# "Take medication at bedtime." Why? **URL:** \ **Category:** Factual Questions\ **Created:** [November 29, 2015, 12:28pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922 "2015-11-29T12:28:59Z")\ **Posts on this page:** 17\ **Page:** 1
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [November 29, 2015, 12:28pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/1 "2015-11-29T12:28:59Z")
Is there any reason why certain medications should be taken at bedtime . . . other than those that cause drowsiness? I have a prescription for Zoloft (an antidepressant) which indicates to take it at bedtime. Strangely, one of the possible side effects is insomnia. ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [November 29, 2015, 12:51pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/2 "2015-11-29T12:51:29Z")
I don’t know whether it’s actually the case, but I could imagine that that recommendation be made for medication which thins the blood or reduces blood pressure, so that you’re lying down and unlikely to injure yourself when the drug’s effects are strongest. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [November 29, 2015, 1:14pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/3 "2015-11-29T13:14:45Z")
For that particular drug, it is indeed due to possible drowsiness. It is an SSRI, and can have an initial drowsiness effect. If you find it more activating, a doctor will usually switch you to a daytime dose. But, for most people, it either causes drowsiness or has no effect in that area. I do also want to point out that having a side effect of insomnia doesn’t necessarily mean the drug is activating. Nor is it necessary that the effect kicks in right away but gets better the longer it’s been since you’ve taken a dose. It’s perfectly possible to have a drug that helps you sleep if you take it at night but makes it hard to go to bed if you take it in the morning. Or for it to cause insomnia no matter when you take it. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [November 29, 2015, 1:42pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/4 "2015-11-29T13:42:33Z")
Statins which reduce cholesterol work on the liver’s cholesterol synthesis process. The liver does most of its cholesterol synthesis at night. So if your statin is a short acting one, it should be taken at bedtime. ---
**Author:** ![Digital\_is\_the\_new\_Analog](https://avatars.discourse-cdn.com/v4/letter/d/a88e4f/32.png) [@Digital\_is\_the\_new\_Analog](https://boards.straightdope.com/u/Digital_is_the_new_Analog)\ **Post date:** [November 29, 2015, 2:40pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/5 "2015-11-29T14:40:26Z")
Some medications for frequent urination help for most, but not all, of a day. If a patient’s complaint is waking up during the night to pee, they may be told to take the medication in the evening instead of the morning. ---
**Author:** ![Kedikat](https://avatars.discourse-cdn.com/v4/letter/k/ed655f/32.png) [@Kedikat](https://boards.straightdope.com/u/Kedikat)\ **Post date:** [November 29, 2015, 7:29pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/6 "2015-11-29T19:29:34Z")
Just a guess. You will not be eating or drinking for 8 hours. Digestion of previous food and drink is far progressed. Maybe some drugs require that state to be properly absorbed. No other random food and chemicals in the stomach and upper digestive tract. ---
**Author:** ![Tim\_T-Bonham.net](https://avatars.discourse-cdn.com/v4/letter/t/46a35a/32.png) [@Tim\_T-Bonham.net](https://boards.straightdope.com/u/Tim_T-Bonham.net)\ **Post date:** [November 30, 2015, 4:13am UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/7 "2015-11-30T04:13:22Z")
My uncle, a pharmacist who dealt with many doctors, said that a quite common reason was that this increases the chances that patients will remember to take their prescribed medication. People forgetting their medications, then taking a double dose the next day, skipping some days, or otherwise messing up their medication schedule is a very common problem for doctors. So often, it might not have anything to do with the properties of the drug; it’s just doing it on a regular schedule. Same thing for many medications that are to be taken 3 times per day – doctors will often say to take them with meals, because most people eat 3 meals a day, spaced regularly through the day. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [November 30, 2015, 4:33am UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/8 "2015-11-30T04:33:45Z")
> [@panache45](#): > > Is there any reason why certain medications should be taken at bedtime . . . other than those that cause drowsiness? > > I have a prescription for Zoloft (an antidepressant) which indicates to take it at bedtime. Strangely, one of the possible side effects is insomnia. Zoloft can cause drowsiness, hence the indication to take it qhs (at bedtime). However, if it does keep you awake, ask the doctor if you can take it earlier in the day. Lots of people take SSRIs early in the day (I do) and since they’re dosed once a day, it usually doesn’t matter. ---
**Author:** ![Atamasama](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/atamasama/32/12961_2.png) [@Atamasama](https://boards.straightdope.com/u/Atamasama)\ **Post date:** [November 30, 2015, 9:10pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/9 "2015-11-30T21:10:36Z")
Antihistamines knock me out like a tranquilizer. Yet they’d keep my brother up at night like caffeine. It’s not unusual for the same drug to have contradictory side effects based on different people’s reactions to the drug. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [November 30, 2015, 10:13pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/10 "2015-11-30T22:13:18Z")
