Chronopharmacology

Chronobiology is the science of biological rhythms (biological clock). The branch dealing with the pharmacological aspects of chronobiology is termed Chronopharmacology. Chronopharmacology is the science dealing with the optimization of drug effects and the minimization of adverse effects by timing medication in relation to the biological rhythm. In simple language, it means that if we take our medication keeping in mind our body clock, the medicine can prove more beneficial and cause minimal side effects.

Here Are a Few Examples:

• In relation to our body clock, maximum synthesis of cholesterol takes place at night. Hence, drugs used to lower cholesterol like Statins will prove beneficial when prescribed at bedtime.

• According to our biological clock, maximum production of acid occurs at night between 10 PM to 2 AM. So, for patients having acid reflux problems, it will be beneficial to take Proton Pump Inhibitors (PPIs) before dinner. If worsening of symptoms occurs, then it should be given in two doses, morning and night.

• Similarly, antihypertensive medication should be prescribed early morning, as the blood pressure rises in the morning. A circadian rhythm characterizes blood pressure both in hypertensive and in nonhypertensive subjects. This pattern is associated with lower B.P values during sleep and periods of minimal activity, and higher B.P levels during wakefulness, and during mental and physical activity.

• According to our biological clock, the severity of cardinal signs in rheumatoid arthritis is three times more common between 8 to 11 AM than at bedtime. Therefore, long-acting NSAIDs (nonsteroidal anti-inflammatory drugs) at bedtime can better control morning symptoms.

• In the case of osteoarthritis, the pain is intense between 2 to 8 PM. If the pain is worst at night, then evening dose, and if the pain is worst in the afternoon, a morning dose of NSAIDs should be given respectively to have better effects of the drug on the patient.