Why do you take some medications in the morning and others at night?

Before breakfast: when food affects absorption

Levothyroxine (Synthroid) replaces a thyroid hormone that your body does not make in sufficient amounts. Levothyroxine tablets are usually taken on an empty stomach with a full glass of water, 30 to 60 minutes before breakfast. Taking the tablet with food can reduce the amount your body absorbs.

For example, if you eat breakfast at 7:30 a.m., taking your tablet at 7:00 a.m. leaves a 30-minute gap. Swallowing it with your first bite of toast does not. Both count as “morning,” but only the first leaves time before you eat.

With breakfast: protecting your stomach and your sleep

Prednisolone (Orapred) is a corticosteroid used to treat inflammation. If it is prescribed as one morning dose, taking it with breakfast can help prevent stomach upset. Taking it early also makes it less likely to interfere with sleep.

Two medications labeled “take in the morning” may therefore belong at different points in your routine: one before breakfast, the other with breakfast. If you take several medications, ask your pharmacist which you can take together and which need to be spaced apart.

Earlier in the day: avoiding nighttime bathroom trips

Furosemide (Lasix) is a diuretic, sometimes called a water pill. It helps your body get rid of excess fluid by making you urinate more. If you take it late in the day, you may have to get up several times during the night to use the bathroom.

A once-daily dose is usually taken in the morning. If you take it twice a day, your prescriber may schedule the second dose around midday or in the early afternoon. If that timing is difficult because you are at work or commuting, ask your pharmacist or prescriber about your options before moving or skipping a dose.

In the evening: why timing matters for some statins

Your liver makes cholesterol throughout the day, but production tends to peak at night. Simvastatin (Zocor) slows cholesterol production and acts for a relatively short time. It is usually taken in the evening so that its effect overlaps with that overnight peak.

That instruction does not apply to every statin. Atorvastatin (Lipitor) and rosuvastatin (Crestor) tablets act for longer and can generally be taken in the morning or evening. If your prescription allows either, choose a time you can remember each day. Two people being treated for high cholesterol can have different instructions because they take different statins.

What if the prescribed time does not work for you?

If you work nights, often skip breakfast, or take several pills, try asking your pharmacist: “For this medication, what matters most: the time of day, whether I take it with food, or taking it at the same time each day?” Give the exact name of the medication and describe when you usually eat and sleep. That makes it easier to work out what can change and what needs to stay the same.

If you realize in the evening that you forgot your morning tablet, check the missed-dose instructions in your medication information or ask your pharmacist. What to do depends on the drug and how soon your next dose is due. Do not automatically take two doses to make up for one you missed.