Many people complain that they have taken medication as directed but have not seen any improvement in their condition. If we rule out external factors such as incorrect diagnosis or low-quality medication, the main reason often lies in improper medication use.
Taking medication is the simplest and most straightforward method, requiring no technical tools or assistance from professionals. However, not everyone understands the specific guidelines that must be followed to ensure that medications are effective.
Often, doctors may be in a hurry and simply note the medication name, dosage, total quantity for the treatment course, and the number of pills to take each time and frequency per day, leaving the method of consumption to the patient’s discretion. Even with the same medication, improper usage (even if it is just putting the pill in the mouth) can reduce its effectiveness and potentially cause harm. Specifically:
How to Take Medication
Some medications are designed to be swallowed whole and should not be chewed, such as antihistamines. Others need to be chewed and taken with water, like carbophos (which contains herbal charcoal, calcium carbonate, and calcium phosphate) to absorb gases and toxins, and neutralize gastric secretions.
For the same medication, some must be dissolved under the tongue for quick effect, such as nifedipine 10 mg. However, this same medication can be taken without chewing for the slow prevention of hypertension (20 mg nifedipine).
When to Take Medication?
Before meals: Some antibiotics like ampicillin and amoxicillin.
If a doctor advises taking medication on an empty stomach, it should be taken 2 hours after eating, for example, biolactyl (live lactic acid bacteria for preventing and treating digestive disorders). Some medications are advised to be taken on an empty stomach for healthy individuals but not for those with gastritis or amoebic dysentery, such as sorbitol (for treating digestive disorders and constipation).
Some medications should be taken just before or at the beginning of a meal, such as bepridil (a medication to prevent angina) and carbosylane (for treating bloating and indigestion). Others should be taken during or after meals, like atropine oxyd, bidentin (for treating hypertension and high cholesterol), co-trimoxazole, and cefuroxime (a second-generation cephalosporin).
If prescribed to take medication during meals, it is crucial to follow this instruction, as some medications can be very harmful to an empty stomach.
Some medications should be taken before sleeping, such as clorazepate (for anxiety and sedation) and effervescent cimetidine. However, some should not be taken at night, such as Upsa C calcium and cloprozamide (for lowering blood sugar in type 2 diabetes).
The timing of medication throughout the day is also important. Antihistamines should be taken early in the morning, as their therapeutic effect lasts twice as long compared to taking them on an empty stomach. Pain relievers are best taken at midday. Asthma medications should be taken before sleep to prevent asthma attacks that often occur between midnight and 2 AM.
Beta-blockers (atenolol, propranolol, nadolol) for hypertension are ineffective at night and early morning; however, diuretics (furosemide, hydrochlorothiazide) and calcium channel blockers (nifedipine, nicardipine, amlodipine, diltiazem) are effective throughout the day. Angiotensin-converting enzyme (ACE) inhibitors (captopril, enalapril) achieve maximum efficacy at night but have limited effects during the day.
Spacing Between Doses
Some medications are taken only once a day, such as contraceptives and azithromycin; others are specified to be taken only in the evening before sleeping (trinordiol: a contraceptive).
Some medications clearly state the required interval between doses. For example, cefixime and cefpodoxime (third-generation cephalosporins) recommend taking 2 pills a day, split into 2 doses 12 hours apart; zalcitabine (for HIV treatment) is prescribed to be taken every 8 hours as 0.75 mg.
To maintain stable drug concentrations in the blood and ensure therapeutic effectiveness, it is advisable to take doses evenly spaced throughout the day. When taking pills, it is best to do so while standing, as lying down may cause the medication to stay longer in the esophagus, potentially leading to mucosal ulcers where the drug contacts (especially with irritants like tetracycline, non-steroidal anti-inflammatory drugs, and iron supplements).
