Why do I need to take some medicines with food?

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Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?

There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.

To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.

Different brands of the same medicine may also have different recommendations when it comes to taking it with food.

Ron Lach/Pexels

Food impacts drug absorption

Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.

When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.

Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as gastric emptying. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.

Quinoa salad and healthy pudding
Eating a meal with medicine will delay its onset. Farhad/Pexels

Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.

But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.

Food can make medicines more tolerable

Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.

Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.

The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).

Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.

Can food make medicines safer?

Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.

While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.

But there isn’t enough research to show taking ibuprofen with food reduces this risk.

Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.

The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.

Pharmacist gives medicine to customer
If it doesn’t upset your stomach, ibuprofen can be taken with water. Tbel Abuseridze/Unsplash

A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.

To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.

For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.

How much food do you need?

When you need to take a medicine with food, how much is enough?

Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.

However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.

Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.

Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Black Bean & Butternut Balti

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Protein, fiber, and pungent polyphenols abound in this tasty dish that’s good for your gut, heart, brain, and more:

    You will need

    • 2 cans (each 14 oz or thereabouts) black beans, drained and rinsed (or: 2 cups black beans, cooked, drained, and rinsed)
    • 1 butternut squash, peeled and cut into ½” cubes
    • 1 cauliflower, cut into florets
    • 1 red onion, finely chopped
    • 1 can (14 oz or thereabouts) chopped tomatoes
    • 1 cup coconut milk
    • ½ bulb garlic, crushed
    • 1″ piece of fresh ginger, peeled and finely chopped
    • 1 fresh red chili (or multiply per your preference and the strength of your chilis), finely chopped
    • 1 tbsp black pepper, coarse ground
    • 1 tbsp garam masala
    • 2 tsp cumin seeds
    • 2 tsp ground coriander
    • 1 tsp ground turmeric
    • 1 tsp ground paprika
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Juice of ½ lemon
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 400℉ / 200℃.

    2) Toss the squash and cauliflower in a little olive oil, to coat evenly. No need to worry about seasoning, because these are going into the curry later and will get plenty there.

    3) Roast them on a baking tray lined with baking paper for about 25 minutes.

    You can enjoy a 10-minute break for the first 10 minutes of that, before continuing, such that the timing will be perfect:

    4) Heat a little oil in a sauté pan (or anything that’s suitable for both frying and adding volume; we’re going to be using the space later; everything is going in here!) and fry the onion on medium for about 5 minutes, stirring well.

    5) Add the spices/seasonings, including the garlic, ginger, and chili, and stir well to combine.

    6) Add the tomatoes, beans, and coconut milk, and simmer for 10 minutes. You can add a little water at any time if it seems to need it.

    7) Stir in the roasted vegetables (they should be finished now), and heat through. Add the lemon juice and stir.

    8) Serve as-is, or with your preferred carbohydrate (we recommend our Tasty Versatile Rice recipe), or if you have time, keep it warm for a while until you’re ready to use it (the flavors will benefit from this time, if available).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • The Dark Side Of Memory (And How To Make Your Life Better)

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    How To Stop Revisiting Those Memories

    We’ve talked before about putting the brakes on negative thought spirals (and that’s a really useful technique, so if you weren’t with us yet for that one, we do recommend hopping back and reading it!).

    We’ve also talked about optimizing memory, to include making moments unforgettable.

    But what about the moments we’d rather forget?

    First, a quick note: we have no pressing wish or need to re-traumatize any readers, so if you’ve a pressing reason to think your memories you’d rather forget are beyond the scope of a few hundred words “one quick trick” in a newsletter, feel free to skip this section today.

    One more quick note: it is generally not considered healthy to repress important memories. Some things are best worked through consciously in therapy with a competent professional.

    Today’s technique is more for things in the category of “do you really need to keep remembering that one time you did something embarrassing 20 years ago?”

    That said… sometimes, even when it does come to the management of serious PTSD, therapy can (intentionally, reasonably) throw in the towel on processing all of something big, and instead seek to simply look at minimizing its effect on ongoing life. Again, that’s best undertaken with a well-trained professional, however.

