What is the most appropriate instruction for a patient starting long-term corticosteroid therapy?

• A. Take on an empty stomach
• B. Take with meals
• C. Take only at bedtime
• D. Skip meals

Answer: (C)

Starting long-term corticosteroid therapy requires protecting the stomach and improving tolerability. These medications can irritate the gastric mucosa and increase the risk of gastritis or ulcers, so taking them with meals helps create a buffer and reduces GI upset, making it easier for patients to stick with the regimen. Options that suggest taking on an empty stomach or at bedtime would worsen sleep or GI symptoms, and skipping meals offers no protective benefit. In practice, taking the dose earlier in the day when possible also helps align with the body’s natural cortisol pattern and minimizes sleep disruption, though the exact timing should follow the prescriber’s guidance.