— Hazel, Canada Pills can get stuck when swallowed and cause significant problems through mechanisms that are not entirely understood. Some compounds, including medications that treat osteoporosis (Fosamax [alendronate], for example) are very irritating to the esophagus, and people taking these drugs are always instructed to sit upright for at least 30 minutes after taking the dose. This is because the medication can cause a problem known as esophagitis — inflammation of the esophagus that can lead to serious complications, including pain and bleeding. This problem requires two factors: a pill or capsule getting lodged in the esophagus, leading to a prolonged period of contact, and a compound that is either too acidic or basic for the esophagus. Other medications that can cause direct irritation to the esophagus include anti-inflammatory agents such as ibuprofen, tetracycline antibiotics, iron, and potassium. To avoid the problem of pills getting stuck, prevention is clearly key. Follow these steps:
Never take a medication when you are lying down; instead, sit or stand when swallowing a pill.Remain upright for at least 30 minutes afterward if possible.Drink enough liquid — usually a minimum of eight ounces — when taking pills so that the pill is “chased” down.
Q2. Is it okay to take Ambien CR indefinitely? I have been taking it for about two months now. I tried to stop it the other night, and I was awake most of the night. This has been the only sleep aid that has allowed me to sleep through constant abdominal pain that I am currently having treated. But I am worried about Ambien’s long-term effects. Do you have any advice? — Lori, Colorado Unfortunately, it is not acceptable to take Ambien CR (zolpidem tartrate extended release) indefinitely, because long-term use of the drug can lead to dependency. The product labeling for Ambien CR approved by the Food and Drug Administration and a March 2007 Dear Health Care Professional letter from Ambien’s manufacturer, Sanofi-aventis, indicate that if insomnia doesn’t get better after the drug is taken for 7 to 10 days, an underlying medical problem may be involved. (“Dear Health Care Professional” letters are provided by drug manufacturers to health care professionals. They detail the latest drug safety information and prescribing instructions and include any discussions or reviews by the FDA.) From what you describe, your abdominal pain is disrupting your sleep, which concerns me. Although you don’t indicate what caused your abdominal pain or how it is being treated, I suggest that you reevaluate the use of Ambien CR as a sleep aid with your physician. (Please be sure to inform all the physicians involved in your current care plan in this evaluation, if in fact you are being cared for by more than one physician.) Here’s something else to keep in mind: Consuming large amounts of caffeine can also affect your sleep. The caffeine in coffee, tea, and other caffeinated drinks can add up quickly. If it’s possible that this is contributing to your sleeping problem, I suggest stopping caffeine or switching to noncaffeinated drinks after 10 or 11 a.m. Learn more in the Everyday Health Healthy Living Center.
