Timing can be crucial when it comes to taking medications, as some require specific scheduling around meals to maximize their effectiveness. While many drugs can be taken with minimal concern about meal timing, others are quite sensitive to whether your stomach is full or empty, which can significantly affect how well they are absorbed and utilized by the body.

Research has shown that the time of day can influence the effectiveness of certain medications, such as those for blood pressure. For example, these drugs may work best in the morning for individuals who are early risers, and in the evening for those more active at night. This finding highlights the importance of considering individual lifestyle patterns when planning medication schedules.

With over 30 million people taking medication daily, understanding when to take each one amidst often lengthy instructions can be overwhelming. Fortunately, emerging scientific studies and established knowledge about food and drug interactions offer guidance on this matter.

Chronotherapy, the study of how our body clock affects drug efficacy, suggests that aligning medication schedules with our biological rhythms—alongside determining the optimal timing in relation to meals—could be the key to enhancing the effectiveness of our medications.

But, an intriguing area of scientific research alongside long-proven effects of food-drug interactions, may provide the answer. 

Chronotherapy—the study of how the body clock impacts drug efficiency—is said to be the key to ensuring we get the best out of our pills, especially once we’ve worked out whether its best to take them before, with or after a meal.

One study found that patients who are ‘morning people’ could reduce their risk of heart attack by around 26 per cent by taking their blood pressure medication in the morning. 

Significantly, they increased their risk of heart attack if they took the drug in the evening—the opposite end of the day to their chronotype. 

So when is the best time to take your pills? 

Clinical trials have proved there is an optimal time of the day for certain medication 

Always on empty  

Food significantly alters the environment of the digestive tract, changing pH levels, delaying gastric emptying and ultimately reducing the bioavailability of certain medications.

For this reason, a lot of drugs should be taken on an empty stomach, at least 30 minutes to an hour before a meal, or two to three hours after eating. 

As prescribing pharmacist Ayesha Bashir explains: ‘Some medications need an empty stomach so nothing gets in the way. Food can slow them down, bind to them, or stop them from being absorbed at all, which means they may not work properly.’

One example of this is bisphosphonates, a widely prescribed drug used to treat osteoporosis, which works by slowing the rate that bone is broken down in the body. 

This helps to maintain bone density and reduce the risk of a broken bone—if taken on an empty stomach. 

According to the NHS, bisphosphonates should always be taken on an empty stomach with a full glass of water. GPs also recommend standing or sitting upright for at least half an hour after taking them to avoid indigestion.

The reason for this is because bisphosphonates, like alendronate or risedronate, have extremely low oral bioavailability meaning that even small amounts of calcium from food can almost completely block drug absorption. 

But if indigestion does strike, the most commonly prescribed anti-indigestion drug, omeprazole should also be taken on an empty stomach ideally 30 mins before eating. 

Preventable fractures as a result of osteoporosis are estimated to cost the NHS £4.5 billion each year, with one million hospital bed days taken up by hip fracture patients alone 

But, Dr Jarvis added: ‘If you’ve got heartburn rather than indigestion, that tends to be worse late at night when you lie down, you could take it half an hour before dinner or an empty stomach, so you have peak levels in your system when you go to bed and the acid will be most suppressed.’ 

Thyroid medications, like levothyroxine, should also always be taken on an empty stomach, around the same time each day if possible. 

Studies show that the body can absorb the drug far more efficiently when taken before any food has entered the digestive tract, whereas taking the pill with food can reduce bioavailability by up to 60 per cent.

With a meal 

Whilst some drugs are best taken on an empty stomach to help boost absorption, others can do serious harm to the stomach lining if taken on empty, increasing the risk of stomach ulcers, liver failure and kidney damage. 

Ibuprofen—taken by millions daily to treat everything from headache to fevers—is safe when taken correctly. 

But routinely taking the painkiller on an empty stomach can cause permanent liver and kidney damage. 

The danger with the ibuprofen and other non-steroidal anti-inflammatory drugs (NAIDs) comes from how they are processed by the body, irritating the stomach lining and increasing the risk of stomach ulcers. 

‘In some cases, this can lead to peritonitis,’ warned Dr Dean Eggitt, GP and CEO at Doncaster Local Medical Committee. 

Ibuprofen is taken by millions to reduce inflammation and ease pain, but Dr Eggitt warned that prolonged use could increase the risk of peritonitis 

Peritonitis occurs when the lining of the stomach becomes infected, which can be caused by routinely taking painkillers on an empty stomach. 

Left untreated, the condition can be life threatening.  

Taking certain medications with food can also help reduce side effects like nausea, dizziness, stomach upset and ulcers. 

This can also protect medications from being broken down in the stomach, before they reach the intestines where most absorption occurs.  

After dinner or before bed 

Some studies suggest that certain short-acting statins, like lovastatin, taken to combat high cholesterol, are best taken in the evening. 

High cholesterol causes fat to build up in the arteries, restricting blood flow. left untreated, it can raise the risk of heart attack, stroke, and even dementia. 

But taking potentially life-saving medication at the wrong time can render the drug almost ineffective.  

This is because statins tend to have a fairly short half-life. 

Most cholesterol in the blood comes from dietary fats, which are then converted into cholesterol by the liver. 

Therefore, taking statins at night can help supercharge the medication as this is when there is the most cholesterol in the bloodstream. 

Nearly eight million people in the UK are on statins but the drug is not without side effects

However longer acing statins, like atorvastatin, sold under the brand name Lipitor, can have a half-life of up to 19 hours, meaning that patients can choose which time of day suits them best. 

Blood pressure drugs are the most commonly prescribed medication in the UK, with as many as non million people receiving prescriptions for drugs including beta blockers, and ACE inhibitors. 

And recently, researchers from the University of Dundee found for the first time that a person’s chronotype—determined by the time they wake up and go to sleep—impacts the efficacy of their blood pressure medication. 

However, some patients may experience dizziness after taking their first dose, as drugs like ACE inhibitors work by relaxing the blood vessels, so it’s usually recommended take the first dose at bedtime. 

Betablockers similarly can make users feel dizzy, as they work by slowing down the heart, so again GPs may recommend starting by taking the drug in the evenings.