How much food is necessary to buffer the stomach when taking medicine?

Question

Very often, doctors or pharmacists will advise patients to take certain pills with food to "act as a buffer" so the patient is less likely to get a stomach ache from taking the pill.How much food is necessary to act as a buffer to protect the stomach?Some doctors claim that a couple of crackers are sufficient, whereas other doctors claim that you need to eat an entire meal.So what's the truth? And what are the best foods to eat (or drink) for this purpose?

Answer 1

The answer to this question is it depends on the situation. The reason for taking food with certain drugs can be for a few reasons: (1) helping to curb side effects as mentioned such as a stomach ache, (2) delay rapid absorption of a particular drug, (3) delayed/slow release of a drug to provide longer coverage of the drug throughout the day. There may be more, but these are the few that come to mind. The amount of food can vary as well. Typically if it's related to curbing side effects such as a stomach ache, a few crackers to a full meal is generally okay (assuming no drug-food interactions). If it's related to absoprtion of a drugs to maintain an adequate drug level in the body, some drugs require taking with a full meal or a meal that may be high in fat. An example of taking a medication with a high fat meal would be rilpivirine (an antiviral medication used in combination with other medication for HIV treatment).

On the contrary, there are drugs that interact with certain foods. An example would be an antibiotic called ciprofloxacin and milk. The calcium within milk can cause ciprofloxacin to chelate or bind to the calcium and inactivates the antibiotic, making it ineffective. There are other foods that interact with the enzymes in your body which subsequently affect how a drug is metabolized in your body and can cause side effects. An example would be a cholesterol medicine called atorvastatin with grapefruit juice. Grapefruit juice blocks/inhibits an enzyme in your body (CYP3A4) from working to metabolize drugs such as atorvastatin. This means atorvastatin would accumulate more rapidly in the body and can potentially lead to more toxic levels and can lead to a serious life-threatening condition called rhabdomyolysis.

If you have specific questions about a particular drug, always consult your doctor or pharmacist first prior to taking the drug.