[China Pharmaceutical Network Health Health] The way of taking oral drugs, the combined use of foods and drinks can affect the bioavailability of drugs and affect the efficacy of drugs. Therefore, it is very important to master the method of maximizing drug efficacy.
5 key points that you must use to maximize your efficacy
The absorption of oral drugs is affected by many factors such as drug solubility, dissolution, dissociation mucosal permeability, first-pass effects, and physiological factors such as the gastrointestinal tract. The way of taking it, the foods and drinks taken together can affect the bioavailability of the drug and affect the efficacy. Therefore, the use of oral drugs needs to be considered in many aspects.
1. Effects of eating on oral drug absorption
The interaction between drugs and food is mainly manifested in:
(1) The pH value of the gastrointestinal tract can be affected by eating. When the human body is fasting or not eating, the proton pump is in reserve state, and the pump acid activity is weak. Eating can promote the reserve state proton pump, that is, the "resting proton pump" enters the endocrine membrane. When activated, it becomes an "active proton pump" and the pH of the gastrointestinal tract is lowered. Therefore, the protection of gastric mucosal drugs and proton pump inhibitors should be taken before meals;
(2) Eating can prolong the time of the drug in the gastrointestinal tract, and the enteric drug may be released in advance, so the enteric drug should be taken before the meal;
(3) The oil in the food is beneficial to the absorption of fat-soluble drugs, which can increase the bioavailability, but it will also increase the effect of food on the blood concentration; (4) If the gastrointestinal tract is more irritating, the food can be eaten. Take to reduce adverse reactions;
(5) For example, gastrointestinal motility drugs and compound digestive enzymes, hypoglycemic agents, etc. should be taken before meals.
Table 1 Common oral drugs related to eating
2. Interaction of pharmaceutical dosage forms with food
Feeding affects the absorption of the suspension, so that the peak time is delayed; but eating can increase the absorption of the long-acting sustained-release tablets, so that the absorption is significantly increased, and the peak concentration is increased. Therefore, the suspension dosage form should be taken 1 hour before the meal or 2 hours after the meal. The long-acting sustained-release tablets should be taken at the time of eating or within 1 hour after the meal. When eating a tablet (capsule), only the peak concentration is slightly decreased, and it can be taken on an empty stomach or taking a small amount of food in advance to reduce the gastrointestinal reaction.
3. How to take medicines
According to the prescribed dose, take the sitting position or standing posture to take the medicine, it is better to take the warm water (about 100 ~ 200 mL), the capsule needs at least 300 mL water to take the service. (1) Do not smash the tablets, open the capsules, or dissolve the drugs with water;
(2) can not take medicine (the drug is easy to adhere to the esophageal wall);
(3) Do not use milk, juice, tea, cola and other beverages to take the drug.
Use juice or acid beverage to take antipyretic analgesics such as compound aspirin and berberine and acetylspiramycin, which will accelerate drug dissolution and damage gastric mucosa. In severe cases, it may cause gastric mucosal bleeding; Neutralization of acid and alkali will completely invalidate the drug; delivery of sulfa drugs such as compound sulfamethoxazole will reduce the solubility of the drug and cause urinary calculi.
Tea is used to treat anemia of iron, and tannic acid in tea is combined with iron to reduce the effect. For special preparations such as syrup, especially cough syrup, it is necessary to cover the surface of the inflamed pharyngeal mucosa to form a protective film to reduce mucosal inflammation, block stimulation, and relieve cough. Therefore, it is recommended to drink syrup within 5 minutes. Do not drink water.
In addition, there are five types of drugs that can not be served with hot water (greater than 40 ° C), respectively: digestive drugs (pepsin mixture, trypsin, multi-enzyme tablets, yeast tablets, etc.), vitamin C, cough syrup, Contains active fungi preparations and live vaccines.
4. Interaction between drugs
Proton pump inhibitors (PPI) can increase the pH value in the stomach, so that the antibacterial drugs can exert the maximum bactericidal effect. Therefore, it is recommended to take PPI before meals and take antibiotics after meals.
Antibacterial drugs can kill the beneficial bacteria in the live bacteria preparation, and the montmorillonite powder can adsorb the live bacteria and cause it to be discharged from the body and fail. A larger amount of water to be delivered will cause the montmorillonite to lose its adsorption capacity, so it should be taken at intervals when used at the same time.
