Q. What do doctors actually mean when they tell us to take medicine ‘on a full stomach’? A senior citizen told me that she would eat as much as she could till she could eat no more, at each meal, because then she would have the necessary ‘full stomach’ required to take her medication. As a result, she had put on masses of weight and had developed several health problems. Why does the stomach need to be full? What would happen if the medication is taken on an empty stomach or if the stomach is not quite stuffed? Does ‘full stomach’ require any particular kind of diet?
A. The food one eats can affect the body’s response to medication taken, and conversely, the drugs one takes can affect the nutritional status of an individual. Foods can enhance, delay, or decrease drug absorption, metabolism, and excretion. Diets that alter the bacterial flora may markedly affect the overall metabolism of certain drugs. Nutritional deficiencies can also affect drug absorption and metabolism. Many drugs can also affect taste, appetite and food intake and absorption, and some drugs are better tolerated and utilised when taken with food. Alcohol and caffeine are also considered influencers of drug therapy, and that’s why the indicated caution with these two beverages when one is on medication.
Patient education regarding the appropriate timing of drugs in relationship to meals and the dietary modifications needed because of drug therapy is most important. For example, anti-depressants and corticosteroids increase appetite, levodopa (used often in the treatment of Parkinson’s disease) inhibits gastric emptying, antacids hinder iron absorption, hypocholesterolemic drugs may decrease the absorption of fat-soluble vitamins, and antibiotics interfere with nutrient metabolism. Knowledgeable about these often overlooked diet-drug interactions, doctors recommend either of the following:
- Take medication on an empty stomach
- Take medication just before a meal
- Take medication immediately after a meal
- Take medication between meals
The potential for diet-drug interactions is greatest in people on long-term drug therapy, the malnourished, those with chronic diseases, children, and the elderly. When told to take a drug ‘on a full stomach’, it actually means to have the medication ‘immediately following a meal’. There is no need to increase the quantity of meal or change the eating pattern unless indicated because of reasons of malnourishment! This advice is often given because a drug taken on ‘an empty stomach’ can prevent the appropriate absorption of the medication or can cause digestive disturbances and thus be ineffective, necessitating a prolonged treatment or a stronger dosage.
SHERYL AFONSO e D’SOUZA
CLINICAL NUTRITIONIST (NORBERT’S FITNESS STUDIO) & DEPARTMENT HEAD (M.Sc. Food Technology, CARMEL COLLEGE)