Two Tablets At The Same Time Or One Twice Daily?

In our latest question and answer, the pharmacist discusses what it means if your prescription says to take two tablets by mouth daily.

Question

I take multiple daily medications and was wondering if I was taking them right. I take them as directed on bottle and my doctor but did not say if I should wait between pills or take all at once. If I take 2 daily, I do one in morning and one after supper. Any thoughts?

Asked by Fred45 On Jul 24, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jul 24, 2018

This is an excellent question! There are often times subtle differences in meaning depending upon how a prescription’s directions were written. Consider the following examples:

  • Take 2 tablets daily OR Take 1 tablet twice daily OR Take 2 tablets daily as directed


In the first example - Take 2 tablets daily: Usually this means to take 2 tablets at the same time once a daily.  There are certainly times that the prescriber (doctor) may have verbally told the patient to take one tablet in the morning and one tablet at night, but that is not how the prescription was written to be interpreted.

 

In the next example - Take 1 tablet twice daily: The intentions of the prescription are very clear.  The patient should take one tablet twice daily.  There is really not room for interpretation here.


In the last example - Take 2 tablets daily as directed: it is implied by the as directed that the patient was given additional instructions on how to take the drug. While usually 2 tablets daily would mean taking both tablets at the same time, the as directed in the directions can mean the prescriber (doctor) instructed the patient a different way.  


If after reading this you are confused, I would call your doctor’s office to clarify the directions. If it turns out you have been taking the prescription a different way than the doctor intended, make sure to tell the office this. You don’t want to suddenly change your medication routine without getting input from your doctor.


In some cases, taking a drug twice a day won’t make a difference if the doctor really wanted once a day dosing. In other cases, the interval between dosing can make a big difference in how effective a drug is potentially.


For example, if you accidentally take an antibiotic as two tablets one time daily, as opposed to twice daily, there is a good chance it will not work as well as blood levels of the antibiotic may drop too low with such an extended dosing interval.


Always ask your pharmacist, doctor or other health care provider anytime you have questions about how a drug should be taken. 


Additional Information

As a general rule of thumb, when pharmacies (or your doctor) writes out directions for you for a prescription, they use the following format:

  • Directions: [Verb] + [Quantity] + [Dosage Form] + [Route Of Administration] + [Frequency]


In the above of example of "Take two tablets by mouth every day", this translates to:

  • Take [Verb]
  • Two [Quantity]
  • Tablets [Dosage Form]
  • By Mouth [Route Of Administration]
  • Every day [Frequency]


The part that often throws individuals off is the quantity and frequency. To prevent medication errors, "take two tablets by mouth daily" is better written as "take two tablets by mouth once daily" as this is what is intended (unless your doctor tells you differently).

About the Pharmacist

Ms. Jennifer Hauder RPh

Jennifer Hauder is a registered pharmacist in the state of Illinois. She has over 10 years experience as a pharmacist in the retail and pharmacy benefit managers (PBM) settings. She became a pharmacist due to her interest in healthcare and the opportunity to help others with their healthcare needs. When not working, she enjoys spending time with her husband, three children and two black labs Lucky and Charms.

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