE (antiasthmatic), antibiotic wide range actions of levomycetin.

AFTER MEAL
If the medicine is prescribed after eating, then to get the best therapeutic effect Wait at least two hours.

Straightaway or after eating take mainly medicines, which irritate the mucous membrane of the stomach and intestines. This recommendation applies to such groups of drugs as:

diuretics- DIACARB, HYPOTHIAZI D, BRINALDIX, TRIAMPUR, FUROSEMIDE (only after meals)
painkillers (non-steroidal) anti-inflammatory drugs - BUTADIONE, ASPIRIN, ASPIRIN CARDIO, VOLTAREN, IBUPROFEN, ASKOFEN, CITRAMON (only after meals).
cardiac glycosides - Lily of the Valley tincture, DIGITOXIN, DIGOXIN, CORDIGIT, CELANIDE.
sulfonamides - STREPTOCIDE, SULFADIMETOXINE, NORSULFAZOLE. FTHALAZOL, ETAZOL; These medications are recommended to be taken with alkaline drinking, For example, mineral water like Borjomi.
drugs that are components of bile - ALLOCHOL, CHOLENZIM, LIOBIL, etc.); taken after meals - prerequisite so that these drugs “work.”

There are so-called antacids , the intake of which should be timed to coincide with the moment when the stomach is empty and hydrochloric acid continues to be released, that is, an hour or two after finishing a meal - MAGNESIUM OXIDE, VICALIN, VIKAIR.

Antibiotics They are usually taken regardless of food, but at the same time, your diet must include fermented milk products. Along with antibiotics, NISTATIN is also taken, and at the end of the course - complex vitamins (for example, SUPRADIN).

Antihypertensive drugs can be taken during the day: before or after meals, morning and evening - ADELPHAN, BRINERDY N, CLOPHELINE, RENITEK, PAPAZOL, RAUNATIN, RESERPINE, TRIRESIDE K, ENALAPRIL, ENAP N).

Antacids(GASTAL, ALMAGEL, MAALOX, TALTSID, RELTSER, PHOSPHALUGEL) and antidiarrheals (IMODIUM, INTETRIX, SMEKTA, NEOINTESTOPAN) - half an hour before meals or one and a half to two hours after. Please note that antacids taken on an empty stomach last for about half an hour, and those taken 1 hour after a meal last for 3 to 4 hours.

TAKING ON AN EAST SCHOOK
Taking medication on an empty stomach is common in the morning 20-40 minutes before breakfast.

Example:
on an empty stomach, when the acidity of gastric juice is low, should be taken heart medications , sulfonamides , as well as drugs that do not irritate the gastric mucosa - ERYTHROMYCIN, NISTATIN, POLYMYXIN (1.5–2 hours before meals).

Medicines taken on an empty stomach are absorbed and absorbed much faster. Otherwise, the acidic gastric juice will have a destructive effect on them, and the medications will be of little use.

■ PHARMACISTS WARN AND ADVICE
Patients often ignore the recommendations of doctors and pharmacists, forgetting to take a pill prescribed before meals and rescheduling it for the afternoon. If the rules are not followed, the effectiveness of the drugs will inevitably decrease. To the greatest extent if, contrary to the instructions, the drug is taken during or immediately after meals. This changes the rate at which the drugs pass through digestive tract and the rate of their absorption into the blood.

Some drugs may break down into their component parts. For example, in an acidic gastric environment, PENICILLIN is destroyed. Breaks down into salicylic acid and acetic acid ASPIRIN (acetylsalicylic acid).

The acidic environment of the stomach can neutralize such antibiotics like erythromycin and ampicillin, cardiac glycosides . The preparations LILY OF THE LILY and STROPHANTA are very sensitive to food juices: taken with food, they are digested along with it.

A number of drugs form poorly soluble and non-absorbable complexes with food components. This can happen if, for example, you take TETRACYCLINE after dairy food. CALCIUM GLUCONATE taken after meals can form insoluble precipitates with food acids. NISTATIN and POLYMYXIN form the same sediments with bile.

