The time of the day by which a drug is taken is no longer a minor concern-according to the growing body of evidence, the time of the day one takes a drug in the morning or in the evening, is considered to have a huge influence on the way in which the drug can be absorbed, metabolized, and activated. It is based on the idea of chronopharmacology and the fact that the way the body clock affects drug behaviour is highlighted.
The circadian rhythm controls the main physiological functions of our body, i.e., the secretions of hormones, gastric emptying, working liver enzymes, blood pressure and immunity. Due to the variation of these processes throughout the 24 hour cycle, the response to the same medication at different times of the day could vary. An example of these changes is that naturally, blood pressure increases before waking, whereas it decreases at night, consequently, some antihypertensives are better controlled upon nighttime use. On the same note, administration of statins at night also increases the effects of statins on the reduction of cholesterol since hepatic cholesterol synthesis is at the highest level at nights.
Medications inducing insomnia, gastrointestinal irritation or daytime symptom reversal may be better early in the day, whereas medications working on nocturnal symptoms or physiological maximum may be better at night. Dependence on a wrong dosage may lessen effect or may increase side effects- but this is a forgotten point in most treatment regimes.
Knowing when a drug functions optimally is one step to more individual and effective treatment. With the development of research, timing could be the new dose and frequency of prescription practice.
Is there a case to have doctors regulate optimum opportunity of dosing by incorporating either morning or night in cases where medications are prescribed to enhance treatment results?
MBH/PS