Is it best to take your medication in the evening or the morning? Is it best before or after food? If you are taking several medications, is it best to take them all at once or space them out?
The instructions which come on a box of pills are often something vague like:
“Take one daily”
That leaves a lot of room for interpretation. In most cases, I’m pleased to report that this is because the time when you take a medication doesn’t seem to make a great deal of difference. However, there are a few things worth considering.
Time of day
Most once daily blood pressure medications are advised to be taken in the morning. Most of us are up and about in the daytime. Our bodies therefore respond to this by increasing our blood pressure to enable us to function normally. Taking medication in the morning should theoretically therefore have a greater influence over this time when blood pressure is likely to be higher.
Secondly, the diuretic class of medication for high blood pressure can make people pass more urine (at least when it is first taken). This tends to be least troublesome in the morning and is certainly rarely welcome overnight!
The medications which are the exception to this advice are ACE inhibitors (e.g. ramipril, enalapril, lisinopril, perindopril) and A2RBs (e.g. losartan, irbesartan, candesartan). When these are first started they can cause a significant drop in blood pressure, especially when stood up. For this reason, people often start taking these medications before bed. However, after a few weeks it is usually fine to switch to taking them in the morning as that effect tends to be short-lived.
Before or after food?
Some medicines are recommended to be taken with or after food. This is sometimes because they would otherwise irritate an empty stomach. Sometimes it is because they are being taken to help with digestion.
In the case of blood pressure medications they are best taken when the stomach is empty. That is because none of them are considered to be particularly irritating to the stomach. Also, having an empty stomach gives them the best chance of being absorbed into your body and getting to work. An empty stomach is considered to be at least an hour before eating or two hours after eating.
All at once or spread out?
We know that some people who have to take more than one medication choose to spread them out over the day. As far as we know, there is no advantage to doing this with blood pressure medication. They can be taken together safely and that means you can get on with the rest of your day and forget about them!
When I’m measuring my blood pressure, should I take my medication first?
A good way to get an accurate measurement of your blood pressure at home is to take a blood pressure diary over a week and average the result. We’ll be releasing a mobile app to help you do that soon. In this situation, when taking your morning readings, should you take your medication first or afterwards?
We recommend taking your medication first. You want to know if the medication you are taking is doing a good job of controlling your average blood pressure. This will let you find that out.
Do you have any other situations when you aren’t sure when, how or where to take your blood pressure medication? Post in the comments below or get in touch on our Facebook group Blood Pressure Questions Answered and we’ll do our best to help out.