How to drink and eat pills so as not to harm yourself

Each medicinal product is accompanied by a special leaflet annotation, which contains all information about the medicinal product, and in particular, recommendations for use. The effectiveness of treatment largely depends on the careful observance of these rules. It is very important to follow the instructions on how to take the drug: before meals, after meals and how to drink it. It turns out that sometimes the wrong combination of a drug and a drink or food can negate all its medicinal properties.

What you need to know about different dosage forms

Medicines meant to be taken orally (by mouth) can be in different pharmaceutical forms. For example, in the form of tablets, capsules, solutions, tinctures, infusions, dragees, pills, powders. Such a variety is not a whim of pharmacists, and even more so not in order to add variety to the medicinal “menu”. The fact is that the rate of absorption of the active substance and its interaction with the body depends on the form of the drug.

You will rarely see drugs in powders and pills in modern pharmacies. They have given way to more effective and practical options – pills. But not all of them are the same: some are covered with a “glaze” shell, while others are without it. “Glaze” is usually used in two cases: if the tablet contains substances that are aggressive for the stomach, or when the active ingredient, on the contrary, must be protected from splitting by gastric juice. Coated tablets usually break down in the alkaline environment of the intestine. In addition, there are options with a multi-layer protective coating. The preparations of this group contain a rather long time of action (prolonged effect), since the active substance is released from them gradually – to the extent of the destruction of the protective membranes. Therefore, it is impossible to break or crush glazed tablets, since the destruction of the protective film leads to premature release of the active substance, irritation of the gastric mucosa and impaired absorption of the drug. Capsules work on the same principle as glazed tablets. Therefore, it is also not recommended to open them and drink the contents without a gelatin “package”.

The fastest-acting, but also the least protected from the influence of gastric juice, are preparations in liquid form. They are usually the easiest to penetrate into the blood, but for optimal absorption, they require strict adherence to the rules of administration.

How tablets are absorbed

To achieve a therapeutic effect of any drug, it must penetrate into the blood. And for this, the active substance must be absorbed through the walls of the stomach or intestines. A significant impact on this process has an acidic environment, which differs in different parts of the digestive tract. For example, the acidity in the stomach is 1-3 pH, in the duodenum this figure already reaches 5-6, and in the large intestine – about 8. For this reason, dosage forms are created for absorption in the stomach, or in the small and large intestines.

Another test that the drug has to pass in our body is the effect of enzymes. Many drugs, when in contact with food enzymes, lose their activity. In particular, we are talking about protein and polypeptide substances, such as insulin and vasopressin, some hormonal preparations (for example, containing testosterone and progesterone). These points are also taken into account when creating dosage forms.

Some medicines are not intended to be swallowed but must be taken sublingually (sublingual tablets). This method of taking the medication allows the active substance to be quickly absorbed into the bloodstream, bypassing the liver.

There are a number of factors that affect the absorption and therapeutic efficacy of medications. And if we cannot influence the physiological characteristics of the body, then everyone can control what we eat and drink before or after taking the medicine. But this plays an important role in the safety of its active substance. Different types of food affect the production of gastric juice and enzymes in different ways, which as a result affects the absorption of the drug. In addition, some substances are destroyed or less absorbed when combined with certain nutrients. For example, drugs from the tetracycline group, amoxicillin and ampicillin are almost not absorbed by the body if they are taken together with a large amount of carbohydrates or iron salts.

The best time to take medicine

If there are no special instructions in the instructions for the drug, this does not mean that the medicine can be taken at any time. In most cases, the optimal time to take a tablet is 20-30 minutes before a meal, when the active ingredient is most easily absorbed. If a certain acid-base environment is necessary for the absorption of a substance, then the exact time of taking the medicine is always indicated in the instructions.

Sometimes food intake can affect the time of action of the drug. For example, antacid medications (prescribed for stomach or duodenal ulcers), taken on an empty stomach, work for about 30 minutes. And if you drink the same drug 60 minutes after eating, then the effect of it will last for 3-4 hours.