    For more trivial annoyances, meanwhile…

    Two Steps To Forgetting

    The first step:

    You may remember that memories are tied to the senses, and the more senses are involved, the more easily and fully we remember a thing. To remember something, therefore, we make sure to pay full attention to all the sensory experience of the memory, bringing in all 5 senses if possible.

    To forget, the reverse is true. Drain the memory of color, make it black and white, fuzzier, blurrier, smaller, further away, sterile, silent, gone.

    You can make a habit of doing this automatically whenever your unwanted memory resurfaces.

    The second missing step:

    This is the second step, but it’s going to be a missing step. Memories, like paths in a forest, are easier to access the more often we access them. A memory we visit every day will have a well-worn path, easy to follow. A memory we haven’t visited for decades will have an overgrown, sometimes nearly impossible-to-find path.

    To labor the metaphor a little: if your memory has literal steps leading to it, we’re going to remove one of the steps now, to make it very difficult to access accidentally. Don’t worry, you can always put the step back later if you want to.

    Let’s say you want to forget something that happened once upon a time in a certain workplace. Rather than wait for the memory in question to come up, we’re going to apply the first step that we just learned, to the entire workplace.

    So, in this example, you’d make the memory of that workplace drained of color, made black and white, fuzzier, blurrier, smaller, further away, sterile, silent, gone.

    Then, you’d make a habit of doing that whenever that workplace nearly comes to mind.

    The result? You’re unlikely to accidentally access a memory that occurred in that workplace, if even mentally wandering to the workplace itself causes it to shrivel up and disappear like paper in fire.

    Important reminder

    The above psychological technique is to psychological trauma what painkillers are to physical pain. It can ease the symptom, while masking the cause. If it’s something serious, we recommend enlisting the help of a professional, rather than “self-medicating” in this fashion.

    If it’s just a small annoying thing, though, sometimes it’s easier to just be able to refrain from prodding and poking it daily, forget about it, and enjoy life.

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  • Why STIs Are On The Rise In Older Adults

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    Three Little Words

    Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:

    ❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.

    These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞

    ~ Dr. Justyna Kowalska

    Read more: Managing The Rise In STIs Among Older Adults

    That said, there is a gender gap when it comes to the increased risk, for example:

    ❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞

    ~ US Dept of Health & Human Services

    Source: CDC: | Sexually Transmitted Disease Surveillance

    Is abstinence the best preventative, then?

    It is inarguably the most effective, but not necessarily the best for everyone.

    This is because for most adults, a healthy sex life is an important part of overall wellbeing.

    See also: Mythbusting The Big O

    Even in this case there is a gender gap in:

    • the level of importance placed on frequency of sexual interactions
    • what act(s) of sexuality are held to be most important:

    ❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.

    Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).

    Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞

    ~ Dr. Lee Smith et al.

    Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

    If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:

    The National Social Life, Health, and Aging Project: An Introduction

    What’s the best preventative, then?

    Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.

    You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.

    Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).

    Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.

    What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:

    • Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
    • Hands that are not clean (watch out for bacteria too)
    • A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in

    Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!

    On a related note, see also: How To Avoid UTIs

    Recap on the single most important part of this article:

    At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.

    Take care!

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  • 7 Kinds Of Rest When Sleep Is Not Enough

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Taking Rest Seriously (More Than Just Sleep)

    This is Dr. Matthew Edlund. He has 44 years experience as a psychiatrist, and is also a sleep specialist. He has a holistic view of health, which is reflected in his practice; he advocates for “a more complete health: physical, mental, social, and spiritual well-being”.

    What does he want us to know?

    Sleep, yes

    Sleep cannot do all things for us in terms of rest, but it can do a lot, and it is critical. It is, in short, a necessary-but-not-sufficient condition for being well-rested.

    See also: Why You Probably Need More Sleep

    Rest actively

    Rest is generally thought of as a passive activity, if you’ll pardon the oxymoron. Popular thinking is that it’s not something defined by what we do, so much what we stop doing.

    In contrast, Dr. Edlund argues that to take rest seriously, we need do restful things.

    Rest is as important as eating, and we wouldn’t want for that to “just happen”, would we?

    Dr. Edlund advocates for restful activities such as going to the garden (or a nearby park) to relax. He also suggests we not underestimate the power of sex as an actively restful activity—this one is generally safer in the privacy of one’s home, though!