USE 2-3 TIMES A DAY
If the instructions indicate " three times a day", this does not mean breakfast - lunch - dinner. The medicine must be taken every eight hours so that its concentration is maintained evenly in the blood. It is better to take the medicine simply boiled water. Tea and juices - no the best remedy.

If it is necessary to resort to cleansing the body (for example, in case of poisoning, alcohol intoxication), usually used sorbents: ACTIVATED CHARCOAL, POLYPHEPAN or ENTEROSGEL. They collect toxins “on themselves” and remove them through the intestines. They should be taken twice daily between meals. At the same time, you need to increase your fluid intake. It is good to add herbs that have a diuretic effect to your drink.

DAY OR NIGHT
Drugs with hypnotic effect need to be taken 30 minutes before bedtime.

Laxatives - BISACODIL, SENAD, GLAXENA, REGULAX, GUTALAX, FORLAX - usually taken before bed and half an hour before breakfast.

Don't have your time medicines, appointed " under the tongue» NITROGLYCERINE, VALIDOL.

Heart medications And asthma remedies accepted closer to midnight.

Remedies for ulcers taken early in the morning and late in the evening to prevent hunger pangs.

After inserting the suppositories, you need to lie down, so they are prescribed at night.

■ PHARMACISTS WARN AND ADVICE
Means emergency assistance taken regardless of the time of day - if the temperature has risen or colic has begun. In such cases, adherence to the schedule is not important.

IF THE INSTRUCTIONS DO NOT SAY
In the absence of any instructions in the package insert, the medicine should be taken 30 minutes before meals. This applies to the bulk of drugs.

IF YOUR APPOINTMENT TIME IS MISSED
If you " we were late» for 1-2 hours, then the drug can be accepted, as usual. If the break is longer, you should skip taking the medicine until the next one to avoid an overdose. After this, it is advisable to restore the medication schedule.

It is forbidden take the drug in double dose just because you missed your appointment time - this may increase side effect medicines.

Hormonal And " cardiac drugs , majority antibiotics should be taken strictly by the clock. The best thing is to draw up a reception diagram and hang it in a visible place (on the door, furniture, refrigerator, etc.). To avoid missing your next medication dose, use an alarm clock or timer.

IN WHAT SEQUENCE SHOULD I TAKE MEDICATIONS?
Many medications interact with each other, so try to accept medicines one by one.

Very often incompatible there are antibiotics. They should not be unnecessarily combined with antipyretics, hypnotics, antihistamines. And, of course, in no case with alcohol.

The gastric mucosa will be safer if you take into account the specifics of taking vitamins. Fat-soluble vitamins (A, D, E, K) are more useful after meals, and water-soluble(C and group B) - before meals or during meals. Complex multivitamin preparations It is better to drink immediately after eating.

■ PHARMACISTS ADVICE
When visiting a doctor, it is advisable for patients write down recommendations. This is important to ensure your own safety, because medications are a delicate thing. As for food, almost all of them can change the effect of the drug. Some (for example, fatty and sweet foods) delay and increase the absorption time of the drug components into the blood, while others increase the effect of the drug several times, causing an overdose

When prescribing medications, doctors, unfortunately, briefly explain the rules for taking pills. Well, they can write briefly. And each medicine has its own nuances that must be taken into account during treatment in order to achieve maximum effect and reduce the risk of developing certain complications.

How to take medications

Antibiotics. Take antibiotics only with water. Or even better, alkaline mineral water. And no other drinks. All of these will interfere with absorption and can also lead to nervousness and stomach irritation.

Drinking alcohol at any time while taking antibiotics can cause severe side effects ( increased heart rate, headaches, abdominal pain, nausea).

Antibiotics are often incompatible with other medications, for example, antipyretics and sleeping pills. Therefore, the gap between taking antibiotics and other medications should be at least an hour.