20-30 minutes before meals take:

• drugs that affect the production of gastric juice;
• some hormonal drugs;
• drugs based on live bacteria;
• homeopathic preparations;
• decoctions of medicinal herbs.

During meals:

• enzymes to improve the absorption of food.

After meal:

• most medications;
• drugs that irritate the gastric mucosa;
• vitamins and dietary supplements.

Food and medicine: how to combine

No matter how useful drugs are in the fight against diseases, most of them also have a negative effect on the body, especially with prolonged use. For example, antibiotics kill not only pathogenic, but also beneficial bacteria. Preparations of other groups often lead to leaching of minerals and vitamins from the body. But if the pills are combined with the right food, then side effects can be avoided.

Antibiotics

To avoid the occurrence of dysbacteriosis, after a course of antibiotics for 2-3 weeks, it is useful to regularly consume bio-yogurt, soft cheeses with mold such as camembert and brie, bran, sauerkraut. Another unpleasant consequence of taking antibiotics is a decrease in vitamins B12 and K, folic and ascorbic acids in the body. Broccoli, fish, brown rice, walnuts, white beans and rosehip broth will help restore the reserves of nutrients.

Painkillers

Medicines from this group are in every home first aid kit. They help with migraines, back and joint aches when teeth ache or earache, and many women take analgesics every month to relieve premenstrual pain. If you abuse such drugs, then along with the pain, you can get rid of the reserves in the body of folic acid, vitamin C, zinc and iron. To prevent this from happening, some time after taking the pill, it is recommended to eat an orange or grapefruit, a little sauerkraut, young lamb or a handful of pumpkin seeds. These products will help restore the supply of nutrients.

Steroid medicines

Drugs from this group are prescribed to patients with asthma, rheumatoid arthritis, eczema. A course of steroid treatment can give good results, but at the same time cause unpleasant consequences. For example, lack of vitamins C, D, B6, K and trace elements zinc and magnesium. Barley and oatmeal, pepper, lentils, tofu will help prevent or compensate for the deficiency.

Birth control pills

Women who take oral contraceptives on a regular basis are at risk of becoming deficient in magnesium, zinc, vitamins C and B9. Good portions of these substances are found in soy, squid, Brussels sprouts, beans, sprouted wheat and spinach. It is these foods that are considered the best food companions for birth control pills.

What is the right way to take medicine

The fact that any pill should be washed down is an indisputable fact. Firstly, the liquid facilitates the process of swallowing, and secondly, it contributes to the dissolution and absorption of the drug. But in order for the pill to work and not cause side effects, you need to know how to properly drink different types of medicines.

Water

If there are no special comments in the instructions for use about how to take the pill, then it is best to give preference to ordinary water at room temperature – boiled or bottled, but without gas. Water has the properties of a good solvent and at the same time does not cause changes in the formula of the drug. In addition, it is necessary to drink the tablet exactly with the amount of liquid that is indicated in the annotation. Usually, the instructions advise taking the medicine with at least half a glass of liquid, and not with one or two sips, as many of us do. If there is not enough water, a solid tablet will not be able to dissolve in the stomach in time and begin to act. The consequence of this is that the body will not accept the entire portion of the active substance, but only a part of what is contained in the preparation.

Tea

Tea and medicine are not such a useful company. “How can tea harm a pill, is it ordinary water?” – many people think. In fact, this is far from the case. In a drink made from tea leaves, there are quite a lot of phenolic compounds from the group of tannins (found in red wine as well). So those same tannins are a rather unfavorable company for codeine, aminophylline, cardiac glycosides, since phenolic substances disrupt the process of their absorption. It is not recommended to drink iron-based medicines with tea, as in such a situation the mineral will not be absorbed. You should also use a tea leaf drink and antibiotics, stomach and cardio drugs at different times. If you drink antidepressants with tea, then later the patient may show signs of overexcitation, and birth control pills may not work.