    Rest physically

    This is about actively relaxing our body—yoga is a great option here, practised in a way that is not physically taxing, but is physically rejuvenating; gentle stretches are key. Without such things, our body will keep tension, and that is not restful.

    For the absolute most restful yogic practice? Check out:

    Non-Sleep Deep Rest: A Neurobiologist’s Take

    this is about yoga nidra!

    Rest mentally

    The flipside of the above is that we do need to rest our mind also. When we try to rest from a mental activity by taking on a different mental activity that uses the same faculties of the brain, it is not restful.

    Writer’s example: as a writer, I could not rest from my writing by writing recreationally, or even by reading. An accountant, however, could absolutely rest from accounting by picking up a good book, should they feel so inclined.

    Rest socially

    While we all have our preferences when it comes to how much or how little social interaction we like in our lives, humans are fundamentally social creatures, and it is hardwired into us by evolution to function at our best in a community.

    This doesn’t mean you have to go out partying every night, but it does mean you should take care to spend at least a little time with friends, even if just once or twice per week, and yes, even if it’s just a videocall (in person is best, but not everyone lives close by!)

    If your social life is feeling a little thin on the ground these days, that’s a very common thing—not only as we get older, but also as many social institutions took a dive in functionality on account of the pandemic, and many are still floundering. Nevertheless, there are more options than you probably realize; yes, even for the naturally reclusive:

    How To Beat Loneliness & Isolation

    Rest spiritually

    Be we religious or not, there are scientifically well-evidenced benefits to religious practices—some are because of the social aspect, and follow on from what we talked about just above. Other benefits come from activities such as prayer or meditation (which means that having some kind of faith, while beneficial, is not actually a requirement for spiritual rest—comparable practices without faith are fine too).

    We discussed the overlapping practices of prayer and meditation, here:

    The Science Of Mantra Meditation

    Rest at home

    Obviously, most people sleep at home. But…

    Busy family homes can sometimes need a bit of conscious effort to create a restful environment, even if just for a while. A family dinner together is one great way to achieve this, and also ties in with the social element we mentioned before!

    A different challenge faced by a lot of older people without live-in families, on the other hand, is the feeling of too much opportunity for rest—and then a feeling of shame for taking it. The view is commonly held that, for example, taking an afternoon nap is a sign of weakness.

    On the contrary: taking an afternoon nap can be a good source of strength! Check out:

    How To Nap Like A Pro (No More “Sleep Hangovers”!)

    Rest at work

    Our readership has a lot of retirees, but we know that’s not the case for everyone. How then, to rest while at work? Ideally we have breaks, of course, but most workplaces do not exactly have an amusement arcade in the break room. Nevertheless, there are some quick resets that can be done easily, anywhere, and (almost) any time:

    Meditation Games: Meditation That You’ll Actually Enjoy

    Want to know more?

    You might also like:

    How To Rest More Efficiently (Yes, Really)

    Take care!

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  • A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Eye Movement Desensitization & Reprocessing (EMDR)

    What skeletons are in your closet? As life goes on, most of accumulate bad experiences as well as good ones, to a greater or lesser degree. From clear cases of classic PTSD, to the widely underexamined many-headed beast that is C-PTSD*, our past does affect our present. Is there, then, any chance for our future being different?

    *PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.

    These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.

    But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.

    This might have been…

    • childhood emotional neglect
    • a parent with a hair-trigger temper
    • bullying at school
    • extended financial hardship as a young adult
    • “just” being told or shown all too often that your best was never good enough
    • the persistent threat (real or imagined) of doom of some kind
    • the often-reinforced idea that you might lose everything at any moment

    If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.

    For more on C-PTSD, see our previous main feature:

    PTSD, But, Well…. Complex

    So, what does eye movement have to do with this?

    Eye Movement Desensitization & Reprocessing (EMDR) is a therapeutic technique whereby a traumatic experience (however small or large; it could be the memory of that one time you said something very regrettable, or it could be some horror we couldn’t describe here) is recalled, and then “detoothed” by doing a bit of neurological jiggery-pokery.

