Have you ever been advised that certain medications should be taken with food?

Most of us have had to wait for the doctor while writing a prescription along with specific instructions on how to take the medications: “Three times a day, with food” or “two capsules on an empty stomach,” for example.

If a medication is not taken as recommended with regard to food, the medication may have no effect. Worse yet, it could cause side effects. The timing of the meal, the size of the meal, and the types of food and drinks consumed can affect the body’s response to a medication.

Since most medications are swallowed and end up in the same digestive tract as the chopped fruit you ate for breakfast, it makes sense that medications and foods have a specific relationship.

Absorption of drugs from the intestine

When we eat, several things happen in the intestine:

More blood flows to the area.
Bile is released from the liver.
The cells of the stomach lining pump gastric acid to break down food into compounds that the body can use for its production (various purposes).

Due to these physiological changes, it is important to keep track of what we put in the stomach, in addition to food and drinks.

For example, ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) are best taken with food.

This is because NSAIDs inhibit the production of prostaglandins –– a set of lipid-based substances derived from fatty acids –– from the body, compounds that promote inflammation, but unfortunately, prostaglandins in the intestine also protect the stomach lining from their own stomach acid.

As you can imagine, a medication that prevents this protective function can easily cause stomach irritation, particularly with regular use.

Taking NSAIDs with a buffering food helps to avoid this problem, although it may delay the absorption of the drug a little.

Why should certain medications be taken with food and others on an empty stomach? Image: Unsplash

But protecting the stomach lining is certainly not the only reason why you should take some medications with food.

There are medications, various antivirals against HIV, for example, that are better absorbed into the bloodstream when the environment in the intestine is particularly acidic. Therefore, taking them with food or even ingesting them with an acidic drink, such as a soft drink, is the recommended approach.

However, other medications dissolve very well in fats or bile acid, and therefore are also best taken with meals.

So what about medications that are taken on an empty stomach?

First, “empty stomach” with regard to medication generally means at least one hour before a meal, and at least two hours after one.

The rule of taking medicines without food, may be because the chemical compound breaks down easily in an acidic environment; the common antibiotic penicillin V is one of these.

Finally, health experts recommend taking medications at the same times each day and being consistent about food and drinks.

If you have specific questions about taking medication with food, it is always important to approach a health expert and not self-medicate.

With information from The Conversation / Science Alert

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