It is also necessary to monitor the reception time. As a rule, they are taken two hours after meals. If antibiotics need to be taken twice a day, this means that they should be taken every 12 hours. If three times, then every 8 hours. This is the only way you can support required level drugs in the blood.

Do not stop or reduce the dose of the medicine under any circumstances, even if you feel better. The entire course must be completed to the end and in full. Otherwise, the disease will return, but it will be more difficult to cure.

Diuretics (diuretics). Diuretics are best taken on an empty stomach, that is, 30 minutes before breakfast. If the medicine must be taken twice a day, then the first dose should be in the morning, and the second in the afternoon. You should drink at least two liters of water throughout the day. Preferably mineral non-carbonated.

The doctor may prescribe potassium supplements along with them. They should be taken with or immediately after meals, and the last dose should be taken an hour before bedtime.

Hormonal drugs. In the human body, all hormones are produced in certain time, so it is advisable to take the pill at this time. You need to find out this time from the doctor who prescribed it. hormone therapy. For example, steroid hormones should be taken in the morning, and contraceptives should be taken in the evening. In this case, you need to take the medicine at the same time.

Most often, hormonal medications are taken after meals. However, when treating thyroid gland The medicine should be taken in the morning on an empty stomach an hour before meals.

If you are also taking calcium or iron supplements, then taking hormones should be no earlier than four hours later.

When taking any hormonal drugs It is not advisable to take analgesics, tranquilizers, antibiotics and large amounts of vitamin C.

Stomach medications. They should be taken twice a day: early in the morning half an hour before meals and late in the evening two hours after meals. Take medications only with water.

You should also take antacid medications (Almagel, Phosphalugel) half an hour before meals. At the same time, if you are taking several drugs at once, then antacids should be taken two hours before taking another drug. Otherwise, antacids will reduce the therapeutic effect to zero.

Choleretic drugs (allochol, cholenzym) should be taken immediately after meals.

Digestive enzymes. These are substances that help the body digest food. They are taken 1-2 tablets during and/or immediately after meals. But you shouldn’t take them before meals, as they will have nothing to digest.

Sorbents. These are medicines that save you from poisoning, intestinal disorders, allergies and other diseases. They should be taken several hours before or after meals. In this case, the break between taking sorbents and other medications should be at least two hours.

Any sorbents must be washed down with water (at least half a cup).

Simultaneously with taking any sorbents, it is necessary to increase fluid intake. It is good to add herbs that have a diuretic effect to your drink (calendula, linden, lemon balm, St. John's wort, nettle, etc.).

Vitamins and minerals. Fat-soluble vitamins (A, D, E, F, K) must be taken immediately after meals or during meals, preferably with foods rich in animal and vegetable fats, which accelerate their absorption. Water-soluble vitamins (C and B) are best taken before meals or at the beginning of meals. But complex multivitamins should be taken in the morning immediately after meals.

Any mineral complexes It is better to drink in the evening between meals. And wash it down with water. Iron supplements are well absorbed if you take them with meat products. But they should not be washed down with milk, coffee or fruit juices.

And coffee, salty foods, as well as fiber and starch interfere with the absorption of calcium.

If you missed an appointment. If you are 1-2 hours late, take the drug as quickly as possible. If the break is longer, then skip this dose of the medicine until the next one to avoid an overdose. After this, it is advisable to restore the intake schedule.

Please keep in mind:

if there are no instructions, the medicine should be taken 30 minutes before meals;
The tablet should be taken with half a glass ordinary water room temperature;
if prescribed after a meal, then the medicine should be taken 2 hours after a meal;
if the instructions say “immediately after eating”, drink immediately after eating;
If you need to take the medicine on an empty stomach, take it 20-40 minutes before breakfast.

Each of us, at least once in our lives, took medication for one purpose or another. And, despite the fact that there are a huge number of both people and medications, mistakes made when taking medications - the same ones.

