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Taking medicines with or without foodTaking medicines with or without food
Foods and medicines can interact with each other in many ways. If the interaction is significant, it may affect the way the medicine is best taken. As a result, some — but not all — medicines have strict guidelines about when they should be taken with respect to food, and their medicine label may include instructions like 'Take on an empty stomach' or 'Take with meals'.
But, what do these instructions really mean, and how important is it to follow them?
Some medicines should not be taken with meals or certain foods
Some medicines should not be taken with meals or certain foods and drinks, because the medicine and the food interact in some way. The interaction may make the medicine not work as well, may make it work too strongly, or may cause unwanted side effects.
Take on an empty stomach
Some medicines should be taken on an empty stomach, because when taken with a meal the digestive processes in the stomach result in the medicine not working as well (see table). 'Take on an empty stomach' means take 1 hour before meals or 2 hours after meals.
Don't take with certain foods
Some medicines should not be taken with certain foods, because the medicine and the food interact with each other while in the stomach. For example, some medicines do not work as well when taken at the same time as calcium-rich foods, such as milk and yoghurt, and calcium supplements (see table).
Don't eat certain foods at all
While taking some medicines, you should not eat or drink certain foods or drinks at all, because the food interacts with the medicine, even when the food is consumed at a different time. For example, grapefruit and grapefruit juice interact with some medicines, making them work too strongly or causing side effects (see table).
Eat consistent amounts of certain foods
While taking some medicines, you should eat consistent amounts of certain foods, because the food (or a component of the food) interacts with the medicine and affects how well it works. For example, the vitamin K in some foods interacts with the blood-thinning medicine warfarin, and affects its ability to thin the blood (see table).
Some medicines should be taken with meals
Some medicines should be taken with meals, because the food protects the inside of the stomach from being irritated by the medicine and causing stomach side effects (see table opposite). 'Take with a meal' means take at meal times or up to half an hour before or after meals.
Take at the same time, each time
Many medicines do not have strict guidelines about when they should be taken in relation to food. If your medicine has no special instructions about when it should be taken, try to take your dose at a consistent time with respect to meals. For example, if you take your dose in the evening, be consistent about whether you take it with a meal at dinner or on an empty stomach just before going to bed.
Taking your medicines at the same time each day makes it easier to remember to take them, particularly if you choose a time that suits your normal routine and meal times.
In summary
Ask your pharmacist if there are any instructions about when you should take your medicine with respect to food.
- Follow any instructions about avoiding particular foods or drinks.
- Unless otherwise advised, take your medicines at the same time each day.
- Always take your tablets and capsules with a glass of water.
Ask about any instructions
Every time your pharmacist gives you a new medicine, ask if there are any special instructions about when to take it with respect to food. Also, check for any instructions on the label and in the Consumer Medicine Information leaflet.
Typical instructions and examples of when they apply
| Instruction | Examples (Active ingredient in bold and some brand names in brackets) |
|---|---|
|
Take on an empty stomach |
Some antibiotics, such as erythromycin (Eryc) and flucloxacillin (Flopen, Floxapen, Staphylex), don't work as well if taken with food. |
|
Don't take with certain foods |
Some antibiotics, such as tetracycline (Achromycin), and some osteoporosis medicines, such as alendronate (Fosamax), don't work as well when taken at the same time as calcium-rich foods, such as milk and yoghurt, and calcium supplements. |
|
Don't eat certain foods at all |
Grapefruit juice interacts with several common medicines, making them work too strongly or causing unwanted side effects. People taking these medicines are advised not to eat grapefruit or drink grapefruit juice at all, because even one glass of juice can have an effect, and the interaction can occur even when the grapefruit or juice is eaten or drunk at a different time. Medicines that may interact with grapefruit and grapefruit juice include
Other citrus juices like orange juice and lemon juice do not have the same effect. |
|
Eat consistent amounts of certain foods |
Vitamin K interacts with the blood-thinning medicine warfarin (Coumadin, Marevan), and affects its ability to thin the blood. People taking warfarin should eat a consistent amount of vitamin K-rich foods each day (but not stop eating them — they're good for you!), so the effect of the warfarin is consistent too. Vitamin K-rich foods include green vegetables, egg yolks, chickpeas and lentils. |
|
Take with meals |
Many common arthritis medicines and painkillers, such as aspirin (Disprin), ibuprofen (Nurofen) and naproxen (Naprosyn), should be taken with meals to reduce the likelihood of developing stomach side effects, such as indigestion. |
MedicinesTalk is a free quarterly newsletter for consumers written by consumers about using medicines wisely. Subscribe to the hard copy version using our online ordering system, or write to MedicinesTalk, National Prescribing Service Limited, PO Box 1147, Strawberry Hills, NSW 2012.
Date published: 2006-09-01 00:00:00
Reasonable care is taken to provide accurate information at the date of creation. This information is not intended as a substitute for medical advice from a qualified health professional. Health professionals should rely on their own expertise and enquiries when providing medical advice or treatment. Where permitted by law, NPS disclaims all liability (including for negligence) for any loss, damage or injury resulting from reliance on or use of this information. Read our full disclaimer.
References to brands should not be taken as an endorsement by NPS.