Coffee

Many of us can take a pill with a sip of black coffee without even thinking about the consequences of such a combination. Coffee is incompatible with most drugs, as it negates their effectiveness. First of all, these are vitamins, or rather vitamin C, which loses its beneficial properties in combination with coffee. The second group of drugs that should never be combined with a caffeinated drink are homeopathic remedies, since their effectiveness in this case is also close to zero.

Another reason why coffee is not suitable for drinking tablets is the strong diuretic property of the drink. The medicine taken with a cup of coffee will quickly be excreted from the body in the urine, often without having time to act.

But there are cases when coffee, on the contrary, enhances the effect of the medication. This is possible with pain relievers containing caffeine. But in this case, an overdose of the drug is not excluded.

The joint intake of coffee and drugs that regulate blood pressure and heart function nullifies the entire effect of the treatment, and also poses a serious threat to the diseased cardiac system. It is also absolutely illogical to take sleeping pills and drink coffee with it – there will still be no result from the pill.

Milk

It is widely believed that it is useful to take the tablets with milk, as this product protects the walls of the stomach from irritation. In some cases, milk really goes well with medicines. For example, with acetylsalicylic acid, non-steroidal anti-inflammatory drugs, fat-soluble vitamins (A, D, E, K), as well as iodine-containing, anti-tuberculosis and some hormonal drugs. But at the same time, there is an impressive list of drugs that do not tolerate the company of milk. In particular, in order to maintain the therapeutic effect of the drug, you should not drink cardiac glycosides, caffeine-containing drugs (citramon, caffetin, askofen), drugs for the treatment of ulcers (ranitidine, cimetidine), enzymes (mezim, pancreatin) with this drink. Under the influence of milk, antibiotics of the tetracycline, penicillin and cephalosporin groups also reduce their effectiveness. They react with the calcium contained in milk, resulting in a substance that is not absorbed by the body. It is also strictly forbidden to consume milk together with iron preparations. And again, the reason is calcium, which prevents the absorption of iron.

Another group of medicines that are incompatible with milk are acid-resistant tablets. Preparations of this group have a special shell that protects the tablet from destruction by gastric juice. That is, the task of such drugs is to begin to act only in the intestines. If such a medicine is taken with milk, it will dissolve in the stomach and the active substance will not be absorbed in the intestines, which means that there will be no effect from the treatment either.

By the way, often manufacturers of medicines in the annotations to some drugs separately indicate the inadmissibility of mixing with milk.

Juices

Many people believe that if fruit and vegetable juices are healthy on their own, then drinking medicines with them can also benefit your body, but this is another misconception.

Juices from vegetables and acidic fruits can both reduce and significantly enhance the therapeutic effect of some drugs. For example, ampicillin, azithromycin, erythromycin lose their strength if they are washed down with juices. But aspirin, paracetamol, ibuprofen and nitrofuran preparations (furazolidone, furagin) against the background of acidic and vegetable juices, on the contrary, increase their activity (they can even cause severe poisoning).

If sulfonamides (antimicrobials) are washed down with tomato juice, then the antibacterial effect of the drug will be significantly reduced. The reason is the reaction with the folic acid contained in the juice. In addition, drugs in this group cannot be washed down with acidic drinks, since chemically sulfonamides are characterized by alkaline properties. A chemical reaction takes place between both substances, leveling the effect of the drug.

Psychostimulants should not be taken with pineapple or grape juice. This combination can cause a hypertensive crisis.

The combination of antacids and acidic juices is inappropriate. Medicines in this group are aimed at protecting the gastric mucosa from irritation with hydrochloric acid and bile. And the fruit acids contained in acidic drinks, on the contrary, destroy the protective layer on the walls of the stomach and increase the acidity in it.

Preparations based on warfarin are strictly forbidden to drink cranberry juice, otherwise very serious consequences are possible. Cranberries contain substances that, like warfarin, thin the blood. An overdose of these substances can cause bleeding.