> [@Qadgop\_the\_Mercotan](#): > > Statins which reduce cholesterol work on the liver’s cholesterol synthesis process. The liver does most of its cholesterol synthesis at night. So if your statin is a short acting one, it should be taken at bedtime. Huh. My guy never told me that; I take them in the AM. > [@Digital\_is\_the\_new\_Analog](#): > > Some medications for frequent urination help for most, but not all, of a day. If a patient’s complaint is waking up during the night to pee, they may be told to take the medication in the evening instead of the morning. That last sentence seems backwards? I’ve starting taking Invokana (diabetes piss-away-the-sugar drug) and my life is one giant trip to a bathroom. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [November 30, 2015, 10:15pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/11 "2015-11-30T22:15:31Z")
> [@Atamasama](#): > > Antihistamines knock me out like a tranquilizer. Yet they’d keep my brother up at night like caffeine. It’s not unusual for the same drug to have contradictory side effects based on different people’s reactions to the drug. Most over-the-counter “sleep aids” are repackaged antihistamines. I keep a few Benadryls–rather than the “less-drowsy” :dubious: Claritin–around for just that reason. ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [November 30, 2015, 11:14pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/12 "2015-11-30T23:14:42Z")
> [@Leo\_Bloom](#): > > That last sentence seems backwards? Nope- the idea is you take the pee-less-often meds in the evening, which keeps you from getting up during the night to pee. The meds last all night and start to wear off during the daytime - when the increased frequency at least won’t wake you up, as presumably you are not sleeping. ---
**Author:** ![Atamasama](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/atamasama/32/12961_2.png) [@Atamasama](https://boards.straightdope.com/u/Atamasama)\ **Post date:** [November 30, 2015, 11:15pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/13 "2015-11-30T23:15:05Z")
> [@Leo\_Bloom](#): > > That last sentence seems backwards? > > I’ve starting taking Invokana (diabetes piss-away-the-sugar drug) and my life is one giant trip to a bathroom. The medicine doesn’t cause urine to form in your body, it stimulates you to pee. So you take it at 8 PM, by 9 PM you urinate like a fire hose, and you go to bed afterward with an empty bladder. You no longer wake up in the middle of the night needing to go. At least that’s how I assume the drug would help with that problem. ---
**Author:** ![PapSett](https://avatars.discourse-cdn.com/v4/letter/p/ecc23a/32.png) [@PapSett](https://boards.straightdope.com/u/PapSett)\ **Post date:** [November 30, 2015, 11:40pm UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/14 "2015-11-30T23:40:34Z")
I’ve starting taking Invokana (diabetes piss-away-the-sugar drug) and my life is one giant trip to a bathroom. Wait… what? I’m on Invokana too, and pee CONSTANTLY. I am actually also on something to help with incontinence… My doctor never told me that Invokana might be causing this. Gona have to check into this more… ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [December 1, 2015, 1:19am UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/15 "2015-12-01T01:19:43Z")
One reason I’ve not seen mentioned yet is because some medications can cause nausea or otherwise upset the stomach. Taking the medication prior to bed will cause the side effects to manifest, hopefully, during your sleep, so you won’t be nearly as bothered. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [December 1, 2015, 7:07am UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/16 "2015-12-01T07:07:47Z")
Re: Several confused comments above about night-time pee drugs: Other than diabetic drugs, you’re mainly talking about prostate medications. It’s a man thing. Benign Prostate Hyperplasia (BPH) is a common affliction for males in the upper age echelons. (I’ve been told that 100% of males can expect to have this sooner or later if they live long enough.) A standard symptom is an urgent need to pee very frequently, even though each individual pee might only be a very small amount. And when you do pee, it’s often a slow dribble rather than a full-strength deluge, and is often incomplete – that is, the bladder doesn’t empty completely, thus setting you up to need to pee again before long. This can also set you up for bladder infections. The pills are alpha blockers, which relax the prostate and allow one to pee a full pee more easily, and thus with less frequent need and less sensation of urgency. One takes this in the evening for best effect during the night, although it remains effective throughout the rest of the next day too. Some common meds for this are terazosin (a.k.a. Hytrin), also used as a blood-pressure med; and tamsulosin (a.k.a. Flowmax) which more selectively targets the prostate with less effect on the rest of the body. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [December 1, 2015, 8:37am UTC](https://boards.straightdope.com/t/take-medication-at-bedtime-why/738922/17 "2015-12-01T08:37:38Z")
Re Invokana: the packaging actually _tells_ you to take it in the AM, because (paraphrasing from memory) it might as well get at the sugar rise from breakfast. But I’m also drinking like a fiend, so I thought it was basically repeating on purpose the classic symptoms of diabetes, along the idea of hair of the dog that bit you. Which made me wonder about other medical goals (if any) that mimic the symptoms of pathology, which often are, after all, a way to alleviate the underlying illness. But then I thought that was as weird as having a drug to induce a fever for so many diseases, and that doesn’t make any sense.