Article is consulted and reviewed by Master of Pharmacy, Pharmacist Nguyen Hoang Phuong Khanh - Clinical Pharmacist - Department of Pharmacy - Vinmec Central Park International Hospital
There isn't a one-size-fits-all answer to whether you should take another dose of medication after vomiting. The decision depends on factors such as the timing of the vomiting, the dosage form, and the amount of medication visible in the vomit.
1.Considering taking medication after vomiting
Several factors can be considered when deciding whether to retake medication after vomiting: the medical condition, the drug's pharmacokinetics, the therapeutic window, and potential side effects. Consult your doctor or pharmacist for personalized advice if you have any questions.
Generally, it may be appropriate to retake the medication if you see a significant amount of it in the vomit or if you vomited within 15 minutes of taking it. If more than 15 minutes have passed, consider the following factors:
Consider retaking the medication if missing a dose could seriously impact treatment:
For example, it's recommended to retake medications for hepatitis C, HIV, or acute bacterial infections, especially for single-dose medications like azithromycin for gonorrhea.
For oral contraceptives containing only progestin or emergency oral contraceptives, retake the medication if vomiting occurs within 3 hours.
In fact, several factors can be considered to consider resuming the drug after vomiting such as: medical condition, pharmacokinetic characteristics, therapeutic window and drug side effects. In case of questions, you should contact your doctor or pharmacist for detailed advice.
In general, medication can be replenished when it is clear that the drug is in the vomit or vomit within 15 minutes of taking the drug. Where the drug has been taken for more than 15 minutes, the following factors can be assessed:
Consider re-administration when missing a dose severely affects the course of treatment:
Example of encouraging resumption of hepatitis C medication , HIV, antibiotics to treat acute infections, especially with single dose drugs such as azithromycin to treat gonorrhea. For progestin-only oral contraceptives or emergency oral contraceptives, it should be restarted if vomiting occurs within 3 hours.
2. Cases where retaking medication after vomiting is not necessary
In the following cases, there is no need to retake medication after vomiting:
- When taking additional medication could lead to side effects, such as hypoglycemia with diabetes medications or hypotension with antihypertensive medications.
- When missing a dose does not significantly affect treatment outcomes, such as for lipid-lowering medications.
- For medications with a narrow therapeutic index: anticoagulants, methotrexate, phenytoin, digoxin.
- For medications with a long half-life: amiodarone, fluoxetine.
- For medications that are rapidly absorbed through the body, such as sublingual tablets or liquid formulations.
Additionally, consult with a doctor or pharmacist in the following cases:
- Oral chemotherapy, immunosuppressants.
- When multiple doses are missed due to recurrent vomiting.
Based on the information provided, patients can consider whether or not to retake medication after vomiting. To ensure optimal treatment, it is best to consult with a doctor or pharmacist for advice.
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References:
Evaluate Whether to Redose Meds After Vomiting – Pharmacist’s letter
Kendrick JG, Ma K, Dezorzi P, Hamilton D. Vomiting of oral medications by pediatric patients: survey of medication redosing practices. Can J Hosp Pharm. 2012;65(3):196-201. doi:10.4212/cjhp.v65i3.1142
Medsafe. I’ve missed a dose; what should I do? May 2003. https://www.medsafe.govt.nz/profs/PUarticles/missed.htm. (Accessed August 2, 2019).
