Wednesday, June 09, 2004
Recent medical articles point out that it is best to take your diuretics WITHOUT food, if you are taking a loop diuretic ("water pill"). The loop diuretics include furosemide (Lasix), bumetanide, torsemide, and ethacrynic acid. Food is known to alter the absorption of a number of drugs and significantly affect the rate at which people respond to the drugs. In the case of loop diuretics, even the PDR doesn't mention this. One study of Lasix showed that the drug reached twice the concentration in the bloodstream if taken while "fasting" than if taken with food. Fasting, in this sense, means no food for about two hours either before or after the pills are taken. Thus, if you take yours first thing in the morning, you should not eat breakfast until two hours later. If you eat breakfast first, then you should wait 2 hours before taking the diuretic, and then wait at least another 2 hours before eating lunch. Another study showed that the diuretic works best if taken before a meal, not after - so your best bet is to take your diuretic the minute you wake up, then do all your morning showering and exercise and stuff, then eat breakfast.
If you're like me, the furosemide (Lasix) takes about an hour and a half to kick in, and then I have to use the bathroom urgently. Since that's an hour and a half, a good rule of thumb is, after that initial pee (pardon the technical term), wait a few more minutes and then start making breakfast, and you'll be close enough to two hours for government work.
Of course you know that in general, you shouldn't take drugs with grapefruit juice. While there are some drugs that are not affected by grapefruit juice, so many of them are that you should just make it a rule. The same 2-hour limit works well - don't drink grapefruit juice within 2 hours before or two hours after taking any of your medications. With some drugs, particularly those designed to have a time-release effect, you shouldn't drink grapefruit juice at all. Time release capsules are like you are continuously taking the drug, so it's always within two hours of taking it. Your doctor and your pharmacist should give you this advice, but even if they don't, it's not a bad idea to just remember it yourself.
So here's your list:
If you are taking a drug that has SR, XL, TR, or other time release letters in its name, don't drink grapefruit juice at all.
If you are taking any prescription medication at all, then don't drink grapefruit juice within 2 hours before or after taking your drugs.
Of course, you can always ask your doctor and your pharmacist specifically about grapefruit juice - if they both say it's OK to drink it, then it's OK. But if you don't remember to ask, then use the above guidelines.
If you're like me, the furosemide (Lasix) takes about an hour and a half to kick in, and then I have to use the bathroom urgently. Since that's an hour and a half, a good rule of thumb is, after that initial pee (pardon the technical term), wait a few more minutes and then start making breakfast, and you'll be close enough to two hours for government work.
Of course you know that in general, you shouldn't take drugs with grapefruit juice. While there are some drugs that are not affected by grapefruit juice, so many of them are that you should just make it a rule. The same 2-hour limit works well - don't drink grapefruit juice within 2 hours before or two hours after taking any of your medications. With some drugs, particularly those designed to have a time-release effect, you shouldn't drink grapefruit juice at all. Time release capsules are like you are continuously taking the drug, so it's always within two hours of taking it. Your doctor and your pharmacist should give you this advice, but even if they don't, it's not a bad idea to just remember it yourself.
So here's your list:
Of course, you can always ask your doctor and your pharmacist specifically about grapefruit juice - if they both say it's OK to drink it, then it's OK. But if you don't remember to ask, then use the above guidelines.
