Gaps between medications

Hi guys,

I have been reading all your notes today, as I do every day. But I was a bit shocked to read about leaving gaps in between the different drugs.

I take Lansoprazol at 6.30am for my stomach, then about 9.15am I am taking pred, enantyum (liquid anti-inflammatory), Natecal D for the calcium. I take these all at the same time and a bone tablet once a week. But I read that there should be a gap between them. I have a job remembering to take them all in one go.

So, please can you give me a rough timetable for when the best times are to be taking them.

Best regards


7 Replies

  • Hi Buenavista,

    Like you I take all my medication together, apart from AA days when Cal D is later. I take usual GCA culprits as well as blood pressure controlling tabs and statins.

    I have never been told not to take them all together, nor does the patients leaflets for them say they shouldn't be taken (apart from aspirin).

    As I have been taking Pred for a year now, I guess it's not doing any harm, but is it doing as much good as it should?

    Where is everybody getting their advice about differing times? Is it medical advice or just hearsay.

    Please advise, life's complicated enough without having to turn taking tablets into a military operation.

    Dorset Lady

  • Hello both

    It is generally recommended to leave a few hours between taking Prednisolone and calcium supplements as Pred can decrease the absorption of calcium by increasing its elimination. Some people take their Pred at breakfast, then their calcium with lunch and evening meals.

    runrig gave a useful website to check interactions between medications over on another thread and it might be helpful to quote it again here:

    Don't worry - you haven't done any harm but I guess if you need to take calcium supplements then it's best to take them in the most effective way.

  • Hello Buenavista,

    I think perhaps you should have a medication reveiw & discussion with your pharmacist.

    Ideally preds should be taken with food as early as possible in the mornng - to help avoid insommnia which affects many people taking preds & because the early morning hours are when your own body would be naturally secreting if you weren't on preds.

    Steroids & Calcium supplements should be taken at least 2 hours apart as steroids interfere with calcium absorbtion. Calcium & Vit D should be taken with food or something containing a little fat e.g. tea/coffee with milk in it, as Vit D is fat soluble & needs fat to be absorbed.

    Non steroidal anti- inflammatory drugs - Ibuprofen, Naproxen, Aspirin, the one you mentioned, are definitely not advisable for people taking steroids (and for people taking the weekly 'bone tablet'). They dramatically increase risk of gastric probems & oesophageal problems.

    Dorest Lady, the best time to take statins is at bedtime as we naturally produce cholesterol during the night - it doesnt matter if you take at a different time of day but bedtime is when they would benefit you most.

    Lansoprazole should be taken on an empty stomach/ half hour before food.

    Yes, it definitely is a military operation & as much as I didn't want to use one, I could not manage it without a tablet dosset box.

    Hope this helps, but definitely worth discussing with your pharmacist.


  • Meggies,

    Thanks for above. I do take the statin at 1800. I was already on low dose aspirin, and in the Guidelines for the management of GCA it does state that low dose aspirin should be considered in patients with GCA, so I guess that's why my GP left me on them. However I will check timings.

    I think my lack of information comes from the fact that GCA was diagnosed in A&E after loss of sight by Ophthamologist, and he just wanted to get me on highest dose to save the other eye. I only saw him twice after that and was then referred back to GP, who has very little knowledge of GCA (she missed the symptoms initially) and although is very keen to do all she can now, it seems to be me advising her rather than the other way around.

    I have seen Rheumatologist once to ascertain whether I had PMR as well, but he wasn't really interested. All he wanted to do was give me a cortisone injection for osteoarthritis. As I have a good relationship with pharmacist, I'll take your advice and talk to her.

    Many thanks, Dorset Lady

  • Thanks Celtic, Maggies and Dorset Lady,

    Really appreciate all your replies. I have learnt a lot today. But goodness only knows how I am going to remember when to take them with my vacant head.

    Is there any chance you could send me a reminder each time I need to take a tablet. Ha ha only joking.

    Many thanks


  • Hi every one . Like you Buenvista I have been taking all my meds together and was really shocked to hear that you should not do so. I have PMR and take steroids. I also have Angina so take a lot of meds for that, also Lansoprazole for my stomach. I also take oral Morphine for severe pain when I have a bad flare. I will be talking to my pharmacists as well. Thank you all for the advise. Cynbil

  • Update on above question.

    Spoke to pharmacist, as far as she knows through her paperwork etc, the only tablets that shouldn't be taken together are Alendronic Acid and Calcium/Vit D. Leave 4 hours between. All others are okay to take together. If anyone has any differing information please advise where it comes from. Thanks. Dorset Lady

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