Here are some common examples of drugs to be taken on empty stomach and the reasons for doing so.
where the oral bioavailability of the drug is reduced by more than 20% by food
- ferrous fumarate
- indinavir (heavy/large meals only)
- d-penicillamine (take with food if GI upset)
- erythromycin base (erythromycin estolate, erythromycin stearate: take with food as drugs may cause a signicicant incidence of gastric side effects)
As gastric acid secretion is maximally stimulated by food ingestion, maximal efficacy of proton pump inhibitors (e.g. omeprazole, pantoprazole, lansoprazole) should be achieved when they are taken before a meal.
where the presence of food reduces the effectiveness of the preparation but is unrelated to absorption
- bismuth subcitrate
- sucralfate (theoretical)
where the rate of absorption of the drug is significantly reduced by food and clinical effect is related to rapid absorption
- The Dispensing Guide 2001, The Pharmaceutical Society of New Zealand