5. Taboos during medication
Do not drink alcohol during the period of taking cephalosporins, barbiturates, nitroimidazoles and within one week of withdrawal, to avoid the occurrence of disulfiram reaction. Some tinctures, alcohol-containing preparations in combination with the above drugs can also cause a disulfiram reaction.
Avoid taking grapefruit juice during the antihypertensive drugs and anti-angina drugs, and avoid foods with high salt content. Naringenin in grapefruit juice can affect the action of certain enzymes in the liver. For example, felodipine, a grapefruit juice can increase the plasma concentration of felodipine by 134%. Excessive salt can cause blood pressure to rise and weaken the efficacy of antihypertensive drugs.
When taking antidepressants, furazolidones, antituberculosis drugs, and antineoplastic drugs, avoid tyramine-containing foods such as cheese, banana, avocado, soy milk, and beer. Antidepressants (monoamine oxidase inhibitors) react with tyramine to produce norepinephrine, which causes abnormally elevated blood pressure, causing nausea, vomiting, abdominal pain, diarrhea, difficulty breathing, dizziness, and headache. Furazolidone, some anti-tuberculosis drugs (such as isoniazid), and anti-tumor drugs (such as procarbazine) also contain monoamine oxidase inhibitors.
Do not smoke within 30 minutes after taking the drug. Nicotine (nicotine) in the smoke can enhance the activity of liver oxidase, accelerate the metabolism and clearance of the drug in the liver, and reduce the efficacy or side effects.
During the calcium supplement, do not eat foods rich in oxalic acid, such as boca, tea, almonds and so on. Because oxalic acid binds to calcium in the small intestine, it produces insoluble substances that cannot be absorbed, and can form stones while hindering the absorption of calcium. During the use of iron supplements, avoid excessive movement, vegetable oils, to prevent oil from inhibiting gastric acid secretion, affecting the conversion of ferric ions into divalent iron, and reducing the effect of iron supplementation. During the period of taking iodine supplements, avoid eating bohai, peach, pear, etc. These foods will prevent iodine from entering the thyroid gland.
5 key points that you must use to maximize your efficacy
The absorption of oral drugs is affected by many factors such as drug solubility, dissolution, dissociation mucosal permeability, first-pass effects, and physiological factors such as the gastrointestinal tract. The way of taking it, the foods and drinks taken together can affect the bioavailability of the drug and affect the efficacy. Therefore, the use of oral drugs needs to be considered in many aspects.
1. Effects of eating on oral drug absorption
The interaction between drugs and food is mainly manifested in:
(1) The pH value of the gastrointestinal tract can be affected by eating. When the human body is fasting or not eating, the proton pump is in reserve state, and the pump acid activity is weak. Eating can promote the reserve state proton pump, that is, the "resting proton pump" enters the endocrine membrane. When activated, it becomes an "active proton pump" and the pH of the gastrointestinal tract is lowered. Therefore, the protection of gastric mucosal drugs and proton pump inhibitors should be taken before meals;
(2) Eating can prolong the time of the drug in the gastrointestinal tract, and the enteric drug may be released in advance, so the enteric drug should be taken before the meal;
(3) The oil in the food is beneficial to the absorption of fat-soluble drugs, which can increase the bioavailability, but it will also increase the effect of food on the blood concentration; (4) If the gastrointestinal tract is more irritating, the food can be eaten. Take to reduce adverse reactions;
(5) For example, gastrointestinal motility drugs and compound digestive enzymes, hypoglycemic agents, etc. should be taken before meals.
Table 1 Common oral drugs related to eating
2. Interaction of pharmaceutical dosage forms with food
Feeding affects the absorption of the suspension, so that the peak time is delayed; but eating can increase the absorption of the long-acting sustained-release tablets, so that the absorption is significantly increased, and the peak concentration is increased. Therefore, the suspension dosage form should be taken 1 hour before the meal or 2 hours after the meal. The long-acting sustained-release tablets should be taken at the time of eating or within 1 hour after the meal. When eating a tablet (capsule), only the peak concentration is slightly decreased, and it can be taken on an empty stomach or taking a small amount of food in advance to reduce the gastrointestinal reaction.
