You might have been told by a pharmacist when ill to take medication in the morning, afternoon, and evening. But what time precisely, some may ask. Amon Nsengimana, a community pharmacist in Kigali, observes that people can interpret morning differently; some may consider it as the time at which they wake up, yet people wake up at different hours. Similarly, he says, evening can be interpreted differently; some people may think it’s the time they go to bed or time they go for dinner. The pharmacist says it is not just the medication that matters, but how timely you take it to maximise the therapeutic effectiveness. He points out that consideration must always be given to the actual time of administration so that a sufficient period occurs between doses. For some medicines, he says, it doesn’t matter what time one takes them. But for others, the pharmacist recommends taking them at the same time each day. “Medications taken regularly ensure that you have an effective amount of drugs in your body at all times,” he says. Though they are meant to improve our health, health experts say that medications can harm us when not properly taken. For instance, when they are not taken regularly, the level of drug in the blood can become either too low to be effective or too high and damage the body organs like kidneys or liver. For each drug to reach the unhealthy part of the body; it is first absorbed into the blood. The blood then distributes the drug through the body. Nsengimana says each drug has a maximum level of concentration in the blood that when it goes beyond, it becomes less beneficial and more toxic to the body. “What to put into consideration is that the moment you start taking your medication, its level of concentration in the blood raises and later falls to its minimum level as the body breaks down the active ingredients and eliminates the waste from the body,” he notes. That minimum level, he says, is called minimum effective concentration, below which the drug becomes ineffective, in fact, the body becomes used to the medication and consequently in the future, use of the same drug doesn’t offer any benefits. It has been established that taking your next dose on time helps to ensure that the drug in the blood stays above the lowest level for effective concentration. Taking a dose too soon could lead to drug levels that are too high, whereas waiting too long between doses could lower the amount of drug in your body and keep it from working properly, according to experts. Nsengimana says that healthcare providers should make it clear how many hours are between doses so that side effects are minimised. Also, he points out that the routine of telling patients to take their medication in the morning, noon, and evening, leaves ambiguity and may cause other issues as it is not clear what exact time to do it. “When your healthcare providers do not clarify your dosing intervals, it is simple to calculate, but people need to make sure the schedule is according to routine,” he says. For instance, medications that are to be taken three times a day are to be taken every eight hours. “They are not to be taken morning, noon, and evening as most of us are led to believe. To know how to calculate it, you simply take 24 hours and divide by the number of times your medication ought to be taken per day. You will find how many hours should be between doses,” advises Nsengimana.