Moreover, as practice shows, we do not take most of the errors in taking certain medications seriously or simply do not pay due attention to it. And such inattention, and in some places “ignorance,” affects both our health and our finances.

In this article we will talk about the main mistakes in taking medications, their possible consequences, and most importantly - how to avoid them!

Mistake #1: Unpretentious medications

Tell me honestly, when buying medications, how many of you pay attention to their storage conditions? Agree that few do, especially taking into account the fact that in order to read this information, you need to carefully turn the package with the medicine or read the instructions for its use to the end.

Conscientious pharmacists usually warn patients about the storage features of the drug they dispense, if any. But this is the exception rather than the rule.

If you follow the rules for storing medicines, you can be confident in their suitability and effectiveness throughout their expiration date

Let's give a simple example: the antiseptic "Iodine", known to all of us since childhood, should be stored not on a shelf in the bathroom, but in the refrigerator, in a bottle packed in cardboard or a plastic bag.

These requirements are due to the fact that iodine solution is characterized by volatility, due to which it evaporates over time, leaving yellow spots on surrounding objects.

Increased room temperature (above 15 degrees) increases the evaporation of iodine. The same applies to sunlight. Therefore, it is prohibited to pour iodine into a light glass bottle!

So, if you do not follow the rules for storing iodine, in a month instead of a full bottle you will have only half, its effectiveness as an antiseptic will decrease, and yellow spots It will be very difficult to get rid of it on the nightstand.

Mistake #2: Forgot - no big deal!

When the doctor tells us to take medicine 2 times a day, we perceive this as 2 doses during the 16-17 hours of the time during which we are awake. The doctor means 24 hours.

Check with your doctor about the specific time to take your prescribed medication. If the appointment sheet says 8:00 and 20:00 or 10:00 and 22:00 there will be no misunderstandings

And this is not due to the fact that it makes taking medications more inconvenient for you, but because the body works not only while we are awake, but also when we are sleeping.

Therefore, if the doctor prescribes the drug 2, 3, 4 times a day, the interval between doses should be 12, 8 and 6 hours, respectively, and not the time when it is convenient for us or when we remember that we need to take a pill.

Mistake #3: Before/after meals - is there a difference?

Medicines can be taken before, after, during meals, or independently of it at all. And, again, if in the understanding of the majority, food is porridge with a cutlet and compote, then for the doctor and our body, daily snacks in the form of a banana, apple or snack are also a full meal. After all, when they are consumed, the stomach secretes enzymes and hydrochloric acid, and all digestion processes occur in the same way as when digesting more “serious” food.

Drugs that must be taken after meals usually irritate the gastric mucosa or are taken to normalize digestion

Therefore, if the drug should be taken before meals, then in most cases this means taking the drug on an empty stomach with a further interval of at least 30 minutes before meals. This is necessary so that the drug, when entering the stomach, is not exposed to gastric juice, and therefore does not lose its properties.

Medicines that are taken with food have only individual exceptions related to the type of food with which they can be mixed. The doctor must inform the patient about them.

For example, some antidepressants should not be taken with cheese, as it contains a substance such as tyramine, which, when interacting with drugs for depression, leads to sharp increase pressure.

Mistake #4: You can divide everything!

For some reason, our people are big fans of dividing tablets into several parts, and some even manage to break pills in half, not to mention dividing capsules into halves.

Dragees, capsules should be taken in the form in which they were released by the manufacturer

In some cases this can indeed be done. Firstly, if the tablet has a division strip, then the manufacturer assumes that it can be divided. Moreover, if there is only one strip, the tablet can only be divided into halves, and only if there are two strips, we can divide the tablet into four parts. Breaking a tablet into “dust” of six or more parts is also irrational.

If there is no separating strip on the tablet, then you cannot break it into pieces! Due to the fact that it is probably covered with one or more protective membranes that protect it from the action of gastric juice.