Experts call medications and grapefruit juice one of the most dangerous combinations. This is due to the fact that grapefruit contains various substances that affect the enzymatic activity of the liver, as a result of which most of the chemicals used in pharmacology have an unpredictable effect on the body. It is most unsafe to combine grapefruit juice with heart medications, antidepressants, antibiotics, medicines for allergies, fungi or viruses, and medicines that lower blood pressure. In addition, scientists from the Lawson Health Institute (Canada) found that furanocoumarins contained in grapefruits and other citrus fruits greatly enhance the effect of drugs, causing severe poisoning.

Any acidic juices (from orange, grapefruit, lemon, cherry) are absolutely not suitable for drinking coated tablets. Acidic drinks disturb the natural environment of the stomach and destroy the protective layer of the tablet, which can be dangerous for the digestive system.

Compote or jelly

For many, jelly and compote are childhood favorite drinks that are not only tasty, but also healthy. Compotes, for example, are rich in vitamins and other nutrients, and jelly has enveloping properties, which is very useful for people with gastritis or stomach ulcers. But with all the benefits of these drinks, they cannot be combined with medications. If you drink a pill with kissel, then its therapeutic effect will significantly decrease. Compote rich in fruit acids is also able to change the pharmacological properties of drugs, in particular those intended for the treatment of hypertension and heartburn.

Alcohol

All types of alcohol take first place in the ranking of drinks that absolutely cannot be combined with medicine. At best, alcohol simply neutralizes the therapeutic effect of drugs. At worst, this combination causes chemical reactions that provoke severe poisoning, disturbances in the functioning of internal organs and the human psyche. For example, many cough or headache medications contain codeine, which reacts with ethyl alcohol and causes respiratory depression. Therefore, if you plan to drink even a glass of wine on the day of taking the medicine with codeine, then it is better not to take the pill at all – this harm will be less than from a combination of both substances. It is no less dangerous to combine taking sleeping pills, antidepressants, analgesics, antibiotics, antipyretics or antiallergic drugs with alcohol, since ethanol significantly enhances the effect of these drugs and significantly increases the load on the liver.

Drinking aspirin regularly with alcohol increases the risk of developing stomach ulcers. Blood sugar lowering drugs taken with alcohol cause hypoglycemia. Soluble cold medicines, as well as aminophylline and ephedrine, in combination with ethanol, cause a sharp increase in blood pressure. By the way, the pressure can rise, even if you drip the nose with vasoconstrictor drops and then drink alcohol.

Is all water suitable for taking pills?

Saying that water is the best companion for tablets, experts always mean the usual pure non-carbonated liquid. But there are many warnings about the combination of mineral or sweet sparkling water with medicines.

Firstly, mineral water is always a rather rich set of salts that can enter into undesirable reactions with the active substance or with the tablet shell.

Alkaline (hydrocarbonate) mineral water can be washed down with aspirin, streptocid, ftalazol, etazol, norsulfazol, erythromycin, biseptol, sulfadimethoxine, sulfalene and other drugs from the sulfonamide group. In an alkaline environment, the duration of the action of the drug is extended, and the removal of toxic decay products from the body is also facilitated.

If you are going to drink analgin, tetracycline or a sedative with alkaline mineral water, then you should carefully monitor the dosage of the drug, since such water enhances the absorption of these drugs.

Favorite by many, cola and other sweet pops are also far from the best choice for drinking pills. Any carbonated water irritates the gastric mucosa, and in combination with tablets, this effect is enhanced and can be very unsafe for people with disorders of the gastrointestinal tract. People with gastritis or ulcers should absolutely not combine drugs to improve digestion, antibiotics and diuretics with sugary carbonated drinks. In addition, in the company of cola, most medicines form insoluble compounds, which reduces their therapeutic effect.

When the pills prescribed by the doctor sometimes do not give the desired effect, patients in such cases usually find many “guilty”. Most often, a doctor is accused of unprofessionalism or a pharmacy for selling a fake. And few people realize that the patient himself is to blame for the ineffectiveness of the treatment, who simply took the prescribed pills incorrectly.

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