Social Question

Seek's avatar

Should I take another pill?

Asked by Seek (34769points) November 22nd, 2015

**Gross detail ahead if you’re sensitive to that sort of thing**


I’m on a course of antibiotics. I ate pizza for dinner (poor choice in retrospect, I know it always makes me nauseated), finishing at about 6:45. Then I took my regular dose at 7:00. It recommends taking with food or after a meal, so right on time.

Unfortunately I threw up about 30 minutes later. I could taste the medicine (sorry).

Should I take another pill? or wait for the next regular dose? It’s a 10 day course of clindamycin.

*** I am fully aware that none of you are giving official medical advice. I’m counting on answers from practical experience. ***

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33 Answers

Earthbound_Misfit's avatar

I think you should. Sounds like you vomited the first one up before it could be absorbed/digested. Given I think you’ve got an infected tooth, I think taking your antibiotics is important. I’d take another one.

Seek's avatar

Thanks. Just needed a second opinion. ^_^

janbb's avatar

Yeah – I would take it too.

JLeslie's avatar

What drug? What’s your dose? How many times a day? What day are you on?

Also, it’s worth mentioning your stomach starts emptying by about 20 minutes, so if it’s supposed to be taken with food take it in the middle of the meal. Taking with food is usually either because the pill is likely to cause ulcers or likely to cause nausea, and food buffers it.

Jeruba's avatar

buffers it

janbb's avatar

I’d prefer the buffet.

Cruiser's avatar

My doc always told me to stick with the prescribed pill dosing protocol. 30 minutes is plenty of time for the pill to be digested and the medicine to be absorbed and to take another pill is to risk double dosing. In the end missing one pill in your antibiotic regimen should not be a deal breaker as long as you finish the prescription as prescribed. Not a doc and don’t play one on TV just going on what my docs have told me before in similar circumstances.

JLeslie's avatar

@Cruiser She had food in her tummy, which usually slows the absorption a little, depends on the drug. Add in she wasn’t digesting well, she threw up.

Cruiser's avatar

@JLeslie Understood and just offering what my docs told me the many times my kids puked up their meds. Not once was I ever told to take another dose until the prescribed time.

Earthbound_Misfit's avatar

If you’re concerned @Seek, why not call your pharmacy and get their advice. I just did a few searches and there is so much conflicting information about how long it would take to absorb, whether you’ve eaten or not, what the drug is etc. Personally, I’d take another, but if you’re unsure, perhaps call you pharmacist.

DrasticDreamer's avatar

I once took medicine that said I would need to contact my doctor if I got sick before 30 minutes. If it was 30 minutes or longer, I’d be fine.

However, I have no idea if certain pills break down more quickly than others.

Best bet it to call a 24 nurse line (usually every clinic has one) and if that doesn’t work, I’d consider calling a pharmacist.

Seek's avatar

I went ahead and took another. Worst case scenario for not taking it was the infection getting an extra six hours of breeding time, worst case scenario for taking it was a tummyache. I went for potential tummyache. So far, so good.

JLeslie's avatar

@Cruiser Kids are different. They are often dosed according to weight and overdose is easier.

Take for instance Augmentin. I take 875mg for a simple sinus infection twice a day. Sometimes adults are only prescribed 500mg. I have taken 2000mg twice a day more than once in my lifetime for a different type of infection. The different doses aren’t so much about one being much more dangerous, but about what amount of meds are needed to kill off a particular bacteria.

That’s why I wanted to know what @seek is taking. If it’s a drug that is commonly prescribed at double the dose, then I would not have any worries if she took another dose and maybe wound up with 50% more between the two pills she took.

ibstubro's avatar

But, now you’ve taken the medicine on an empty stomach, @Seek.

I, too, would have taken another pill, but probably tried to eat some saltines or the like first.

My first reaction wasm “Well, are you larger now, or smaller?”

Cruiser's avatar

@JLeslie I expect all sizes of people are dosed according to their weight.

JLeslie's avatar

@Cruiser If only that were true. Petite women are constantly over-medicated because most drugs are not given based on weight. Look up dosage recommendations for antibiotics and dosage recommendations are based on the type of infection.

Even simple things like ibuprofen; a lot of women who are around 110 pounds tell me they have bad reactions. I’m convinced because of the dosage.

Recently, Ambien was the first drug to have different dosage recommendations for women than men. They had data when it was first brought to market many many years ago that women had scary side effects from the same dose as men, but they ignored the findings deciding women’s hormones vary through the month and they aren’t valid in the study. The thing is, our hormones to vary through the month, so how is that invalid? Secondly, I really want to know if they took weight into consideration? They didn’t mention it in the interview I saw, so I assume they still just chalk it up to gender differences and not weight, but for sure the women on average weighed less than the men I would bet.

My main point is, why would you think the drug companies, FDA, or doctors necessarily are adjusting dosage?

Cruiser's avatar

@JLeslie If someone is not being prescribed base on their weight then they need to find a different doctor. Not once have I or my sons through their lives were we ever given a dosage not based on our weight. I am sorry to hear you have had the opposite experience.