Mistake #5: I drink whatever I want!

Almost all tablets without exception must be taken with a glass of water clean water! Using coffee, tea, juice, etc. instead. you risk not only nullifying the entire effect of the medicine you are taking, but you can also incur considerable side effect from such a combination!

It is especially undesirable to take medications with alcohol, grapefruit and other juices, tea, coffee, cola and other carbonated drinks.

There are rare exceptions to this rule. For example, paracetamol, aspirin, etc. NSAIDs (non-steroidal anti-inflammatory drugs) are recommended to be taken with milk, as it protects the gastric mucosa from the irritating effect of these drugs and accelerates their absorption. But your doctor will definitely inform you about this and other exceptions.

Mistake #6: I take a handful of pills!

Usually, when doctors prescribe a treatment regimen, they describe in detail which drug to take, when to take it, which makes it clear whether they can be taken together. If your doctor hasn't told you this, be sure to ask him about it.

Remember that if you take any medications yourself, try to keep at least a half-hour interval between taking them

This is necessary because in our understanding, taking pills by the handful is absolutely normal, although even today medicine has not studied all the options for drug interactions.

Moreover, vitamin complexes, dietary supplements and herbs are also pharmacologically active substances and can enter into various reactions with the pills we take for the same cold, cough, etc.

Such a “medicinal smoothie” in best case scenario It will simply turn out to be ineffective and will “transit” through your body. Another option would be to develop adverse reactions, from allergies to ulcers or gastritis.

Mistake #7: The month doesn’t count!

Review your first aid kit; most likely you will find not one or two expired medications in it. Needless to say, the time during which the drug is suitable for use is the time indicated by the manufacturer on its packaging.

By using an expired medicine, you not only do not get the expected effect from its use, but you also risk your health

This rule applies not only to tablets, injections, capsules, but also to iodine, brilliant green, peroxide and other antiseptics, herbal teas, etc. (for some reason, many of us believe that these products are suitable for use forever).

By adhering to the above rules, consulting with your doctor and carefully studying the instructions, you get the maximum therapeutic effect from the medicine and protect yourself from the consequences of improper use.

They should be washed down with water (not milk).

You should also take it half an hour before meals. antacids (ALMAGEL, PHOSPHALUGEL, etc.) and choleretic agents .

TAKEN WITH MEALS
During meals, the acidity of the gastric eye is very high, and therefore significantly affects the stability of drugs and their absorption into the blood. In an acidic environment, the effect of ERYTHROMYCIN, LINCOMYCIN HYDROCHLORIDE and others is partially reduced antibiotics.

Should be taken with food gastric juice preparations or digestive enzymes , as they help the stomach digest food. These include PEPSIN, FESTAL, DIGESTAL, ENZISTAL, PANZINORM.

It is advisable to take with food laxatives to be digested. These are Senna, buckthorn bark, rhubarb ROOT and JOSTER FRUITS.

During meals you have to take some diuretics , QUINIDINE (antiarrhythmic and antimalarial drug), EUPHYLLINE (antiasthmatic drug), broad-spectrum antibiotic LEVOMYCETIN.

AFTER MEAL
If the medicine is prescribed after eating, then to get the best therapeutic effect, wait at least two hours.

Straightaway or after eating take mainly medications that irritate the mucous membrane of the stomach and intestines. This recommendation applies to such groups of drugs as:

diuretics- DIACARB, HYPOTHIAZI D, BRINALDIX, TRIAMPUR, FUROSEMIDE (only after meals)
painkillers (non-steroidal) anti-inflammatory drugs - BUTADIONE, ASPIRIN, ASPIRIN CARDIO, VOLTAREN, IBUPROFEN, ASKOFEN, CITRAMON (only after meals).
cardiac glycosides - Lily of the Valley tincture, DIGITOXIN, DIGOXIN, CORDIGIT, CELANIDE.
sulfonamides - STREPTOCIDE, SULFADIMETOXINE, NORSULFAZOLE. FTHALAZOL, ETAZOL; It is recommended to take these medications with an alkaline drink, for example, Borjomi-type mineral water.
drugs that are components of bile - ALLOCHOL, CHOLENZIM, LIOBIL, etc.); Taking it after a meal is a prerequisite for these drugs to “work.”

