A pharmacist can answer most questions in this subcategory in a few minutes with access to a proper interaction database, and that access is the thing a forum does not have.
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Practice · Interactions · continued
Coming back to: Delayed gastric emptying and oral medication absorption: which drugs matter posts 61–75
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
Small methodological point on Delayed gastric emptying and oral: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.
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The practical advice most consistently given by pharmacists here is to keep the timing of other oral medication consistent rather than to change it, because consistency is what makes a problem visible.
I would be interested in a counterexample if anyone has one.
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mi.almeida, post #2: That is a fair summary of where the discussion has got to. Go to post
Adding the measurement that post #61 says would settle it.
Oral contraceptive absorption has been studied specifically for some compounds in this class and the findings are compound-specific. Generalising from one to another is not supported.
Anyone who has looked at this more carefully, please correct the record.
Where I part company with post #61, and it is a narrow parting.
Trying to state the Delayed gastric emptying and oral position in a way that someone who disagrees would recognise as fair, because I do not think the version in this thread passes that test.
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Thyroid medications: semaglutide is associated with a slowing of gastric emptying, which might affect thyroid medication absorption if they are taken very close together. Separating them by a few hours is the conservative approach.
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g.ekstrom, post #10: Oral contraceptive absorption has been studied specifically for some compounds in this class and the findings are compound-specific. Generalising from one to another is not supported. Go to post
An update on my earlier Delayed gastric emptying and oral post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.
ni.stanescu, post #62: Small methodological point on Delayed gastric emptying and oral: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone. Go to post
Reading rather than answering, but this is the post I would point somebody at.
t.varga, post #1: Delayed gastric emptying and oral medication absorption: which drugs matter Writing it up because I had to work it out twice and would rather nobody else did. Reading back through what has been written here about Delayed gastric emptying and oral, three questions come up every time and only one has ever been answered properly. Listing… Go to post
Right, and stated more narrowly than I would have dared to state it.
Building on post #67 rather than restating it.
Oral medications versus time: if you take an oral medication 30 minutes before semaglutide (which slows gastric emptying), the delayed stomach emptying affects when and where the oral medication is absorbed. Separating by a larger interval (1 to 2 hours) usually resolves this.
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mi.almeida, post #66: Thyroid medications: semaglutide is associated with a slowing of gastric emptying, which might affect thyroid medication absorption if they are taken very close together. Separating them by a few hours is the conservative approach. Go to post
Delayed gastric emptying and oral is one of those subjects where the general answer and the answer for a specific case diverge, and the thread will go in circles until someone says which one is being asked for.
Vitamins: most vitamins have no significant interaction. Fat-soluble vitamins (A, D, E, K) might be affected by the slowing of fat absorption during weight loss, but that is a nutritional consequence rather than an interaction.
It is worth checking rather than assuming, which costs nothing.
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The arithmetic in post #72 is right; the assumption feeding it is the part to check.
For anyone finding this later: the short answer on Delayed gastric emptying and oral is that it depends on one thing, and the rest of the thread is people identifying which thing.
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Answering the question post #70 raises rather than the one it answers.
I keep a log for Delayed gastric emptying and oral specifically because my memory of it turned out to be systematically wrong in one direction. Six weeks of notes cost nothing and settled it.
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buffer_margin, post #3: Timing separation is the standard mitigation where absorption rate is the concern, and the interval that matters depends on the other drug rather than on this one. Go to post
Oral medications with a narrow therapeutic index are the ones where that matters most. The interaction is about rate and timing rather than about the total absorbed, in most published cases.
Second-hand, so weight it accordingly.
This topic was referenced in
- Warfarin and altered intake: the monitoring argument — the long versionPractice › Interactions · 134 replies
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