Table. Taking medicines with or without food.

Factors to consider	Clinically relevant examples
Absorption: Will absorption be impaired or enhanced if taken with food?	If absorption is significantly impaired by food, give the drug at least 30 minutes before food, e.g. bisphosphonates such as alendronate, metronidazole benzoate (liquid)*, rifampicin. If absorption is significantly increased with food, give the drug with or after a meal, e.g. griseofulvin, some antiretrovirals. If absorption is impaired by food but tolerance is a concern, the drug can be given with food, e.g. erythromycin base*, roxithromycin, sodium fusidate.
Therapeutic effects: Will the drug be more effective if taken with or without food?	Phosphate binders, e.g. calcium carbonate, must be taken with food to bind dietary phosphate in the gastrointestinal tract to decrease phosphate absorption. Sulphonylureas are given with food to decrease the risk of hypoglycaemia.
Gastrointestinal factors: Will the drug be better tolerated if taken with or soon after food?	To minimise gastrointestinal upset, including nausea and vomiting, give the drug with or soon after food, e.g. azathioprine, corticosteroids, erythromycin ethyl succinate, metformin, metronidazole*.

Compiled from the product information and the Australian Medicines Handbook.

* variable depending on salt