Antibiotics They are usually taken regardless of food, but fermented milk products must also be present in your diet. Along with antibiotics, NISTATIN is also taken, and at the end of the course - complex vitamins (for example, SUPRADIN).

TAKING ON AN EAST SCHOOK
Taking medication on an empty stomach is common in the morning 20-40 minutes before breakfast.

Medicines taken on an empty stomach are absorbed and absorbed much faster. Otherwise, the acidic gastric juice will have a destructive effect on them, and the medications will be of little use.

■ PHARMACISTS WARN AND ADVICE
Patients often ignore the recommendations of doctors and pharmacists, forgetting to take a pill prescribed before meals and rescheduling it for the afternoon. If the rules are not followed, the effectiveness of the drugs will inevitably decrease. To the greatest extent if, contrary to the instructions, the drug is taken during or immediately after meals. This changes how quickly drugs pass through the digestive tract and how quickly they are absorbed into the blood.

Some drugs may break down into their component parts. For example, in an acidic gastric environment, PENICILLIN is destroyed. ASPIRIN (acetylsalicylic acid) breaks down into salicylic and acetic acids.

USE 2-3 TIMES A DAY
If the instructions indicate " three times a day", this does not mean breakfast - lunch - dinner. The medicine must be taken every eight hours so that its concentration is maintained evenly in the blood. It is better to take the medicine with plain boiled water. Tea and juices are not the best remedy.

If it is necessary to resort to cleansing the body (for example, in case of poisoning, alcohol intoxication), it is usually used sorbents: ACTIVATED CHARCOAL, POLYPHEPAN or ENTEROSGEL. They collect toxins “on themselves” and remove them through the intestines. They should be taken twice daily between meals. At the same time, you need to increase your fluid intake. It is good to add herbs that have a diuretic effect to your drink.

DAY OR NIGHT
Drugs with a hypnotic effect should be taken 30 minutes before bedtime.

Laxatives - BISACODIL, SENAD, GLAXENA, REGULAX, GUTALAX, FORLAX - usually taken before bed and half an hour before breakfast.

Don't have your time medicines, appointed " under the tongue» NITROGLYCERINE, VALIDOL.

Heart medications And asthma remedies accepted closer to midnight.

Remedies for ulcers taken early in the morning and late in the evening to prevent hunger pangs.

After inserting the suppositories, you need to lie down, so they are prescribed at night.

■ PHARMACISTS WARN AND ADVICE
Emergency supplies taken regardless of the time of day - if the temperature has risen or colic has begun. In such cases, adherence to the schedule is not important.

IF THE INSTRUCTIONS DO NOT SAY
In the absence of any instructions in the package insert, the medicine should be taken 30 minutes before meals. This applies to the bulk of drugs.

It is forbidden take the drug in double dose just because you missed your appointment time - this may increase side effect medicines.

IN WHAT SEQUENCE SHOULD I TAKE MEDICATIONS?
Many medications interact with each other, so try to accept medicines one by one.

Very often incompatible there are antibiotics. They should not be unnecessarily combined with antipyretics, hypnotics, and antihistamines. And, of course, in no case with alcohol.

The gastric mucosa will be safer if you take into account the specifics of taking vitamins. Fat-soluble vitamins(A, D, E, K) are more useful after meals, and water-soluble(C and group B) - before meals or during meals. Complex multivitamin preparations It is better to drink immediately after eating.

How to take the medicine: before meals or after? Influence chemical composition food on the pharmacological activity of the drug. Medicines containing sugar (information for patients with diabetes mellitus). Can I take the drug with tea or milk?

