Spacing medications

[Wenben]

I know I have read on here before about the best way to space medications throughout the day but can't seem to find it now.

I have had an irritable hard cough for years (unproductive and not chesty). This year it seems to be worse and of late has become quite troublesome. GP has suggested it could be due to acid reflux and so I have agreed (reluctantly) to give Omeprazole a try.

I take thyroxine first thing and Pred after breakfast. Never quite sure then how to manage the other meds.......Atenolol and Bendroflumiazide for BP, Calcium and Vit D, and now Omeprazole.

I know this has been answered before but can anyone remind me please? Many thanks

[SheffieldJane]

The Omeprazole should be taken first thing before the Pred which should be taken as early as possible. I am taking it between 2 and 3 am with a banana and a glass of milk. I am on 7 mgs and so far this all seems better. I sleep well and don't feel ill in the proper morning, which I used to do.

Thyroxine should be taken on an empty stomach ( only found that out on here after 30 years of taking it) so I take that before breakfast with Atenolol. I expect your other blood pressure med would be alright after breakfast. Then take your Calcium and vit D with lunch ( it needs to be well away from Pred). Some say it aids restful sleep so you could take it in the evening.

I am sure someone will give you their view in a nice little chart. I need the narrative.

[Wenben in reply to SheffieldJane]

Thankyou

[DorsetLady PMRGCAuk volunteer]

Hi,

Are you sure the cough isn’t related to the BP medication? I used to have a niggly cough that was a nuisance more than anything and put it down to Ramipril (another BP tablet) but strangely enough since I stopped the Atenolol and just have Ramipril it seems to have disappeared!

I would take Omeprazole & Thyroxine first thing, then Pred & BP tablets after/with breakfast, VitC Calcium lunch time (and before evening meal if you take it twice a day).

[Wenben in reply to DorsetLady]

Thankyou DL for the meds info - that is very helpful. I have taken Atenolol for a very long time and I have had a cough for a very long time (or so it seems) but I can't remember if it came together. I have asked GP this question and she said Atenolol was not one of the BP meds which causes cough but I really have my doubts about that and wonder if it could be related.

[DorsetLady PMRGCAuk volunteer in reply to Wenben]

Maybe, I don’t think they always know the full implication of all drugs - and you can’t expect that.

Just my experience which I thought might interest you.

[PMRpro Ambassador in reply to Wenben]

" she said Atenolol was not one of the BP meds which causes cough"

Really? The Mayo Clinic thinks it can cause cough. And cough starting soon after starting a beta-blocker of any sort may be cough-variant asthma,

[Wenben in reply to PMRpro]

Thanks, that's really interesting. Have never heard of cough-variant asthma. I had discounted asthma firstly because I don't cough at night and secondly because I thought I had read that it was treated with prednisolone. However, despite what GP says, I am beginning to think the Atenolol may well be responsible.

[PMRpro Ambassador]

The basic rule is not to mix pred and calcium - 2-3 hours between is advised.

Thyroxine CAN be taken at night if it makes the rest of the performance easier.

thyroid.org/patient-thyroid...

What is important is that it is always taken at the same time.

Ask a pharamcist for interactions - although in hospital they usually just throw everything at you and tell you to take it...

[Wenben in reply to PMRpro]

Thankyou. I have printed the thyroid info for a friend who also takes iron and is having problems. I think she will find it very interesting.

[Marijo1951]

Another reason to be grateful for this forum: nobody (i.e. no doctor) has ever told me not to take my calcium supplement at the same time as pred. So far I've merrily been taking both in the morning with breakfast. I change from today and I'll try to remember to mention this to my rheumy when I see her in December.

[piglette in reply to Marijo1951]

It is printed on my vit D and calcium pack by the pharmacy that I should not take them at the same time as steroids and to leave at least two hours in between.

[PMRpro Ambassador in reply to piglette]

Most pharamcists seem aware - but there are a few who aren't. I wish I knew why it is so patchy.

[Wenben in reply to piglette]

Thankyou

[Wenben in reply to piglette]

Just checked my pack. Definitely nothing mentioned about steroids - just says take one in the morning and one at night. If it wasn't for this site I would probably be taking them all together. GP didn't say anything either !

[Wenben in reply to Marijo1951]

I couldn't agree more. I have learned so much from this forum and am so thankful I found it.

[sondya]

I throw the lot down at the same time! But, there is separation in timing. Prednisone, Omneprazole and aspirin in one go (whatever time I remember to, usually before lunch), multivitamins and magnesium at night. Fozamax (Vit D) weekly which is a pain as it has to be first thing in the morning, with no body bending or lying down or food for 30 mins and that really upsets my sitting on the deck with a cup of coffee, listening to the dawn chorus and watching the sun rise! My doc was unmoved by my petulance, looked at me over the top of spectacles with 'honestly, Sandy, get over it'. And we laughed.

[PMRpro Ambassador in reply to sondya]

Fosamax isn't vit D - and do you NEED it? I haven't and my bone density has remained at a perfectly acceptable level for over 7 years! Despite pred. But then - I suppose I don't take omeprazole and that can cause osteoporosis all on its ownsome...

[sondya in reply to PMRpro]

Oh. I get it now . . .

What FOSAMAX PLUS is used for

-------------

FOSAMAX PLUS is used for the treatment of osteoporosis in select patients where vitamin D supplementation is recommended.

Probably don't need it. But then I didn't need GCA either and old rules don't apply anymore. My doc pointed out that it costs the (NZ) govt's pharmaceutical arm $500 for the drug but thanks to her 'registration', I get it for $5. Always liked a bargain! But seriously, rheumatologist and GP have been so helpful, so spot on with advice and treatment I don't feel the need to change their recommendations.

[Joydeck in reply to sondya]

Since pred and aspirin both attack the stomach lining, I take aspirin after lunch.