With drugs, timing can be everything

People's Pharmacy

June 04, 1996|By Joe Graedon and Teresa Graedon | Joe Graedon and Teresa Graedon,King Features Syndicate

When 110 people died because a ValuJet crashed, it captured headlines for weeks. Imagine if a jumbo jet went down every day. You would expect shock and outrage.

Yet more people than that die daily as a consequence of medication mistakes. It is estimated that there are at least 125,000 deaths annually in the United States because of drug errors. The wrong medicine in the wrong combination or wrong time can be lethal.

Unless the physician tells you exactly how and when to swallow those pills, you might not get the maximum benefit -- or you could be taking an unnecessary risk. The time of day is an important but often unappreciated factor in how well the body responds to a drug.

Medical education has virtually ignored timing, but biological rhythms vary during the day. One medicine may work best in the morning, another may be less toxic if swallowed in the afternoon.

Pharmacologist Gaston Labreque of Laval University in Quebec offers a striking example of how medication timing can be a life-or-death matter. In one study, children with leukemia took an anti-cancer drug at home every day. The parents were asked to give it consistently at the same time of day. The kids who got their daily dose in the evening were three times less likely to have a recurrence of the cancer.

Asthma attacks are most common in the wee hours of the morning. To get the best protection from asthma medicine such as theophylline, it should probably be taken at supper time. Oral steroids provide maximal benefit when they are swallowed in the middle of the afternoon.

Research into chronobiology is relatively new. The Food and Drug Administration has mostly ignored daily cycles when instructions were written.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert.

Pub Date: 6/04/96

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