Tablets should generally be taken in an upright sitting position with sufficient liquid – at least 125 ml of water.

Time of administration

The right time is important to ensure that the medicine works as best as possible and is well tolerated. With some medicines (e.g. certain antibiotics), it is particularly important to take them at exactly the right time to ensure that a consistent amount of the active ingredient is present in the body.

Even if the signs of your illness are already improving, the duration of treatment prescribed by the doctor must be strictly adhered to. Early or sudden discontinuation can lead to the medicine not working properly.

Frequency of intake

• Once daily: The medicine should be taken at the same time every day.
• Twice daily: It should be taken about every 12 hours to ensure that the level of active ingredient in the body remains high enough.
• Three times a day: It should be taken about every 8 hours. It is important to consider how sleep and the time of administration fit together so that the 8-hour interval is not overdo.

Relationship to meals

• “Regardless of meals”: The medicine may be taken before, during or after meals.
• “On an empty stomach”: The medicine should be taken 30 to 60 minutes before a meal or at least two hours after.
• “Before a meal”: It is specified that it should be taken 30 to 60 minutes before a meal.
• “With food”: Some medicines (e.g. certain painkillers) can irritate the stomach when taken on an empty stomach and should therefore be taken during or shortly after eating.

Time of day

For some active ingredients, it is important at what time they are taken. This is because bodily functions change throughout the day.

• Morning: For example, thyroid hormones and cortisone preparations should ideally be taken early in the morning, unless your doctor told you otherwise.
• Evening: Some rheumatism medications are better tolerated in the evening. Certain antidepressants with a calming effect should also be taken in the evening.

Pill boxes can provide a better overview. These are particularly helpful when a patient needs to take several different medicines.

Dividing tablets

As a general rule, tablets should only be divided if the package insert states that this is permitted. Many tablets have a visible break line for this purpose. 

If no information is available, consult your doctor or pharmacist first. When splitting tablets, make sure that the pieces are as equal in size as possible so that each part contains the same amount of active ingredient. A tablet splitter can be helpful.

Do not split retard tablets or capsules. In such tablets the active ingredient is incorporated in such a way that it is released slowly or with a delay. If such a tablet is split or opened, the active ingredient can be released very quickly, which may result in an overdose.

Careful and correct use of medicines is essential to ensure that they work and are well tolerated.

Taking medicines at the same time as food or other medicines can have negative consequences. For example, absorption into the body may be delayed or the way the medicine works may be altered.

Active ingredients that are mainly absorbed in the gut are particularly affected, as food can delay the emptying of the stomach. This also applies to paracetamol (a common painkiller and fever reducer), for example – it therefore works much faster when taken on an empty stomach.

Examples of combinations that should be avoided:

Alcohol 

Like many medicines, alcohol is broken down in the liver. If it is taken at the same time as certain medicines (e.g. certain antibiotics, medicines for fungal infections), this can lead to higher concentrations of the active ingredient in the body and a stronger or prolonged effect. Combinations with painkillers, sleeping pills, sedatives or antidepressants should also be avoided, as thedepressant effect and side effects can be significantly increased. In general, alcohol should be avoided when taking medicines.

Coffee, tea

Iron tablets, e.g. for anaemia, should not be taken at the same time as coffee or tea. Coffee and tea contain tannic acid, which binds iron in the stomach and thus reduces its absorption. Orange juice, on the other hand, can improve absorption.

Grapefruit juice

Grapefruit contains certain substances that can inhibit the breakdown of many medicines in the liver. This can cause the concentration of active ingredients in the body to rise sharply (e.g. up to threefold), which can lead to an overdose. This applies, for example, to certain antihypertensive drugs, cholesterol-lowering drugs or drugs that suppress the body's immune system.

Milk

The calcium contained in milk can influence the effect of certain medicines when taken at the same time. Certain antibiotics and medicines for bone loss (osteoporosis) form compounds with calcium that are difficult to dissolve and can therefore be absorbed less easily.

Foods containing vitamin K

Vitamin K is important for blood clotting. It is found, for example, in green vegetables (broccoli, lettuce, cabbage, asparagus, spinach, peas, beans) and in eggs. The effect of blood-thinning medicines (e.g. Marcoumar), which are used after a heart attack or in cases of thrombosis risk, can be reduced by foods containing vitamin K. Important: This does not apply to heparin.

Liquorice

When taken with medicines that increase the excretion of urine, liquorice can increase potassium loss in the body and thus increase side effects. This can lead to muscle weakness, fatigue or cardiac arrhythmia.

Salami, cheese, sauerkraut and white beans

These foods contain the protein product tyramine. Tyramine is normally broken down by the enzyme monoamine oxidase. However, if the enzyme is inhibited by certain antidepressants (monoamine oxidase inhibitors), tyramine cannot be broken down. This can result in increased blood pressure, headaches and, in the worst case, cerebral haemorrhages.

Important: When taking medicines, always follow the instructions in the package leaflet to avoid interactions between medicines and food. If you are unsure, consult your doctor or pharmacist.

An adrenaline auto-injector is used for emergency treatment of a severe allergic reaction (anaphylaxis) until medical help arrives.

Recommendations for patients:

• If you have been prescribed an adrenaline auto-injector, you should familiarise yourself with it and always carry it with you. It is recommended that you always carry two auto-injectors., just in case that the effect after the first injection is insufficient.
• Your family members, caregivers, or teachers should also be familiar with the correct use of the device.
• Your doctor or pharmacist should show you how to use the auto-injector and provide you with training materials. If you are unsure, ask for clarification.

Transdermal patches contain a reservoir of active ingredient and release it continuously through the skin into the bloodstream. The advantage, the active ingredient is not affected by digestion or the liver.

Types of TTS

• Matrix patches: The active ingredient is evenly distributed across a “matrix” and applied directly to the skin with an adhesive layer.
• Membrane patches: The active ingredient is contained in a reservoir and is released onto the skin via a membrane. If the membrane is damaged, there is a risk that large quantities of the active ingredient will be released suddenly ("dose dumping"). 

Examples for the use of such patches:

• Pain patches – e.g. for severe pain such as back pain or tumour pain; they contain active ingredients such as diclofenac or opioids such as fentanyl.
• Nicotine patches – to help you quit smoking.
• Hormone patches – e.g. for contraception or to treat menopausal symptoms.
• Heat patches – used e.g. for muscle pain.

General information on use

• First read the entire package leaflet carefully.
• After removing the protective film, do not touch the adhesive area with your fingers, as this may impair the adhesive effect.
• After applying the plaster to the skin: press the plaster down with the flat of your hand to ensure good adhesive contact.
• The area of skin to which the plaster is applied should not be greasy, injured or irritated.
• Elevated temperatures (e.g. sauna) can accelerate the release of the active ingredient or reduce the adhesive effect – this should be taken into account.

Disposal information

Please observe the instructions for disposing of the patches under the heading “Disposal” or in the package leaflet.