Why does some medicines say "take with food"?

I’m taking Macrobid for a UTI. It has a take with food sticker.

I dutifully trotted down to Kroger for a box of crackers.

Eat 5 or 6 crackers, then swallow the pill.

What does that accomplish? Why does some medicines say “take with food”?

Some medicines say before meals or after meals.

Before meals means on an empty stomach.

After meals - full stomach

Never understood what a few crackers acomplishes. But they’ll sometimes offer crackers in the hospital.

Some medications irritate the stomach, and being taken with food helps alleviate this effect.

Yes, I’ve also heard (from doctors/nurses) that it’s because they irritate the stomach, and having some food in there sort of softens the blow, kind of like cushions on a hard chair. Also, the last time I had some “take with food” medications, the doctor said a glass of milk worked just as well as a light snack.

For the “before meals” medications, I was told (by Dr.) that some of it got absorbed by food (which somehow kept it from being absorbed by the body after the food was broken down), so it needed to be taken at the start of a meal, preferably 20-30 minutes before.

On the other end, my thyroid medicine has specific instructions to take at least four hours after eating and at least one hour before eating anything else. Obviously, they don’t want anything in my digestive tract to hinder absorption, but it sure limits my ability to schedule.

If I don’t eat before or with my morning medication, I will shortly be vomiting. Not so pleasant in the car on the way to work.

Also become some meds (and supplements) are only fat soluble.

My 82 year old father-in-law is on a range of medications many of which are to be “taken with food”. He’s a crotchety stubborn bugger and didn’t see the need “It’s a bunch of bullshit…”

Last December he noticed very bloody stools and then started vomiting blood the next day. He was rushed to Emergency, then ICU for 3 days at a hospital near Tampa. (He’s a Canadian snowbird who winters there). The medications had burned a hole through his stomach lining.

His hospital bill was well over $60,000 (US). (Fortunately insurance paid, but since it’s now pre-existing, they won’t pay again).

He learned his lesson.

The most common reason is because the medication is irritating to the stomach and food helps blunt that effect; the second most common reason is because the medication is absorbed better on a full stomach. Sometimes, solid food is necessary, and other times, fruit juice or milk are adequate. Macrobid (nitrofurantoin) is a little bit of both.

And there are some foods or beverages that should not be taken with certain medications. For example, calcium and iron binds to fluoroquinolones (antibiotics like Cipro) and tetracycline, and reduces their absorption. Conversely, iron is absorbed better when taken with vitamin C, so the supplements are often combined with it, or it can be taken with fruit juice.

Thyroid, in whatever form it’s prescribed, is absorbed best on an empty stomach, and can be taken any time of day. Levothyroxine could theoretically be taken once a week, but it’s usually dosed daily to improve compliance.

Eating also dramatically extends gastric emptying time, which can be significant if (say) a medicine is absorbed from a specific part of the GI tract.

j

Some of them can cause nausea if you don’t. Source: took high-dose ibuprofen without food after having my wisdom teeth removed.

Yes, but that a whole ’ other and big cup of tea. The most well known is ixnay on grapefruit with anti-cholesterol medicines, and a whole bunch of foods–an interesting bunch with interesting chemical similarities you might not have suspected–that must be avoided by the few number of people still taking MAOI anti-depressants.

Not all food components get broken down, or broken down completely, before exiting. If it connects to indigestible fiber, for instance, it’s going to pass through.

This is something that varies a lot person to person. I have digestive issues to start with and a light snack or glass of milk instead of something more substantial pretty much assures that I’ll throw up antibiotics as readily as if I’d eaten or drank nothing first.