Please, I don't want to be a Typhoid Mary!

June 8, 2008 8:13 PM

Will I get typhoid?

I purchased the oral typhoid vaccine (vivotif) at the pharmacy last week and have taken two pills so far on schedule.

My pharmacist said to take it on an "empty stomach" and when pressed clarified that to mean at least two hours before eating or two hours after eating. This whole not eating thing seemed rather important so I've been taking the vaccine in the middle of the night by setting my alarm. However, now I find that it is recommended to take the vaccine one hour before one eats or two hours after, which is rather different. I've been not eating for up to 8 hours before and after these pills.

Obviously I am going to call the pharmacist to clarify, if not the doctor, but I want to know if I should expect the pharmacist to replace these pills since the directions given are not actually how I should take the pill.

If I can't get the pills replaced I will probably just get the shot because of a completely different problem : my power went out yesterday and my pills were in the fridge. Any idea how hot a fridge gets in two hours if the door stays shut? I just noticed it was hot enough to curdle some milk.

posted by aetg to health & fitness (9 comments total)

As an aside, when I picked up these meds the pharmacist has also messed up my husband's order. He only gave him 30 days worth of malaria meds instead of 60. Luckily, my husband overheard the pharmacists talking together and was able to clear up the mishap before we left the store (or the country, for that matter).
posted by aetg at 8:32 PM on June 8, 2008

I think from reading your link that the important part is the empty stomach part. Otherwise time of eating would be immaterial.

I would check with your doc re the refrigeration part.
posted by konolia at 8:45 PM on June 8, 2008

Your schedule should be fine, if not inconvenient.
As for the fridge, 2 hours doesn't seem that long if the door stayed shut, but I would also double check with the pharmacist/doctor to make sure.
posted by rux at 8:51 PM on June 8, 2008

Given what your stomach and immune system is going to do with the contents of those pills I can't imagine two hours doing much damage to them even if you took them out and left them on the kitchen table.

The rate at which milk turns is dependent on both temperature and on the concentration of lactobacilus already present, so it's not really a good measurement of anything.
posted by Kid Charlemagne at 8:53 PM on June 8, 2008

I wouldn't be so worried about the fridge, but the doctor did stress keeping the pills cool. Thanks for the note about the milk though, I very rarely have milk anyway so I'm not a good judge for how long milk stays fresh.

The writing on the typhoid box said that the pills needed to break down in the intestines, not in the stomach and not to drink them with hot water because they will break down.

Since this website says to eat an hour later, I thought that perhaps this would encourage the pills to leave the stomach? I don't know enough about digestion to say.
posted by aetg at 8:59 PM on June 8, 2008

Those guidelines seem like they are to give the pills time to clear your stomach before you add food or food time to clear you stomach before you add pills. If I was reading that, I'd interpret the times given as 'at least' and not 'precisely'.
posted by jacquilynne at 9:27 PM on June 8, 2008

"Empty stomach" usually means an hour before or two hours after eating, it's pretty straightforward. Your 8 hours is likely extreme overkill (not sure how you got from "at least two hours" to setting your alarm for the middle of the night), and the pharmacist's instructions seem fine to me.
posted by biscotti at 4:55 AM on June 9, 2008

Aaahh...Is it overkill? Or is not eating while I sleep merely a convenient way of ensuring an empty stomach?
posted by aetg at 5:04 PM on June 9, 2008

Most people find waking up in the middle of the night to take medicine an inconvenience, but if it works for you, I wouldn't worry about it.
posted by rux at 3:33 PM on June 10, 2008