Seek's avatar

I did eat about half a bowl of cereal with the other pill. No upset stomach to report, and my size has remained more or less stable.

Seek's avatar

And for interested parties, it’s a 10 day course of Clindamycin 150mg Po q.i.d.

That is, by mouth four times a day.

JLeslie's avatar

@Cruiser Only very very recently are package inserts (that’s not the info the pharmacy gives you (the insert is the official information for warnings and prescribing that comes from the manufacturer with the drug like the information you find in the PDR) mentioning things like adult male prescribing information. It still might be absent of female information, because it was never tested on females, or insufficient data. Previously, I never say male and female on inserts it was just adult and pediatric, and adult there was almost never mention of weight. Sometimes weight is not mentioned for children either. Depends on the drug. There is some voodoo in prescribing. Many drugs have not been tested on children and they are given to kids every day off label. They even are within the standard of care, but never scientifically tested.

Here is an example of a drug most people know, Zithromax, the drug found in a Z-pack for sinus infections. Look at the dosage box. Nothing about weight, it has to do with the type of infection.

@Seek I’m not a doctor as you know, but that drug is given in much much higher doses intravenously so I think you did the right thing popping another.

JLeslie's avatar

@Cruiser For that matter just look at the Tylenol, ibuprofen, decongestant, in your medicine cabinet over the counter and they don’t talk about weight for adults.

I can’t find the insert for @Seek‘s drug PO, but I looked again and there is this which is probably accurate for dosing. The IV dosing actually says adult males and nothing for females, but it is given to women every day.

Earthbound_Misfit's avatar

Drug testing is also biased towards men. I read about this ages ago, but I can’t find that source. This Slate article discusses the bias. The original source I read discussed how drugs developed specifically to deal with problems women experience were being tested on men.

And @Cruiser, I’ve never had a doctor or pharmacist prescribe based on weight. I don’t think I’ve even read any information about weight on the packaging for adults.

Cruiser's avatar

@JLeslie Not sure what your point is as your example you gave was very explicit in dosage amounts for both adult patients in section 2.1 and pediatric patients in section 2.2 and in the pediatric recommendation section 2.2 they list the dosage per weight as well. I am NOT a doctor but I have complete confidence in my doctor to prescribe medicines based on what dosage is best for my weight and why the very first thing they do when I visit my doctor is to weigh me.

JLeslie's avatar

@Cruiser 2.1 on what document? What page is it I’m having a hard time finding it. The link for what I said about male dosage is for IV and IM, not a typical pill prescribed by a doctor for patients to take at home. Was it on that link?

My point is a 110 lb adult is typically prescribed the same as 180 lb adult. You seemed to be saying doctors always consider weight even for adults. The truth is they generally don’t worry about weight when prescribing to adults. There are some medications they do, I might have mentioned this above, like cancer drugs, because they can be so toxic.

Pediatrics is completely different.

janbb's avatar

Well, that sort of went off course.

JLeslie's avatar

It’s not really off course. The point was if you are taking a drug that is often prescribed at even double the dose, if you accidentally, or purposely in this case, take more medication it likely won’t hurt you. It has been tested and used at that higher dose.

You can look up the drug and see common dosages if you want to make an educated guess what to do. Or, call your pharmacist or doctor for advice. You can also do both and then decide.

ibstubro's avatar

Well, the immediate question was answered, @janbb, so why not?

Seek's avatar

I’ve given the mods permission to move this to social.

I find the tangent interesting. My husband, who is a big guy, often suspects he is being under-mediated.

He now doubles his OTC allergy medicine dose, because one 10mg pill is the recommended dose for anyone 6 years old and older. He’s got 200lbs on the six year old.

longgone's avatar

[Mod says] Moved to Social with OP’s permission.

JLeslie's avatar

@Seek It can be tricky. Weight is not the only thing that influences how a drug is metabolized. You can see if the drug comes in prescription dose, sometimes under a different name, you have to look up the chemical or generic name, and then you can see common dosages at that level.

Like ibuprofen is very commonly prescribed at 600mg prescription, but OTC the dosage on the package is not to exceed 400mg. The higher dose went through testing since the pill is made in that higher dose.

Some drugs, like the old Dimetapp 12 hour release OTC was dangerous at the double dose. It eventually was pulled. My mom remembered when it was approved for OTC and there was some objections, because it was already known a double dose posed quite a but if risk for some people and OTC users regularly take two of something. Think about it, two Tylenol, two aspirin, but prescription is typically one pill. The argument was people wouldn’t read the dosage information and just pop two. That was bad. It caused high blood pressure, and enough people stroked that it was taken off the market. I miss that drug.

I would say especially the time release or long lasting drugs be careful.

ibstubro's avatar

This is interesting.
Potentially dangerous?

I only really see body size or weight discussed as a factor in dosage in pediatrics.

Dutchess_III's avatar

Further, studies show that medicines are prescribed assuming that a woman’s body will respond the same as a man.

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