If you are taking a pill which came with the directions that it should be taken with food, can you take it with a drink instead?
From looking around a bit, I see two reasons given for the directive. Some (e.g. Walgreens) say it’s because it might cause an upset stomach. If that the case, then whatever works works, and you can take it with nothing if it doesn’t happen to cause you upset stomach. But others say it’s because the pills get absorbed into the body better if they are combined with food that is being digested. This raises the question about whether liquids are enough?
I think it varies by medication. I have been advised to take food with certain medications because they’re harsh on the stomach. However when I was on Geodon (Ziprasidone), I was told to take it with food for different reasons. From Wikipedia:
I apologize if this is WAG territory, but here it goes:
For drugs absorbing better with food - perhaps the drug is fat-soluble but not water-soluble. Certain vitamins, A for instance, are fat-soluble and must be taken with food to be absorbed properly. If you just take them with a drink they won’t be fully absorbed. Other vitamins are water-soluble and don’t have this caveat.
As far as upsetting the stomach, perhaps the drug interacts adversely with stomach acid and might cause an upset stomach, but the food would act as a buffer between the drug and the acid. This is more of a guess and hopefully someone can confirm or deny this.
I was told that eating food closes your pyloric sphincter which retains the food in your stomach for longer, and that a pill by itself, or a pill with a drink, doesn’t cause this reaction. So for drugs that are primarily absorbed through the stomach, food helps keep the pill in your stomach where it is absorbed better.
Some pills are certainly different from others in the mechanics of their absorption, as mentioned up thread. As soon as I saw this item, the first thing that jumped into my mind - vitamins.
One morning (I don’t eat in the morning b/c it makes me nauseous), I had to go do a PT test for work. Wanting to carb/protein load, I grabbed a few sports bars on the way out the door to nibble at in the 2-3 hours before the test, and popped one of those Men’s Vitamins that turns your urine bright yellow. About five minutes later, gingerly nibbling my first bar at about 50 mph, it happened. At first just pain… then sweating… and then puking bile out the window.
Upon later telling my then-girlfriend (a doctor), her response was something along the lines of “you deserved it you f*ckin idiot. Everyone knows you don’t take vitamins on an empty stomach.”
I guess that makes me a 1%er, at least in this regard. It’s lonely and pukey at the top.
This is pure anecdote but, my mother needed to take an antibiotic with food. Her definition of with food was half a slice of bread moistened with broth. Her definition was inadequate, she couldn’t tolerate the antibiotic without vomiting, and her infection progressed, and she went to the hospital – where she got I.V. antibiotics, and a stern lecture on the definition of “with food.”
When I was travelling I was taking a Doxycycline pill every day as an anti-malaria tablet. The packet said “take with food”. I usually did and everything was fine. One morning I forgot to take it with breakfast so I took it an hour or so later instead just with water. I spent the next 20-30 minutes feeling cripplingly nauseous. I thought I was going to be sick, had to sit with my eyes closed for an entire taxi ride trying to get myself together… It subsided pretty quickly and I felt absolutely fine about half an hour later. But clearly - for doxycycline at least - the reason it said to take it with food was probably to avoid getting that type of side effect.
It could be for any number of reasons: the product insert or monograph provided to medical professionals (and which are generally available online) often explains why a given medicine should be taken with food or drink.
In the section titled Proper use of this medication, it says the following:
Interestingly, food actually decreases the effectiveness of several tetracyclines, so it’s recommended to take with water rather than food unless gastrointestinal irritation occurs:
In many cases, it is to avoid irritation or ulcers in the gastrointestinal tract; basically to make the medicine easier to take. In very few cases, it has something to do with where and how the drug is absorbed and metabolized, but most of the time the actual formulation of the drug will take care of that (e.g. a coating to avoid dissolution in the stomach and release only in the higher pH areas of the GI tract), since it’s not such great drug design to rely on the availability of specific foods to a patient in order to obtain a medicinal dose!
As others have said, it varies somewhat from drug to drug. It’s very complex chemistry and we don’t always understand how or why something works; we just know that it does, and what the side effects and risks are over a statistical population.
You have to remember, when you take a medicine you are expecting it to screw around with your body chemistry somewhat. Unfortunately, that means that in addition to targeting whatever you’re taking it for, there’s a good chance that something else will get hit along the way. All we can do is try and minimize that.
This jives with what I was told about being on the Pill. I was complaining to my doc about spotting, and was told that if your gut is full of food it takes longer for the pill to move through your system and gives your body a better chance to absorb it.
And oh, my, yes - antibiotics *always *made me nauseous unless I nibbled crackers or toast with them.
Well, this was a multivitamin. I’m aware that vitamin C is generally just cheap ascorbic acid that manufacturers throw in to say “hey, we’re giving you a whole day’s supply of that vitamin you always hear about,” but given the rigorous training regimen I had at the time (along with my absurdly small appetite), the other vitamins/minerals in multi-vitamins seemed important. Also, surplus B vitamins are alleged to affect urine color.
But the point of my post was that taking vitamins on an empty stomach is (at least for some of us) a very bad idea.
For my medication, it’s because it can lead to stomach ulcers without food. So it’s the ‘stomach pain’ reason, but you wouldn’t know you were hurting yourself until months later, and by then it’s too late. So if it says “take with food”, take with food!
