Taking medication at the right time of day isn’t always easy

Many of us are guilty of taking medication at all times of day. While many doctors recommend that medication be taken on a prescribed schedule. Some medications can not be taken together, so it’s most important to follow your physicians suggested times for taking medication.

Most of us practice Chronotherapy twice a year when we change our clocks and expect our inner clock to adjust and reset without upset.

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Sometimes it’s not a smooth transition as falling asleep can struggle against the change of early/or late hour.

There may be a similar struggle when you take your medications if  chronotherapy isn’t considered.

First thing in morning may not be the best time to mix and tip a handful of pills altogether. Vitamin pills, cholesterol pills, and high Blood pressure pills may have specific, preferred times that make them work better with fewer side effects.

We all have an inner clock that has it’s own preference for medication, sleep and work.

Michael Terman, PhD Director, Center for Light Treatment and Biological Rhythms and Ian McMahan, PhD, City University of New York explain a few of the inner workings of our Inner Clock in their book: Reset Your Inner Clock 

But does this mean time really matters when taking medication or pills? I use to think it didn’t make that much difference. They all go to the same place anyway before dissolving and dispensing their magic potion. If you take the same medicine daily isn’t it in your system continuously no matter what time of day it is?– at least, that’s what I thought.

Michael Smolensky, Adjunct Professor of biomedical engineering at the University of Texas, Austin, writes in the AARP Bulletin, “The body doesn’t respond to medications in the same way at different times of the day,” he says. “Some drugs are not as effective or as well tolerated if they’re taken at the wrong biological time. It’s not that they’re not effective at all, but they’re certainly much less effective.” Smolensky explains that there is a master clock in the body that directs a host of peripheral clocks found in organs, tissue and cells.

In other words, some meds work better when taken at a certain time. The objective is to time the medicaiton to achieve the greatest benefit with the lowest risk of unpleasant side effects. This method of dispensing medication is called drug chronotherapy.

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 Timing treatments for hypertension and rheumatoid arthritis are making great strides, according to Smolensky. And even some cancer treatments can be improved by timing the medication.

The biggest problem with drug chronotherapy is that not every doctor is aware of all the recommended times for particular medications. So when you get your next refill, instructions for time of day to take the medication may be missing.

The AARP Bulletin gives this list of a few common drugs and the best time to take them:

• Statin drugs for High Cholesterol: Take at bedtime; The liver produces most cholesterol after midnight
• High Blood Pressure Medications: Take just before bedtime normalizes daily blood pressure rhythm
• NSAIDs, such as naproxen and ibuprofen, are the most widely used medications for Osteoarthritis: Take 4-6 hours before pain 
• Acid-reducing H-2 medication for relief of heartburn: These drugs have a chemical name that ends in “tidine” (cimetidine, famotidine, ranitidine, nizatidine.) Take them 30 minutes before your evening meal. 
• Asthma attacks occur 50 to 100 times more often between 4 and 6 a.m. than during the day: Four in 10 people with asthma wake up every night with trouble breathing. Take in midafternoon if it’s an oral medication, or late afternoon if it’s an inhaled steroid. These times May not apply if your Asthma is COPD and you take multiple inhaled medicines: A good list for times to take these medications can be found here: Emphysema Inhaled Medication Sequences 
• Rheumatoid arthritis: Since it tends to be at worst in the morning, take RA medicines in the evening or at night.
• HayFever: Take (one a day) antihistamines in the evening. Take (twice a day) antihistamines morning and evening. Otherwise follow label directions, taking at least one dose in the evening.

I’ve adjusted few of my own medications from this list and noticed a marked difference in some symptoms.

My Hint: I now take my Statin drug for high cholesterol in the late evening and follow with 2 glasses of water. Previously, I’d had issues with severe toe cramps as the statin does not like a few of my COPD medications. But since taking at night and adding the water, I’ve had no cramps in several months.

I hope a few of these medications are on your list so you can give drug chrono therapy a try!

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