Swallowing pills together is OK, unless meds shouldn’t interact

Dear Dr. Roach: I have always wondered if it matters if you swallow a bunch of pills in one swallow or if it would be better to space them out. I take a bunch, like Eliquis, dicyclomine, gabapentin, etc.

— B.A.

Dear B.A.: With most pills, it’s OK to take them as a bunch together, if you can tolerate doing so (I’ve known people who have a tough time taking multiple pills at the same time due to gagging). There are a few combinations of pills that shouldn’t be taken together, such as tetracyclines and calcium, but these should be labeled clearly on your bottle. A few medicines, like alendronate (Fosamax), can’t be taken with any other medicines. Some medicines, including all the ones you mentioned, can cause sedation, which can be worse if taken together.

As always, your pharmacist is your best friend for questions about medication interactions.

Dear Dr Roach: Despite having family history of high cholesterol (including early death due to heart failure), I was told at 53 that my 10-year risk is not alarming. I do not smoke nor drink.

I recently had some tests done and was told that my Lipoprotein (a) is above normal. I am wondering if that may explain my concern of why, despite keeping a very careful diet over two decades (and a fairly good Mediterranean diet before, as well) and an ideal BMI, my figures are not getting better. (I still have a high LDL, low HDL and high triglycerides.)