Any medicine purchased at a pharmacy is accompanied by special instructions by application. But how often do we pay attention to this information? Meanwhile, compliance (or non-compliance) with the rules of administration can have a large, if not decisive, impact on the effect of the medicine. For most drugs this is due to processes occurring in gastrointestinal tract. Food, as well as gastric juice, digestive enzymes and bile that are released during its digestion, can interact with medications and change their properties. That is why it is not at all indifferent when the medicine is taken: on an empty stomach, during or after a meal.

The doctor's instructions or recommendations contained in the instructions for use of the drug are determined mainly by known facts physiology of digestion. 4 hours after meals or 30 minutes before next appointment food (this time is called “on an empty stomach”) the stomach is empty, the amount of gastric juice in it is minimal (literally a few tablespoons). Gastric juice at this time contains little hydrochloric acid. As breakfast, lunch or dinner approaches, the amount of gastric juice and hydrochloric acid in it increases, and with the first portions of food its secretion becomes especially abundant. As food enters the stomach, the acidity of gastric juice gradually decreases due to its neutralization by food (especially if you eat eggs or drink milk). However, within 1-2 hours after eating, it increases again, since by this time the stomach is empty of food, and the secretion of gastric juice still continues. This secondary acidity is especially pronounced after consuming fatty fried meat or black bread. Anyone who knows heartburn can attest to this. In addition, when using fatty foods its exit from the stomach is delayed, and it is even possible for pancreatic juice produced by the pancreas to reflux from the duodenum into the stomach (so-called reflux).

Food mixed with gastric juice passes into the initial section small intestine – duodenum. Bile produced by the liver and pancreatic juice secreted by the pancreas also begin to flow there. Thanks to the content large quantity digestive enzymes in pancreatic juice and biologically active substances begins in bile active process digestion of food. Unlike pancreatic juice, bile is secreted constantly, including between meals. Excessive amount of bile enters gallbladder, where a reserve is created for the needs of the body.

Knowing what happens to food in our stomach and intestines during the day, let's try to answer the question, when is it better to take medications: before, during or after meals?

If there are no other instructions in the instructions or in the doctor's prescription, it is better to take medications on an empty stomach, 30 minutes before meals, since interaction with food and digestive juices may disrupt the absorption mechanism or lead to changes in the properties of drugs.

Take on an empty stomach:

– all tinctures, infusions, decoctions and them similar drugs made from plant materials. They contain the amount active ingredients, some of them can be digested under the influence of hydrochloric acid of the stomach and turn into inactive forms. In addition, under the influence of food, the absorption of individual components of such drugs may be impaired and, as a result, insufficient or distorted action;

– all calcium supplements, although some of them (for example, calcium chloride) have a pronounced irritant effect. The fact is that calcium, when bound with fatty and other acids, forms insoluble compounds. Therefore, taking drugs such as calcium glycerophosphate, calcium chloride, calcium gluconate and the like during or after meals are at least useless;

- medications that, although absorbed when taken with food, for some reason have an adverse effect on digestion or relax smooth muscles. An example is a drug that eliminates or weakens smooth muscle spasms ( antispasmodic ) drotaverine(known to everyone as No-shpa) and others;

Immediately after eating, it is better to take medications that irritate the gastric mucosa: indomethacin , acetylsalicylic acid , steroids , metronidazole , reserpine and others. To avoid the irritating effects of these drugs and calcium supplements, it is better to drink them with milk, jelly or rice water.

A special group consists of medications that should act directly on the stomach or on the digestion process itself. Thus, drugs that reduce the acidity of gastric juice ( antacids ), as well as means that weaken the irritating effect of food on a sore stomach and prevent copious discharge gastric juice, usually taken 30 minutes before meals.

