by Michael R. Cohen
Do you know how much water or other fluid should be taken with medicines that are swallowed? Our colleagues at ISMP Canada recently tackled this question in their consumer publication, Safe Medicine Use.
For some medicines, a small sip may not be enough. The amount and type of fluid that is best for you will depend on the properties of your medicine and on the particular diseases or conditions that you have.
Water helps medicine pass from your mouth to your stomach and small intestine and to be absorbed to give the desired action. Swallowing medicines without enough water may prevent the medicine from acting properly and may even lead to undesired side effects in some cases.
One example is the class of drugs known as nonsteroidal anti-inflammatory agents (NSAIDs). Some commonly used NSAIDs are acetylsalicylic acid (also called ASA or Aspirin), ibuprofen, and naproxen. Taking NSAIDs without enough liquid, or taking them on an empty stomach, can increase your chances of experiencing irritation of the esophagus or stomach or even ulcers.
Another example is a class of drugs called bisphosphonates, which are used to treat or prevent osteoporosis. These medicines are usually taken on an empty stomach. To reduce your risk of experiencing irritation of the esophagus, it's important to take these medicines with plenty of water, and to avoid lying down for at least half an hour after taking them.
The amount of water needed can also depend on the dosage form. For example, you may need to swallow more water with a large tablet or capsule than with a small tablet or a liquid medicine.
Here are some important points to remember:
- Always carefully read the label of your medicine and any information that comes with it. Find out how much water you need to take with your medicine. The right amount of water for you will depend on which medicines you are taking and the medical conditions that you have. If you are not sure how much water you should drink, ask your pharmacist or other healthcare provider.
- Be sure you know what fluid you should take with your medicine. Milk, fruit juices, or food can affect the absorption and action of some medicines. Most medicines are best taken with plain water, but there are exceptions. If one of your medicines needs to be taken with milk, fruit juice, or food, you may need to take this medicine at a different time than your other medicines. Your pharmacist can help you to develop a schedule to be sure you are taking all of your medicines properly.
- If you are having a medical procedure, eating food or drinking water beforehand may be dangerous. Therefore, you may be told not to eat or drink anything for a specified period before the procedure. If you have been told not to eat or drink anything, be sure to ask your healthcare provider what to do about taking your medicines. In some cases, it may be safe to take your medicines with a small sip of water. In other cases, you may be given your medicines by a different route, or you may be told to delay taking your medicines until you are able to drink water. The specific directions for you will depend on which medicines you are taking and your individual health issues.
- If you are in hospital or confined to bed, sit up when swallowing medicines, if you are able to do so safely. If you feel that a caregiver has not given you enough water with your medicine, don’t hesitate to speak up and ask if you can have more water.