Prescription medication cascading out of orange pharmacy vials isolated on white

Answer

This is a great question, and I'm sure it's one that many others have but never ask!

If you have a prescription and the label instructs you to take the medication 'three times a day', what exactly does that mean?

Well, there is no 'standard' that determines what 'three times a day' actually means.

In fact, when your prescription says 'three times a day', it is simply an English translation from the Latin 'ter in die'. This is why you may notice your paper prescription with the directions 'TID', which is simply an abbreviation for 'ter in die'.

So, there is really no more context behind the term 'three times a day' than that. It is not a standardized term to denote a specific time interval in hours. It also is not the same as your prescription saying 'every 8 hours'.'Every 8 hours' is a specific time interval. Again, 'three times daily', is not.


How To Take A 'Three Times A Day' Prescription

While there isn't an exact answer to this question, and it may vary depending on the drug you are taking, 'three times a day' generally means to take your medication three times during the day at close to even intervals during waking hours.

For example, let's say you wake up at 6 AM, go to bed at 10 PM and the drug in question is the antibiotic amoxicillin. An appropriate way to take the medication would be at the following times:

  • 6 AM (when you wake up)
  • 2 PM (early afternoon)
  • 10 PM (when you go to bed)

In the vast majority of cases, medication can simply be taken during waking hours and you wouldn't be expected (nor would it be necessary) to wake up in the middle of the night to take a dose.

Sometimes, more generally, three times a day can just mean to take a medication as follows:

  • In the morning
  • In the early afternoon
  • In the evening

The best thing you can do if your prescription reads 'three times a day' and you are unsure of how to take it, ask your doctor or pharmacist! They can provide you with appropriate guidance.

It is important to note that some medical organizations (mostly hospitals and in-patient facilities) do standardize what 'three times a day' means.

For example, the Windsor Regional Hospital in Canada has standardized 'three times a day' for their most of their in-patients as:

  • 9 AM
  • 1 PM
  • 5 PM

As another example, the Shands Hospital, a teaching hospital of the University of Florida, standardizes 'three times a day' as follows:

  • 9 AM (8 AM for psychiatric patients)
  • 2 PM (12 PM for psychiatric patients)
  • 9 PM (5 PM for psychiatric patients)

What I hope I have illustrated here is that when your prescription says to take it 'three times a day', it does not necessarily mean 'every eight hours''. It simply means to take split your dosages up roughly in an even manner throughout the time you are awake (unless your doctor or pharmacist has specified otherwise).


When 'As Needed' Is Also On Your Prescription

Adding a small wrinkle to everything discussed here is when your prescription says to take it 'as needed' as in 'take one tablet/capsule by mouth three times a day as needed.'

'As needed' prescriptions are generally for drugs that provide symptomatic relief for some sort of condition, like pain or anxiety.

Many of these drugs don't have a long duration of action and are often controlled substances (e.g. opioids for pain or benzodiazepines for anxiety).

'Three times a day' in the case of these drugs may mean that you can take a dose, if you need to, up to three times daily, but not necessarily at the longer intervals discussed above.

If we use a drug like oxycodone as an example, which has a duration of action around 3 to 6 hours, it may be okay to take it every 3 to 4 hours if you need to.

The 'three times a day' in this situation is likely there more as a dosage limit (as in you can take it three times a day, but no more), as opposed to trying to give you an idea of how to evenly split it up throughout the day.

As mentioned above, if you have any questions about how to take the medication that has been prescribed to you, your best option is to speak with your prescriber or pharmacist.


Summary

  • TID, or 'three times a day', isn't a standardized time interval and doesn't necessarily mean 'every 8 hours'.
  • In general, if your prescription says to take it 'three times a day', it simply means to split it up at close to even intervals during your waking hours.
  • If you are unsure of how to take your medication, ask for clarification from your doctor or pharmacist.

  • References
    1. Use and Meaning of Medical Acronyms. AMA Journal of Ethics
    2. Drug & Therapy Bulletin. University of Florida
    3. Inappropriate Medical Abbreviations. PubMed
    4. Medical abbreviations. PubMed
    5. The use of Latin terminology in medical case reports: quantitative, structural, and thematic analysis. PubMed
    6. Impact of reducing dosing frequency on adherence to oral therapies: a literature review and meta-analysis. PubMed
    7. STANDARD MEDICATION ADMINISTRATION TIMES. WRH