Dear Pharmacist,

What does it mean when it says "take on an empty stomach" or "take with food" because I never adhere to those warnings and I'm still alive. Does it really matter?

—J.J., Denver, CO

Answer: It matters in most cases, but not all. With antibiotics, it may be that your medicine reaches a higher blood level when you take it on an empty stomach, but over the course of therapy, it doesn't change the outcome, meaning the pathogens are killed. With other medications, for example sleeping pills, a warning to avoid alcohol is important and should be adhered to because the combination could be fatal. Same thing with certain antidepressants (MAO inhibitors) that can't be combined with cheese, or death could result. For your safety, let me give you the proper questions to ask your doctor and/or pharmacist:

  1. What is the name of the condition that you are treating me for?
  2. What is the brand name and generic name of the medication that you're prescribing?
  3. Do I take it in the morning, or at night, or divide the dose throughout the day?
  4. Better with food or empty stomach?
  5. About how long before I begin to see results?
  6. Is there a less expensive generic alternative?
  7. Are there any supplements that could help this medicine work better, or any to avoid?
  8. Is it okay to drink wine (if that applies) with my medicine?
  9. Will coffee, dairy or mineral supplements inactivate my medicine?
  10. How long do I stay on this medication? Some medications are only intended for a few days or weeks, but people remain on them indefinitely. This is the most important question to ask.

If the caution label states "on an empty stomach" that means 2 hours after you eat, or 1 hour beforehand. If it states "take with food" it means to take it while eating or right after. If it says "do not operate machinery or equipment …" that is your clue that your medicine makes you drowsy or clumsy. It means to avoid driving, using a chainsaw, mowing your lawn or anything that requires you to focus.

Here's another good rule of thumb: Start low and go slow! With medications, the lowest effective dose is ideal. You don't need to kill a fly with a shotgun and if you try, you could wind up with side effects that you would not experience with a lower dose. And finally, if you notice your medication keeps you up at night, then don't take it too late in the day. Examples of medicines that are best taken in the morning include thyroid medicine, steroids like prednisone, attention-deficit drugs like Ritalin or the fatigue buster Provigil. Examples of medicine that should be taken at night include certain antihistamines (like diphenhydramine), anxiolytics like alprazolam, pain medicines like hydrocodone and muscle relaxers. If in doubt, call your local pharmacist or physician.

Suzy Cohen

Suzy Cohen, is known as America’s Pharmacist. She has been a licensed pharmacist for 24 years and is a Functional Medicine practitioner. She’s the author of 6 books, including her most recent Amazon #1 best-seller, “Thyroid Healthy: Lose Weight, Look Beautiful and Live the Life You Imagine.”

She was the host of The Thyroid Summit which broadcast worldwide in June 2014. Suzy has been a syndicated columnist for 19 years reaching 20 million in circulation each week. She is a Huffington Post writer, and also hosts her own syndicated medical minute on TV. Suzy has been featured on The Dr OZ Show 6 times, and has appeared on The View, Good Morning America Health, The Doctors and hundreds of other networks. She is a member of The Institute of Functional Medicine, also the American Academy of Anti-Aging Medicine, The American Pharmacists Association and ILADS, the International Lyme and Associated Diseases Society. You can read free articles and receive your free newsletter by visiting her website, SuzyCohen.com

Books authored by Suzy Cohen include:

  • Thyroid Healthy
  • Headache Free
  • Drug Muggers
  • Diabetes Without Drugs
  • The 24-Hour Pharmacist
  • Eczema: Itchin’ for a Cure (kindle only)
  • Understanding Pancreatitis & Pancreatic Cancer (kindle only)