5 tips to help avoid stomach upset when taking medicine

Q: I’m taking a medicine that really upsets my stomach. Is there any way to keep it from doing that?
You are not alone if you suspect your medicine is upsetting your stomach. As a pharmacist, I hear this complaint the most: “These pills are making me sick!” In fact, the most common side effect of ANY medication is stomach upset, also called “gastrointestinal distress” or “GI distress.” Symptoms of GI distress have been reported with every single prescription medication. No exceptions.
Do you experience nausea, vomiting, stomach cramps, burning, or intestinal cramping after taking your medicine? If you suspect one of your medicines could be making you feel sick, you are probably right.
If there were a Hall of Fame of drugs that cause significant nausea and vomiting, the top three categories would be antibiotics, pain medicines, and cancer chemotherapy drugs.
Chemotherapy drugs top the list of drugs that can cause severe nausea and vomiting. You’re more likely to have stomach upset when taking a chemotherapy agent if you are younger than 50, female, prone to motion sickness, have had “morning sickness” during pregnancy, or suffered from nausea while taking other chemotherapy drugs.
Depending on the particular treatment regimen, multiple anti-nausea medicines are often used to combat the side effects of chemotherapy. They include tablets or capsules, melt-in-your-mouth tablets, skin patches, rectal suppositories, and injections.
Although most medications can be taken with or without food in your stomach, there are some exceptions.
Some drugs must be taken on an empty stomach to ensure your body absorbs the entire dose. These include the thyroid supplement levothyroxine and the bone-building medicines alendronate (Foxamax®), risedronate (Actonel®), and ibandronate (Boniva®).
Some antibiotics should not come in contact with certain minerals like calcium, magnesium, or iron. Common antibiotics like doxycycline, ciprofloxacin, and levofloxacin should not be taken with multivitamins with minerals. It’s OK to take these antibiotics with a meal. However, because of the concentrated calcium, you should avoid drinking a full glass of milk with them. Not sure if this is an issue? Look at the label on the side of your medicine bottle or ask your pharmacist.
If you vomit after taking your medicine, what should you do? If it’s an antibiotic or pain medicine, try it again, but make sure you take it with food, a full glass of milk, water, juice, or both.
Contact your doctor if you take the drug a second time and still vomit within the first 30 minutes. When you can’t keep your antibiotic or your pain medicine down, it won’t be able to help you. Delaying treatment with an antibiotic can lead to severe consequences.
If the medicine is for your heart, blood pressure, or anxiety, contact your doctor or pharmacist before repeating the dose. Has it been more than 30 minutes after taking your medication before you vomited? If so, you may have absorbed enough medicine to cause an overdose if you take another dose right away.
Here Are 5 Tips to Help Avoid Stomach Upset When Taking Medicine:
1. Take medicines immediately after eating.
If your medicine can be taken with food, take it just after finishing a meal, instead of before you eat. This way, there’s more food in your stomach, helping to dilute any irritating effects on your innards. If it’s time to take your medicine, but you’re not ready to eat, try taking your pills with a full glass of water or juice.
2. Take your medicine at night.
Taking your medication at bedtime allows you to sleep through the queasiness they can cause. This is particularly helpful with oral contraceptives, pain medicines, and prenatal vitamins.
3. Split up the dose.
Ask your pharmacist if you can safely split your medicine into more than one dose and then take them several hours apart, with breakfast and dinner. Some pills can be split safely, while others need to be changed to a lower strength to be given as separate doses.
4. Request a long-acting or coated drug formulation.
Ask your pharmacist if a delayed-release or specific coated formulation is available for your medicine. Some drugs have special coatings that protect them from the acid in your stomach. These unique coating helps keep the medicine from dissolving in your stomach.
5. Take anti-nausea medicine ahead of time.
Don’t wait until you are already queasy before taking pills for nausea. You should take motion sickness and other anti-nausea medicine at least 30 minutes before you need it, not when you’re already miserable and about to hurl.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog TheMedicationInsider.com. ©2022 Louise Achey