    How the neurological jiggery-pokery works:

    By engaging the brain in what’s called bilateral stimulation (which can be achieved in various ways, but a common one is moving the eyes rapidly from side to side, hence the name), the event can be re-processed, in much the same way that we do when dreaming, and relegated safely to the past.

    This doesn’t mean you’ll forget the event; you’d need to do different exercises for that.

    See also our previous main feature:

    The Dark Side Of Memory (And How To Make Your Life Better)

    That’s not the only aspect of EMDR, though…

    EMDR is not just about recalling traumatic events while moving your eyes from side-to-side. What an easy fix that would be! There’s a little more to it.

    The process also involves (ideally with the help of a trained professional) examining what other memories, thoughts, feelings, come to mind while doing that. Sometimes, a response we have today associated with, for example, a feeling of helplessness, or rage in conflict, or shame, or anything really, can be connected to previous instances of feeling the same thing. And, each of those events will reinforce—and be reinforced by—the others.

    An example of this could be an adult who struggles with substance abuse (perhaps alcohol, say), using it as a crutch to avoid feelings of [insert static here; we don’t know what the feelings are because they’re being avoided], that were first created by, and gradually snowballed from, some adverse reaction to something they did long ago as a child, then reinforced at various times later in life, until finally this adult doesn’t know what to do, but they do know they must hide it at all costs, or suffer the adverse reaction again. Which obviously isn’t a way to actually overcome anything.

    EMDR, therefore, seeks to not just “detooth” a singular traumatic memory, but rather, render harmless the whole thread of memories.

    Needless to say, this kind of therapy can be quite an emotionally taxing experience, so again, we recommend trying it only under the guidance of a professional.

    Is this an evidence-based approach?

    Yes! It’s not without its controversy, but that’s how it is in the dog-eat-dog world of academia in general and perhaps psychotherapy in particular. To give a note to some of why it has some controversy, here’s a great freely-available paper that presents “both sides” (it’s more than two sides, really); the premises and claims, the criticisms, and explanations for why the criticisms aren’t necessarily actually problems—all by a wide variety of independent research teams:

    Research on Eye Movement Desensitization & Reprocessing (EMDR) as a Treatment for PTSD

    To give an idea of the breadth of applications for EMDR, and the evidence of the effectiveness of same, here are a few additional studies/reviews (there are many):

    As for what the American Psychiatric Association says about it:

    ❝After assessing the 120 outcome studies pertaining to the focus areas, we conclude that for two of the areas (i.e., PTSD in children and adolescents and EMDR early interventions research) the strength of the evidence is rated at the highest level, whereas the other areas obtain the second highest level.❞

    Source: The current status of EMDR therapy, specific target areas, and goals for the future

    Want to learn more?

    To learn a lot more than we could include here, check out the APA’s treatment guidelines (they are written in a fashion that is very accessible to a layperson):

    APA | Eye Movement Desensitization and Reprocessing (EMDR) Therapy

    Take care!

    Don’t Forget…

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  • What the Most Successful People Do Before Breakfast – by Laura Vanderkram

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    First, what this is not:this is not a rehash of “The 5AM Club”, and nor is it a rehash of “The Seven Habits of Highly Effective People”.

    What it is: packed with tips about time management for real people operating here in the real world. The kind of people who have non-negotiable time-specific responsibilities, and frequent unavoidable interruptions. The kind of people who have partners, families, and personal goals and aspirations too.

    The “two other short guides” mentioned in the subtitle are her other books, whose titles start the same but instead of “…before Breakfast”, substitute:

    • …on the Weekend
    • …at Work

    However, if you’re retired (we know many of our subscribers are), this still applies to you:

    • The “weekend” book is about getting the most out of one’s leisure time, and we hope you have that too!
    • The “work” book is about not getting lost in the nitty-gritty of the daily grind, and instead making sure to keep track of the big picture. You probably have this in your personal projects, too!

    Bottom line: if, in the mornings, it sometimes seems like your get-up-and-go has got up and gone without you, then you will surely benefit from this book that outstrips its competitors in usefulness and applicability.

    Click here to check out What the Most Successful People Do Before Breakfast, and get the most out of your days!

    Don’t Forget…

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    Learn to Age Gracefully

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