Antibiotics and a course of something with delayed emptying posts 91–109

Small correction to my own earlier position on antibiotics. I had the units the wrong way round, which changes the conclusion by an order of magnitude and therefore changes it entirely.

The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather than filling the gap.

That distinction has done more work for me than anything else in this category.

Post #92 answers the question as asked. The question underneath it is different.

Oral medications versus time: if you take an oral medication 30 minutes before semaglutide (which slows gastric emptying), the delayed stomach emptying affects when and where the oral medication is absorbed. Separating by a larger interval (1 to 2 hours) usually resolves this.

I read post #91 twice before replying, because I had assumed the opposite.

The question underneath antibiotics is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.

Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.

I would put moderate confidence on the mainstream reading of antibiotics and no more. That is not scepticism for its own sake; it is where the sourcing actually stops.

Post #94 and I disagree about the size of the effect, not about the direction.

SGLT2 inhibitors: frequently co-administered and relevant to renal and cardiovascular discussion, not to interactions. There is no pharmacokinetic interaction of concern.

Narrowing post #96, because the general version has more than one answer.

On antibiotics: the maintained page in the documentation commons covers the general case with citations and a review date, which is more reliable than any reply here including this one.

Answering the antibiotics question as asked, then the question I think is meant. As asked: yes, with the qualification below. As meant: it depends on how the first measurement was taken.

Adding the measurement that post #96 says would settle it.

Food interactions: most interactions are absorption interactions. Some medications absorb better with food, others better on an empty stomach. With an incretin agonist that already slows gastric emptying, food effects interact with the drug effect as well.

Alcohol is not contraindicated in the labelling and it does irritate a stomach that is already emptying slowly. There is no published interaction study, and the conservative reading is the obvious one.

Supplements and herbs: many have no established interaction. Some do. If you are taking something unusual, checking a reference (like a pharmacist) is more useful than guessing from forum discussion.

It is the kind of thing that is obvious once and never again.

Agreed, and I will stop repeating the version of this I had been repeating.

Taking post #101 at face value and following it one step further.

The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather than filling the gap.

I changed my mind about antibiotics after someone here asked me for the source and I could not produce one. That is worth saying out loud because it is the ordinary way it happens.