Lying down, sitting, leaning over? What science says about the best way to take your medicine

When pharmacists dispense tablets or capsules, they usually indicate when and how often they should be taken, and whether this must be with or without food.

You generally don’t hear them tell you to lean to one side when swallowing. However, preliminary research from Johns Hopkins University in the United States suggests that doing so may improve the absorption and effectiveness of your medicine.

Results are based on a computer simulation and not actual patients and may not reflect the real world. So it’s too early to suggest that you adopt a yoga pose while taking your medicine.

But your posture can be important when taking pills or capsules, for comfort or safety.



Read more: What time of day should I take my medication?


What happens if you swallow your medicine?

Once you swallow a pill or capsule, it moves down your throat and into your stomach. There, a tablet swells and disintegrates, or a capsule ruptures. The drug can then dissolve and your body can absorb it.

Most drugs are not absorbed until they reach the small intestine. However, some medications, like aspirin, are likely to be absorbed in the stomach due to its acidic environment.

A number of other factors can also influence where and how a drug is absorbed.

These include how quickly the tablet dissolves to release the medicine, how quickly swallowed contents travel from the stomach to the small intestine, the amount of food and drink consumed before taking the medicine, and how easily the medicine is absorbed through the lining of the intestine.

How about this latest study?

The US researchers used computer simulations to examine how posture affects the absorption of medication.

The researchers used software they developed to simulate different ways of taking a pill: staying upright, leaning left or right, or leaning backwards.

They showed that tilting 45 degrees to the right favored faster movement of stomach contents into the duodenum (the first part of the small intestine). As a result, the pill could be absorbed more quickly and take effect.

The results could be important for medicines that need to work quickly, such as painkillers or medicines to treat heart attacks.

There is already some previous evidence from real patients that suggests that posture can affect drug absorption. This includes the ability to lean to the right. But the authors acknowledge that many factors affect absorption, not just posture.



Read more: Health check: Is it okay to chew or crush your medicine?


When is it best to sit or stand?

Sometimes your pharmacist may advise you to take your medicine while sitting, standing or lying down for reasons other than speeding up absorption.

For example, certain medications are more likely to cause side effects such as heartburn, which is when stomach acid leaks out of the stomach and into the esophagus (gullet).

These include nonsteroidal anti-inflammatory drugs such as ibuprofen (Nurofen), diclofenac (Voltaren), and iron supplements.

If this is a problem for you, it may help to take these medicines while sitting or standing and not lying down immediately afterwards. That’s because your stomach acid is less likely to back up into your esophagus.

Elderly woman sitting down at table with pill and cup
Some medicines can irritate your throat or cause heartburn. So it’s best to keep this up.
Shutterstock

Some medications can irritate your throat if they get stuck. This is because they damage the protective mucosal barrier that lines your esophagus and stomach, leading to irritation and inflammation.

With these medicines, it is important to take them while you are sitting or standing and then remain upright for 30 minutes.

These include the antibiotic doxycycline and drugs known as bisphosphonates (used to treat osteoporosis) such as risedronate (Actonel) and alendronate (Fosamax).



Read more: Why older people develop osteoporosis and fall


How about lying?

Glyceryl trinitrate (Nitrolingual) is a spray under the tongue. It’s prescribed for people with angina, a type of chest pain caused by an underlying heart problem.

Pharmacists advise patients to sit or lie down before using this spray as it can cause a sudden drop in blood pressure which can make you feel very dizzy.

Other heart medications, such as diuretics, are also known to cause dizziness. Although you do not usually have to take these medications while lying down, if you get dizzy, it is best to sit or lie down and make sure you get up slowly afterwards.

There are also medications that can cause drowsiness or drowsiness. These can include strong painkillers (like opiates), sleeping pills, some medicines for epilepsy, or medicines for certain mental illnesses like anxiety or schizophrenia.

These do not have to be swallowed while lying down, but lying down may help if you get dizzy or sleepy.

Woman lying on her side in bed holding a glass of water and a pill
Some medicines can cause dizziness. So you can lie down after taking it.
Shutterstock

What if I’m not sure?

In general, the next time your pharmacist dispenses your medicine, unless they have specific instructions about sitting, standing, or lying down, you can safely take it in the manner that is most comfortable for you.

So how about this latest evidence suggesting that a right tilt might be helpful? At this stage, you probably won’t hear from your doctor or pharmacist that you should bend over to take your medication until further investigation is complete.

But the next time you need to take pain medication, as long as it’s not uncomfortable, feel free to try it to see if your pain gets relieved faster.

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