Taking your medicine: what’s the best way to make sure the drugs work?

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Name: Taking your medicine.

Age: The use of medicinal herbs goes as far back as the Paleolithic age.

Appearance: Recumbent.

I don’t take my medicine lying down. Well, you should, apparently.

Who says? A new study called Computational modelling of drug dissolution in the human stomach: Effects of posture and gastroparesis on drug bioavailability.

You lost me at “computational”. Published in Physics of Fluids, the study suggests that when you take a tablet, it’s best to lie down laterally on your right side.

Why would that matter? Basically, gravity – when you lie on your left side, the stomach’s exit into the duodenum is at its highest point. In that position, the rate at which a drug leaves your stomach and enters your bloodstream is reduced significantly.

What about standing up? Surely that’s gravitationally advantageous? It’s certainly better than lying on your left. Standing and leaning back a bit is better still. But they tested a variety of postures on the StomachSim, and lying on your right side came top.

The StomachSim? A computer simulation of a human stomach based on MRI imaging. In this case, they used the modelling data of the stomach of a 34-year-old male known as “Duke”.

Can your posture really make that much of a difference? In some cases, lying on the right side led to a doubling of the concentration of the active ingredient released.

Does this hold true for all different kinds of pills people might take? Asking for a friend It’s complicated. Some pills are designed to release their active ingredient slowly, others quickly, so hastening dissolution is not always a good thing.

I think my friend was hoping for a less complicated answer. There are also a lot of other factors involved, including stomach contents, stomach motility, and gastric fluid dynamics. “In particular,” the study says, “stomach contractions induce pressure and shear forces that generate complex pill trajectories.”

What about a spoonful of sugar? Doesn’t that help the medicine go down? They didn’t test that on the StomachSim, but some research suggests that giving sucrose to babies does lessen the discomfort of injections by reducing their pain response.

In that case, I think I might eat loads of sugar while also lying down. I’m not sure how that would help the dynamic physiological environment of your stomach.

Who cares? I’m just planning the rest of my summer. OK, have fun then.

Do say: “Oral administration remains a safe, economic, and easy way to administer drugs, and lying on your right side can aid absorption considerably.”

Don’t say: “I don’t think I’m going to be able to dance like this.”

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