Is It Bad to Take Pills On an Empty Stomach?

Not all medicines are meant to be taken with food. In fact, some medicines work better if you take them on an empty stomach. It’s all rather complicated, but it’s important to get it right. 

Some medications, including NSAIDs, corticosteroids, certain antibiotics, and medicines that lower blood sugar, need to be taken with food for various reasons.

One reason for taking medications with food is to protect the stomach. Some drugs, such as NSAIDs (non-steroidal anti-inflammatory drugs), can irritate the lining of the stomach, causing bloating, gas, heartburn, and even bleeding ulcers. Common over-the-counter NSAIDs are ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin. Prescription NSAIDs include celecoxib (Celebrex) and diclofenac (Voltaren).

Food provides a buffer that helps prevent intestinal irritation, which is why medical professionals usually advise you to take these drugs with food.

Other drugs might not do any lasting damage if you take them on an empty stomach, but they can make you feel nauseated or give you indigestion. Corticosteroids, for example, stimulate the release of acids in your stomach, potentially causing nausea or indigestion. Having some food in your stomach can help neutralize the acid and prevent, or at least minimize, any discomfort.

With some drugs, the reason for taking them with food is not to protect your stomach but to make sure you get the most effectiveness from the medication. Some antibiotics, such as amoxicillin, are better absorbed in fat. In addition, having food in your stomach means it will take longer for your gastrointestinal system to empty. This gives your body more time to absorb the medicine.

Medicines that lower blood sugar (e.g. Glucophage) usually need to be taken with food. If you take them on an empty stomach, they can lower your blood sugar too much. The timing of any medicine used to treat blood sugar is tricky, so it’s very important to talk with your doctor about how to take these meds and follow the doctor’s instructions exactly.

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On the other hand, some medications are meant to be taken on an empty stomach. According to the FDA, this usually means at least one hour before meals or two hours after. A good example of this is levothyroxine (Synthroid). Levothyroxine is the second most commonly prescribed medicine in the United States and is used to treat hypothyroidism, also known as under-active thyroid.  

Used for osteoporosis, medications like alendronate (Fosamax) are more effectively absorbed when the stomach is empty.

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You might also note that some medications advise you to avoid alcohol while taking the drug. Alcohol can increase the chances of intestinal irritation because it, too, can be hard on the stomach. However, that’s not the most severe problem. Alcohol can amplify the effects of some drugs, such as pain medicines, particularly opioids. Alcohol and opioids can be a deadly combination, causing, among other things, life-threatening breathing difficulties. In addition, alcohol can make medicines less effective or, in some cases, more toxic.

There’s a more general reason for avoiding alcohol while taking medicines. Alcohol can slow down your metabolism, and that means the medicine stays in your system longer than it’s intended to, which can increase the likelihood of toxic effects from the drug. 

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When you’re sick, you often don’t have much appetite, yet the instructions on your medication may say to take it with food. What to do then? You don’t have to eat a full meal. Often, a small glass of milk or bowl of yogurt is enough to protect your belly from the harmful effects of the medicine.

In any case, always follow the instructions that come with your medications. If you’re unsure about whether to take your meds with food or without, ask your doctor, or better yet, ask your pharmacist when you pick up your prescription. Pharmacists are specialists in medications and their interactions and are happy to answer any questions you might have.

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