The Right Time to Take 15 Daily Medications
When it comes to your medications for depression, allergies, heartburn, and more, timing is everything.
Many prescription instructions say “take once a day”
But because of your circadian rhythm—the biological clock that governs sleep, hormone production, and other processes—your body doesn’t respond to medications in the same way at different times of the day. “Some drugs are not as effective or as well tolerated if they’re taken at the wrong biological time,” says Michael Smolensky, adjunct professor of biomedical engineering at the University of Texas at Austin. “It’s not that they’re not effective at all, but they’re certainly much less effective or tolerated.”
Now a cutting-edge field called drug chronotherapy advocates syncing your medication regimen with your circadian rhythm to maximize effectiveness and minimize side effects. Here we describe the best times to take meds based on chronotherapy and other factors. Note: Before you alter a current drug routine, be sure to first talk to your doctor or pharmacist. Diverging from your prescribed med schedule is just one of the everyday medication mistakes that can make you sick.
Best in the morning: Depression meds
Disrupted sleep is a common side effect of some SSRIs (selective serotonin reuptake inhibitors), such as Prozac and Paxil, which is why experts often recommend that patients take them when they wake up.
Best in the morning: Osteoporosis meds
Your body doesn’t easily absorb bisphosphonate drugs, such as Boniva and Fosamax. So doctors advise taking them on an empty stomach first thing in the morning with a glass of water, then waiting 30 to 60 minutes before eating, drinking, or taking other drugs or supplements.
Best first thing in the morning: Thyroid meds
To do their best work regulating your body’s hormones and metabolism, a thyroid med like levothyroxine needs to be the star of the show and make its daily debut in your stomach before you eat or drink anything else. “When taken on an empty stomach, thyroid medication does not compete with anything else to be absorbed,” says Eric M. Ascher, DO, a family medicine physician at Lenox Hill Hospital. He advises taking it approximately one hour prior to eating—and definitely before having any dairy. In fact, you should avoid calcium- and iron-rich roods—including milk, yogurt, and green, leafy vegetables—for four hours before or after taking the medication, since they can interfere with absorption and, as a result, make your dosage less effective. Thyroid meds also happen to be one of the medications you should never stop taking abruptly.
Best in the morning: ADHD meds
Taking your ADHD meds when you wake up won’t just start your day off right—it will also end your day just right. That’s because ADHD drugs, such as Adderall and Ritalin, are stimulants that work to increase alertness and energy levels. “If taken in the afternoon or nighttime, you may have difficulty sleeping,” says Dr. Ascher, “as common side effects are irritability, restlessness, and insomnia.” For that reason, Dr. Ascher says it’s best to take these meds when you first wake up, at least 45 minutes prior to eating.
Best in the morning: Diuretics
Often prescribed to patients with high blood pressure or congestive heart failure, diuretics (aka water pills) help your kidneys remove excess water from your body. How? By making you pee… a lot. For that reason, doctors often suggest taking them in the morning, so that you can get uninterrupted sleep at night.
Best around dinnertime: Heartburn meds
Your stomach produces the most acid in the evening up until around midnight, according to research published in the journal Pharmaceutics. If you’re on an acid-reducing H2 medication such as Pepcid or Zantac, take it 30 minutes before dinner. This controls stomach acid during the overnight period, when secretion reaches its peak. Plus, watch out for the over-the-counter medications you could be using all wrong.
Best in the evening: Allergy meds
Hay fever typically worsens at night and feels most severe in the morning, when levels of symptom-triggering histamine are highest. Once-daily antihistamines, such as Claritin, reach their peak eight to 12 hours after you take them, so using them at dinnertime or before bed means better control of morning symptoms. Take twice-a-day antihistamines in the morning and evening—which is exactly the kind of question it’s good to ask your pharmacist or doctor about before taking prescription medications.
Best in the evening: Cholesterol meds
Your liver’s peak time for the production of cholesterol is in the late afternoon and evening, according to the Pharmaceutics study; production dips in the morning. Take statins that your body can breakdown quickly—such as Zocor—in the evening so they can work their magic while cholesterol levels peak. Timing is less critical for statins that stay in your system longer, such as Lipitor and Crestor.
Best two hours before bedtime: Nerve-pain meds
When you’re dealing with chronic nerve pain, you don’t want to trade one set of problems for another. And when it comes to medications like gabapentin and pregabalin, you could be doing just that if you take them during the day. “Common side effects of medications for nerve pain include drowsiness, confusion, and unsteadiness, which is why it’s good to take these medications prior to bedtime,” says Dr. Ascher. “Many patients also complain that their nerve pain will keep them up at night, so I tell my patients to take them two hours before they are ready to go to sleep.” Dr. Ascher additionally cautions against taking other prescription pain or antidepressant meds at the same time, as they can increase side effects. He also recommends avoiding antacids two hours before and after your dosage because they can affect absorption and efficacy.