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Does Drinking Excessive Amounts Of Water Reduce The Effectiveness Of Anti-TB Medication?

Posted on Mon, 6 Mar 2017

Question: if at all we take tubular lymphadentis drugs(nearly four tablets) with two or more glass of water is it ok
will it effect treatment.now within taking of one and half hour of tablets my urine color is getting orange ,is it OK,or the tablets absorption was not fully occurred.please anyone can explain.

Answered by Dr. Geeta Sundar (43 minutes later)

Brief Answer:
take enough water needed to comfortably swallow the tablets--not more

Detailed Answer:
Hi welcome to Health care magic,

Please take enough water needed to comfortably swallow the tablets--not more, not less. More may delay absorption and less may interfere with absorption.

Do not worry about orange urine. It is due to excretion of breakdown products of Rifampicin, one of the drugs in your treatment. It does not mean absorption is less. It is harmless.

But a word of caution--drugs for tuberculosis can cause liver damage, which can also cause orange urine. So if you are having loss of appetite or severe nausea--check your liver functions.
You can revert back.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Geeta Sundar (32 minutes later)

is taking tablets with more water (nearly two glass or more)will make them ineffective.

Answered by Dr. Geeta Sundar (11 hours later)

Brief Answer:
it may delay absorption and thus efficacy may come down a bit.

Detailed Answer:
Hi, it may delay absorption and thus efficacy may come down a bit.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Geeta Sundar (34 minutes later)

madam I took one week my pills with nearly one and half glass or more water but not took food for nearly three hours is it ok

Answered by Dr. Geeta Sundar (3 hours later)

Brief Answer:
No--half an hour gap is enough after taking the pills.

Detailed Answer:

The water is fine.

half an hour gap is enough after taking the pills.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Geeta Sundar (1 hour later)

madam I little bit worried not remembered so much as whether I took less water or more water but every day swallowed medicine comfortably as per the required dosage will this effect my treatment.

Answered by Dr. Geeta Sundar (2 hours later)

Brief Answer:
Hi no cause to worry. I think you did fine.

Detailed Answer:
Hi no cause to worry. I think you will do fine.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Geeta Sundar (25 minutes later)

is this intake of water with medicine or after medicine whether low or high amount really concern as this thinking is making me sick from inside.whether medicine is taken or not I always maintained the record.so as said above will these things really matter in treatment.

Answered by Dr. Geeta Sundar (1 hour later)

Brief Answer:
yes it is of a little bit of concern.

Detailed Answer:
Hi, yes it is of a little bit of concern. But do not worry too much.
If you take water before, after, or excess----acid and digestive enzymes will get diluted and breaking down and absorption of drug may be interfered with.
So drink with medicine and enough to swallow comfortably only.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Geeta Sundar (19 hours later)

madam as I regularly taken the medicine Akurit 3 as per dosage and each day my urine used to be orange colour due to medicines rifampicin ,that means my medicine absorption was done ,so whether less or high water this will not effect my total treatment na,as I am getting tensed

Answered by Dr. Geeta Sundar (3 hours later)

Brief Answer:
Absolutely correct XXXXXXX

Detailed Answer:
Absolutely correct XXXXXXX

To be sure we can also get our blood levels of drug checked but that is not necessary in your case.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Geeta Sundar (8 minutes later)

madam which test to be conducted to check blood levels of drug in case

Answered by Dr. Geeta Sundar (1 hour later)

Brief Answer:
These are called drug assays

Detailed Answer:
Hi XXXXXXX

These are called drug assays and can be done for Rifampicin, Isoniazid, Ethambutol and Pyrazinamide--the four drugs you are probably taking.

But you do not require it.
Your doctor will tell you if you do.
These tests are expensive and reserved for treatment failure cases.

You can check with a big lab or diagnostic centre.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Geeta Sundar (1 hour later)

madam how to find normal presence of drug in blood I am getting very tense even I am regular

Answered by Dr. Geeta Sundar (5 minutes later)

Brief Answer:
As you are regular with your treatment, you do not require them at present.

Detailed Answer: XXXXXXX please go to nearest diagnostic centre and find out about drug assays (drug levels in blood that you are asking about). But do them only if your treating doctor advises.
As you are regular with your treatment, you do not require them at present.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Geeta Sundar (53 minutes later)

madam attaching the x-ray report during first week of my treatment at that time I have no symptoms except swallow of lymph node now during 7th we

Answered by Dr. Geeta Sundar (9 hours later)

Brief Answer:
I do notice a significant improvement.

Detailed Answer:
Hi XXXXXXX

I spent 15 minutes comparing November and February x-rays and you will be happy to know that I do notice a significant improvement.

I am pretty confident that you can stop treatment in six months.

Also stop worrying about the drugs now. Go by your doctor's advise and you should be fine. I hope your ESR and Liver functions have also be done in the beginning and repeated with second x-ray and they are normal.

Please relax.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Geeta Sundar (8 hours later)

Madam asking you this weird questions please explain 1)is this intake of water ( whether high or low ) will really affects the dosage for that day...As my urine was always used to be in yellow orange colour which proves my daily intake of medicine but this water absorption making me sick.
2) attaching my LFT and ESR report

Answered by Dr. Geeta Sundar (1 hour later)

Brief Answer:
Your LFT and ESR are normal.

Detailed Answer:
Hi XXXXXXX

I have seen the reports.

Your LFT and ESR are normal.

Your water intake at present with medication irrespective of urine colour before or after starting medication is fine. Stop worrying.

Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Geeta Sundar (54 minutes later)

madam as already completed three months the shadows showing in the x ray taken in Feb also will disappear in six month na....

Answered by Dr. Geeta Sundar (25 minutes later)

Brief Answer:
Sure they will.

Detailed Answer:
Hi XXXXXXX Sure they will. With an ESR of 4mm you can consider yourself almost cured.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Geeta Sundar (1 hour later)

madam my ESR was Normal from starting of my treatment.but the swallow lymph node in my neck was also regressed during 7th week of my treatment.my only concern is now is chest pA which my doctor told me after or nearly six months .that is my worry hence always in my mind I am getting this tension whether the medicines are absorbed completely or not or if there efficacy will reduce after taking lot water or in take of water in between breakfast and medicine.I am sorry to you this question repeatedly but this thoughts always haunting me.

Answered by Dr. Geeta Sundar (31 minutes later)

Brief Answer:
x-ray chest shows improvement, so treatment is working.

Detailed Answer: XXXXXXX
your neck nodes have regressed.
x-ray chest shows improvement, so treatment is working.
Stop worrying about water part.
Chest x-ray will come totally to normal in six months.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Geeta Sundar (16 hours later)

madam as I took medicine today my urine colour was not orange in color today ,but as I cleaned my teeth and started doing tongue clean with tongue cleaner a saliva in red color came out of stomach while cleaning the tongue hence I think the absorption for today medicine was not proper after that I took some water and took extra pill as my saliva with red color came out so I took extra pill now after some time when I went to toilet the urine color was in yellow color now my question is today dosage was not absorbed properly and as I took all the pills morning but still the saliva in my stomach came out in red color of medicine ,I didn't vomit and also I took the breakfast after nearly five hours so that the extra pill and the medicine both will be absorbed well so please explain the today dosage will be effective

Answered by Dr. Geeta Sundar (5 hours later)

Brief Answer:
yes it is possible that sometimes absorption can get delayed.

Detailed Answer:
Hi XXXXXXX yes it is possible that sometimes absorption can get delayed.

Hi XXXXXXX

The stomach is such a sensitive organ that many factors influence its action and emptying like gas/too much or too little acid, extra mucous formation, undigested food etc.
There was obviously a delay in absorption of tablets.
But do not take extra dose.You might end up with drug toxicity.
Actually a little extra is provided for such situations in the dosage itself.
Also even if we do not take daily dose, action of drugs is adequate.
Even Alternate days or bi-weekly may be sufficient.
We continue with daily dose just to be 100% sure.
So even if one day absorption is delayed, it does not matter.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Geeta Sundar (22 hours later)

good evening madam , here I am to disturb you again, please don't mind even asking you silly questions but you can understand,
as per my earlier query if at all saliva come out of red even if there is a delay in absorption then also my medicines taken will not be ineffective na for that particular day as what I mean to say if at all there is delay in absorption of medicine but still in empty stomach maximum absorption must have been completed as I came to know this delay absorption during the cleaning of my tongue only hence this should not compromise my daily dose na since I took. all the medicines in empty stomach early morning. also is it compulsory that the urine color will be red or orange every time we take medicine or it can be light yellow color

Answered by Dr. Geeta Sundar (1 hour later)

Brief Answer:
if there is gastric reflux, the drug can show up in your saliva

Detailed Answer:
Hi XXXXXXX
if there is gastric reflux, the drug can show up in your saliva as orange colour.

And it takes more time for the drug to enter blood stream, act on the affected part and then be broken up in liver.

It is only after this that it gets excreted in urine giving orange colour.
Sometimes this process can get delayed.
If you had waited some more time the urine would have shown up orange.
If the urine is diluted then it may not show up bright orange.
But that does not mean drug is ineffective.
Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Geeta Sundar (1 hour later)

madam it is OK ,then it means urine color doesn't mean for the absorption of drugs in the body...... even sometimes after taking medicines the urine color doesn't come in orange but it shows in yellow color for half of day and becomes normal in evening ... after taking lot of water so is that the excretion of drug of rimafician

Answered by Dr. Geeta Sundar (55 minutes later)

Brief Answer:
if urine is dilute then it may not show bright orange

Detailed Answer:
Yes XXXXXXX
if urine is dilute then it may not show bright orange or the colour may not last long.
But Rifampicin is being absorbed and excreted normally.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Geeta Sundar (1 hour later)

madam if we have gastric reflux or acidity then it can obviously hamper the medicine of the day ....but as taking the pills in empty stomach ,the absorption should be fine .....

Answered by Dr. Geeta Sundar (8 hours later)

Brief Answer:
'reflux' must have occurred because of vigorous tongue cleaning.

Detailed Answer:
Hi XXXXXXX the 'reflux' must have occurred because of vigorous tongue cleaning.

It would have been a one-off occurrence.

The absorption would still be fine.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Geeta Sundar (7 hours later)

madam thanks for your guidance, hence relax myself with your Valuable suggestions,I am sorry to always ask you weird questions as I scared that this intake of water with medicines was effecting my daily dose hence always raised this question and always stretched on this how to take water and all this ...I am happy with your answers as I am always up date with my daily dose .once again thanks

Answered by Dr. Geeta Sundar (4 hours later)

Brief Answer:
You are welcome XXXXXXX I can understand your anxiety

Detailed Answer:
You are welcome XXXXXXX I can understand your anxiety--regards

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Nagamani Ng