How to take your COC protocol

How to take your COC protocol

(The below guidelines cover all the COC protocol medications. Depending on your individual circumstances, your doctor may have prescribed some rather than all medications at the outset. Please refer to your doctor's letter for specific information regarding the medicines you have been prescribed and the dosing instructions.)

Metformin

Metformin modified release is generally prescribed because it has been observed to be better tolerated than the standard, immediate release tablet. Gastro-intestinal side effects (e.g., flatulence, bloating, diarrhoea) are less common in patients taking the modified release version.

We recommend that you take Metformin with or directly after meals to help reduce any stomach or bowel side effects that may still occur. Swallow the modified release tablet whole with a full glass of water. Do not crush, break, or chew it.

Atorvastatin

It is important to be consistent and take the Atorvastatin tablet(s) at the same time each day. Most patients are advised to take Atorvastatin after their evening meal (1-2 hours before bedtime) or after breakfast.

Atorvastatin has a longer half-life than other lipophilic statins such as Simvastatin, and therefore maintains a therapeutic drug concentration over a 24-hour period, which allows more flexibility in administration time. Simvastatin’s short half-life means this statin is best taken at night.

Statins are not known for upsetting the stomach, so can be taken with or without food.

Mebendazole (Vermox™)

Mebendazole tablets may be swallowed whole or chewed and taken at any time of day with or without food.

To help facilitate the best possible absorption, we normally recommend - a) taking the tablet with a fatty meal or snack; b) chewing rather than swallowing the tablet. If you have trouble chewing the tablet, you can place it in a tablespoon and add a small amount of drinking water. The tablet will absorb the water within a few minutes and turn into a soft mass with semi-solid consistency, which may be easier to swallow.

Doxycycline

Doxycycline capsules should be swallowed whole with a full glass of water. Do not break, crush, chew, or open capsules. If Doxycycline appears to irritate your stomach, you can take it with or just after a snack.

It is best to take it consistently at the same time each day and well before bedtime to avoid irritation of the gullet. It is important a) not to lie down for at least 30 minutes after taking Doxycycline, b) not to take indigestion remedies, medicines/supplements containing iron or zinc, or consume dairy products 2 hours before or after Doxycycline.

N.B. Alternative formulations of the COC protocol medicines may be considered if a patient has swallowing difficulties, drug tolerance issues or a stoma.