3. How to take medicines
According to the prescribed dose, take the sitting position or standing posture to take the medicine, it is better to take the warm water (about 100 ~ 200 mL), the capsule needs at least 300 mL water to take the service. (1) Do not smash the tablets, open the capsules, or dissolve the drugs with water;
(2) can not take medicine (the drug is easy to adhere to the esophageal wall);
(3) Do not use milk, juice, tea, cola and other beverages to take the drug.
Use juice or acid beverage to take antipyretic analgesics such as compound aspirin and berberine and acetylspiramycin, which will accelerate drug dissolution and damage gastric mucosa. In severe cases, it may cause gastric mucosal bleeding; Neutralization of acid and alkali will completely invalidate the drug; delivery of sulfa drugs such as compound sulfamethoxazole will reduce the solubility of the drug and cause urinary calculi.
Tea is used to treat anemia of iron, and tannic acid in tea is combined with iron to reduce the effect. For special preparations such as syrup, especially cough syrup, it is necessary to cover the surface of the inflamed pharyngeal mucosa to form a protective film to reduce mucosal inflammation, block stimulation, and relieve cough. Therefore, it is recommended to drink syrup within 5 minutes. Do not drink water.
In addition, there are five types of drugs that can not be served with hot water (greater than 40 ° C), respectively: digestive drugs (pepsin mixture, trypsin, multi-enzyme tablets, yeast tablets, etc.), vitamin C, cough syrup, Contains active fungi preparations and live vaccines.
4. Interaction between drugs
Proton pump inhibitors (PPI) can increase the pH value in the stomach, so that the antibacterial drugs can exert the maximum bactericidal effect. Therefore, it is recommended to take PPI before meals and take antibiotics after meals.
Antibacterial drugs can kill the beneficial bacteria in the live bacteria preparation, and the montmorillonite powder can adsorb the live bacteria and cause it to be discharged from the body and fail. A larger amount of water to be delivered will cause the montmorillonite to lose its adsorption capacity, so it should be taken at intervals when used at the same time.
5. Taboos during medication
Do not drink alcohol during the period of taking cephalosporins, barbiturates, nitroimidazoles and within one week of withdrawal, to avoid the occurrence of disulfiram reaction. Some tinctures, alcohol-containing preparations in combination with the above drugs can also cause a disulfiram reaction.
Avoid taking grapefruit juice during the antihypertensive drugs and anti-angina drugs, and avoid foods with high salt content. Naringenin in grapefruit juice can affect the action of certain enzymes in the liver. For example, felodipine, a grapefruit juice can increase the plasma concentration of felodipine by 134%. Excessive salt can cause blood pressure to rise and weaken the efficacy of antihypertensive drugs.
When taking antidepressants, furazolidones, antituberculosis drugs, and antineoplastic drugs, avoid tyramine-containing foods such as cheese, banana, avocado, soy milk, and beer. Antidepressants (monoamine oxidase inhibitors) react with tyramine to produce norepinephrine, which causes abnormally elevated blood pressure, causing nausea, vomiting, abdominal pain, diarrhea, difficulty breathing, dizziness, and headache. Furazolidone, some anti-tuberculosis drugs (such as isoniazid), and anti-tumor drugs (such as procarbazine) also contain monoamine oxidase inhibitors.
Do not smoke within 30 minutes after taking the drug. Nicotine (nicotine) in the smoke can enhance the activity of liver oxidase, accelerate the metabolism and clearance of the drug in the liver, and reduce the efficacy or side effects.
During the calcium supplement, do not eat foods rich in oxalic acid, such as boca, tea, almonds and so on. Because oxalic acid binds to calcium in the small intestine, it produces insoluble substances that cannot be absorbed, and can form stones while hindering the absorption of calcium. During the use of iron supplements, avoid excessive movement, vegetable oils, to prevent oil from inhibiting gastric acid secretion, affecting the conversion of ferric ions into divalent iron, and reducing the effect of iron supplementation. During the period of taking iodine supplements, avoid eating bohai, peach, pear, etc. These foods will prevent iodine from entering the thyroid gland.
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