It is recommended to take secretion stimulants 10-15 minutes before meals digestive glands(bitterness), and choleretic agents . Gastric juice substitutes are taken with food, and bile substitutes (for example, Allohol) at the end or immediately after a meal. Preparations containing digestive enzymes and facilitating the digestion of food are usually taken before meals, during meals or immediately after meals. Drugs that suppress the release of hydrochloric acid into gastric juice, such as cimetidine should be taken immediately or soon after a meal, otherwise they block digestion at the very first stage. All multivitamin preparations are also taken with or immediately after meals.

Of course, there are drugs that act regardless of food intake, and this is usually indicated in the instructions.

However, not only the presence of food masses in the stomach and intestines affects the absorption of drugs. The composition of food can also change this process. For example, with a diet rich in fat, the concentration of vitamin A in the blood plasma increases (the speed and completeness of its absorption in the intestine increases). Fats, especially vegetable fats, reduce the secretion of gastric juice and slow down stomach contractions. Under the influence of food saturated fat, absorption is significantly reduced, and, accordingly, the effectiveness of action anthelmintic drugs , nitrofurans , sulfonamides . At the same time rich in fats food is recommended in cases where it is necessary to increase the absorption of fat-soluble drugs - anticoagulants , vitamins A, D and E, metronidazole , tranquilizers benzodiazepine group. Carbohydrates also slow down gastric emptying, which can interfere with the absorption of sulfonamides, antibiotics ( macrolides , cephalosporins ). Milk enhances the absorption of vitamin D, the excess of which is primarily dangerous for the central nervous system. Protein nutrition or consumption of pickled, sour and salty foods impairs the absorption of anti-tuberculosis drugs isoniazid, and protein-free, on the contrary, improves.

Of particular note are medicinal products containing sugar (sucrose, glucose) as a flavoring agent. In addition to the additional carbohydrate load (which, by the way, is small, given the small volume of the tablet or spoon of syrup), this is a potential source of danger for people with diabetes. Information about the sugar content of the drug is contained in the package insert and/or indicated on the drug packaging.

A change in acidity in the stomach can occur when taking medications with various fruits and vegetable juices, tonic drinks and dairy products. Tea contains tannin, which forms compounds that are indigestible by the body with nitrogen-containing drugs: papaverine, codeine, caffeine, aminophylline, amidopyrine, antipyrine, belladonna preparations, cardiac glycosides and others. If a person suffering from anemia takes iron supplements and washes them down with tea, the “tannin + iron” complex precipitates - therefore, the medicine is not absorbed. You should not drink sedatives or sleeping pills tea, because it stimulates the central nervous system. However, there are exceptions: vitamin C preparations can be taken with tea, which itself - like any plant - contains vitamin C. Tetracycline, doxycycline, metacycline and other tetracycline antibiotics cannot be taken with milk, since the calcium present in it, interacting with the drug, reduces it effect. For the same reason, when treating with tetracyclines, you should avoid smoked meats and sausages. However, sulfa drugs are recommended to be taken with alkaline solution(for example, slightly alkaline mineral water) to prevent kidney stone formation.

So, let's summarize. Cannot be combined :

antibiotics of the tetracycline group, lincomycin, preparations containing caffeine (askofen, citramon, caffetin) - with milk, kefir, cottage cheese;
iron supplements - with tea, coffee, milk, nuts, grain products;
calcium supplements – with carbonated soft drinks and juices containing citric acid;
erythromycin, ampicillin - with fruit and vegetable juices;
sulfadimethoxine, sulgin, biseptol, cimetidine, theophylline - with meat, fish, cheese, legumes containing a lot of protein;
aspirin and medications containing acetylsalicylic acid, furagin, 5-NOK - with butter, sour cream, fatty foods;
paracetamol, sulfadimethoxine, biseptol, furosemide, cimetidine - with prunes, beets, sweet and flour dishes;
sulfonamides: biseptol, etazol, sulfalene - with herbs, spinach, milk, liver, grain products;
baralgin, analgin, panadol, spazgan, paracetamol, maxigan - with smoked sausages.

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