Getting the most out of your medicines while minimizing side effects
Physician's Weekly
November 14, 2023

Getting the most out of your medicines while minimizing side effects

It is imperative that you fully appreciate the dos and don’ts of any medicine that you may use.

Both prescription and over-the-counter. Irrespective of the route that the medicine is administered or used, a medication needs to be taken correctly for it to be maximally effective and to minimize its potential side effects.

Correct way of taking the most commonly used pain medicines:

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Examples of NSAIDs include asprin, diclofenac, ibuprofen, Voltaren, Cataflam, Ponstan, Naprosyn, naproxen, Aleve, indomethacin, Celebrex, Mobic, etc. In order to reduce the chances of stomach irritation, stomach ulcers, and stomach bleeds these should always be taken with a meal and must never be taken on an empty stomach.
  • Paracetamol: Many foods, in particular foods high in pectin (e.g. guavas, plums, citrus fruits, and apples), carbohydrates (e.g. bread, pasta, macaroni, ground provisions), and cruciferous vegetables (e.g. callaloo, cabbage, broccoli, cauliflower, kale, watercress, Brussel sprouts, Chinese cabbage, and others) can interfere with paracetamol’s absorption. So it is highly recommended that paracetamol or any of its forms, (e.g. Panadol, Tylenol, or acetaminophen) be taken on an empty stomach.

Medicines That Should Be Taken On An Empty Stomach

For the best results, the following commonly taken medicines should be ingested on an empty stomach: amlodipine, ampicillin, azithromycin, bisacodyl, captopril, cloxacillin, ciprofloxacin, Floxin, levothyroxine, loratadine, metoclopramide, propranolol, proton pump inhibitors (e.g. Nexium, omeprazole, pantoprazole, lansoprazole), sotalol, sucralfate, sulfonamides (e.g. Bactrim, Septra, sulfatrim, etc.), tetracycline.

Medicines That Should Be Taken With Food

These are some medicines that are best taken with food to improve their effectiveness and or to reduce their side effects: allopurinol, amiodarone, antacids, augmentin, bromocriptine, carbamazepine, CBD, carvedilol, Daonil, dexamethasone, Diamicron, digoxin, erythromycin, glipizide, Januvia, ketoconazole, mebendazole, metformin, nitrofurantoin, potassium, prednisone/ prednisolone, metronidazole, nifedipine, sodium valproate, spironolactone, zinc.

Alcohol needs to be avoided if taking any of the following medications

  • Paracetamol.
  • Sleep medications e.g. Ambien.
  • Anti-anxiety medications – Ativan, lorazepam, Valium, diazepam, Xanax, alprazolam.
  • Antidepressants/ antipsychotics.
  • ADHD medications – Adderal, Ritalin, Methylphenidate.
  • Certain antibiotics – Azithromycin, Erythromycin, Metronidazole, Sulfonamides.
  • Opioid pain medicines.
  • NSAIDs.
  • Diabetes medications.
  • Warfarin (Coumadin).
  • Over-the-counter cold and flu medications.
  • Erectile dysfunction medicines – Viagra, Levitra, Cialis.

Grapefruit and its juice need to be avoided if you are taking

  • Amlodipine, nifedipine, buspirone, Cilias, Levitra, Viagra, amiodarone, Allegra, verapamil, rosuvastatin, simvastatin, and atorvastatin.

Dairy products should be avoided if you are taking

  • Dairy products (e.g. milk, yogurt, or cheese) reduce the absorption of iron supplements, Fosamax, and certain antibiotics – cipro/ ciprofloxacin, levofloxacin, and tetracyclines (e.g. minocycline, doxycycline). Dairy products could reduce the efficacy of antacids.

If taking warfarin (coumadin) the following must be absolutely avoided

  • Callaloo, spinach, parsley, cabbage, lettuce, kale, broccoli, green onions, cauliflower, Chinese cabbage, cranberry juice, alcohol, ginseng, ginkgo, seaweed, soy, chamomile tea, green tea, grapefruit juice and NSAIDs.

Medications that are most effective if taken at night

  • Blood pressure medicines
  • Cholesterol-lowering medicines

Other important points regarding the taking of medicines

  • Let your doctor and pharmacist know about any allergies.
  • For the rapid onset of a medicine’s action (e.g. pain relief, erectile dysfunction), you should lie on your right side for 30-45 minutes immediately after taking it.
  • One can become dependent on benzodiazepines (e.g. alprazolam, diazepam, lorazepam) in as little as 3 weeks.
  • Patients with liver or kidney disease should ask their doctor if their medication’s dose needs to be adjusted
  • Report immediately suspected medication side effects to your doctor and or pharmacist.
  • Medicines should be taken exactly as prescribed.
  • Some generic brands of medications are substandard.
  • Store your medicines properly and out of the reach of children.
  • Check for the expiration date for any medication that you are taking
  • When taking multiple medications it is best to get all your medicines from one pharmacy to minimize the chances of drug interactions.
  • If on many different types of medication, getting a pill organizer is recommended.
  • You should check with your doctor or pharmacist before stopping any medication.
  • Check with your pharmacist to see if there is a less expensive but similarly effective alternative to the original brand.
  • If you are on medication, before taking or continuing with a supplement check with your doctor or pharmacist.
  • Always have an up-to-date list of all medicines and respective doses, that you are currently taking.
  • Take your medicines along to every doctor’s visit.
  • Remember to pack your meds when travelling.
  • Insulin does not lose its effectiveness if stored or transported at room temperature.


In closing

By taking your medicines correctly, you are ensuring that:

  • They are maximally effective and have little to no side effects
  • You recover in the shortest possible time frame from any acute illness being treated
  • Potential complications from your chronic illness(es) are minimized
  • You improve your overall health and well-being.


Author: Dr. C. Malcolm Grant – Family Physician – Family Care Clinic, Arnos Vale – Former Tutor, Faculty of Medical Sciences, UWI, Cave Hill, Barbados. For appointments: clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.