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12 Medications That May Affect Your Workout Routine

cartoon of two pills holding weights

Besides your training regimen, many things can affect your workout routine, such as your nutrition, sleep, and state of mind. But what many people don’t know is that some commonly prescribed medications and over-the-counter drugs can also affect exercise performance. Please keep reading to find out which medications commonly have effects on exercise and physical activity.

Can you work out while on medication?

For most people, including anyone taking medications, it is recommended to maintain a certain level of physical activity as tolerated unless the doctor specifically instructs otherwise.

However, for specific medications, health professionals recommend that you work out before taking a dose or wait until the effects of the medication have worn off (usually in 4-6 hours). It is also important to stop exercising and take a break if perceived exertion is more than usual or you get overheated during the workout.

That said, it is never a good idea to skip taking medications. The best thing is to ask your doctor if you can exercise before starting a new medication. Tell your healthcare provider if you feel shortness of breath or any unusual symptoms with the same workout routine or exercise habit. Maintaining a consistent level of aerobic exercise, resistance training, and strength training is beneficial for your heart and overall health.   

Can I work out on antidepressants?

It is safe to work out on antidepressants for the most part. However, there are a couple of things to keep in mind. A class of antidepressants, selective serotonin reuptake inhibitors (SSRIs), can cause extreme fatigue and drowsiness, which can make it harder for you to exercise. These medications can also affect your alertness levels, increasing the risk of injuries during a workout. Sertraline (Zoloft) and fluoxetine (Prozac) are some commonly prescribed SSRIs. 

Planning ahead is key; you should have at least 4 hours between the last dose of antidepressants and exercise. If the antidepressant makes you drowsy, you should take it at bedtime. In the long run, if you can get through the initial hump, antidepressants can help relieve symptoms of depression and improve your motivation to exercise and build muscle mass.

What other drugs should I be careful of if I want to exercise?

Besides antidepressants, below are some other drug classes that can affect your exercise performance. The effects of different medications on exercise routines have always been a fascinating topic among health professionals across different disciplines, from internal medicine specialists and cardiologists to health professionals specializing in exercise science and sports medicine. 

Statins

Statin drugs such as simvastatin (Zocor), atorvastatin (Lipitor), and fluvastatin (Lescol) are used to treat high cholesterol. They can cause side effects like fatigue, muscle aches, and muscle cramps. This muscle pain and cramping can affect your ability to exercise. If you experience this symptom, it is best to avoid resistance training to reduce stress on your muscles. Talk to your doctor about changing to a different statin if achy muscles are bothersome or don’t improve.

Although rare, in severe cases, statins can cause a condition called rhabdomyolysis, which is associated with severe muscle damage. Seek immediate medical attention if you develop signs and symptoms such as dark-colored urine, severe muscle pain, and fatigue while on a statin drug.

Sleeping Pills and Anti-Anxiety Medications

Medications called benzodiazepines are used to treat anxiety and insomnia. Examples of benzodiazepines include alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), and lorazepam (Ativan). These medicines can cause fatigue, low energy levels, weakness, drowsiness, and poor coordination. Sleeping pills can also cause the same side effects, which are further enhanced by long-acting sleep medicines. This can affect your exercise performance. 

Taking your medication several hours before or after your workout may help to limit these effects. If you take a benzo or a sleeping pill to help you fall asleep, you should try to schedule your workout in the afternoon instead of the morning. Ambien CR is another  example of a long-acting sleep-aid formula. A short-acting formula may help improve the morning-after grogginess.

Antihistamines

Antihistamines are commonly used to treat allergy symptoms. These allergy meds can cause side effects like dry mouth, tiredness, lightheadedness, dizziness, and drowsiness. They can also relax your blood vessels and increase your risk of fainting, potentially leading to injuries. 

If an allergy medication like Benadryl zaps your energy or reduces focus during exercise, talk to your doctor about trying a different medication that’s less sedating, such as Zyrtec, Allegra, or Claritin.

Beta Blockers and ACE Inhibitors (medications used to treat high blood pressure)

If you are taking beta blockers or ACE inhibitors to lower blood pressure, you may not be able to achieve your peak heart rate. Talk to your doctor about what your adjusted target heart rate and blood pressure should be when you are on a beta blocker or ACE inhibitor medication for high blood pressure. 

Also, mild to moderate exercise can lead to post-exercise hypotension (low blood pressure). If this is the case, cool down carefully to avoid fainting due to low blood pressure. Your doctor may recommend frequent monitoring of your blood pressure and then adjust your medication dose based on your blood pressure readings after exercising.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Ibuprofen (Advil, Motrin) is a common OTC product of the drug class nonsteroidal anti-inflammatory drugs, which are a common class of drugs available over the counter. Long-term use or high doses of NSAIDS can lead to complications like gastrointestinal bleeding, which in turn can cause anemia and symptoms like low energy, fatigue, shortness of breath, and dizziness. This can lead to poor exercise ability. In addition, taking a pain reliever like ibuprofen can mask pain symptoms and increase your risk of injuries. 

If you take anti-inflammatory drugs regularly, talk to your doctor about getting tested for iron deficiency and/or taking dietary supplements.

Proton Pump Inhibitors

These medications are used to treat acid reflux or gastroesophageal reflux disease (GERD). Examples of proton pump inhibitors (PPIs) include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), and others. PPIs affect calcium and magnesium absorption. Long-term use of these drugs can lead to calcium loss from the bones. Weak bones can affect your ability to exercise to your full potential and put you at risk of fractures. 

Talk to your healthcare provider about lifestyle measures to treat your condition or other medications if PPIs cause severe side effects.

Muscle Relaxers

Medications like cyclobenzaprine (Amrix) and tizanidine (Zanaflex) are used to treat muscle spasms. These drugs can cause you to feel drowsy and become dehydrated, with symptoms like dry mouth and blurred vision. Excessive sweating can make the effects even more pronounced. 

Increasing your water intake may help limit the undesirable effects of muscle relaxers. You can also try taking the medication at night, several hours before your morning workout, to limit how your body reacts to the drug. It may be a good idea to hold off on exercising if you are taking muscle relaxers while you recover from an injury.

Diuretics

Diuretics or water pills help the body eliminate excess salt and water. They are used to treat conditions like high blood pressure, heart failure, and edema (fluid buildup). Diuretics can cause side effects like dizziness, dehydration, and hypokalemia (low potassium), which can lead to muscle cramps and reduced ability to exercise. 

Eating potassium-rich foods may help. Also, talk to your doctor about taking a potassium-sparing diuretic like spironolactone (Aldactone), amiloride (Midamor), eplerenone (Inspra), or others.

Certain Antibiotics and Corticosteroids

Fluoroquinolones are a class of strong antibiotics that can effectively fight off complex infections. Unfortunately, they have a boxed warning; they can cause painful tendons with or without tendon ruptures. Levofloxacin and ciprofloxacin are some popular examples of this drug class. Corticosteroids, like prednisone, when taken chronically, can lead to muscle weakness. If you are on these medications short term, it may be worth doing less intensive workouts and paying particular attention to stretching to avoid injuries.

Decongestants

Taking decongestants like pseudoephedrine (Sudafed) can raise your heart rate and blood pressure. Combined with the effects of exercise, elevated blood pressure can put considerable stress on your heart. Talk to your doctor about exercising safely while on decongestants, especially if you have heart disease or a history of a cardiac event such as a heart attack.

Stimulants

ADHD medications like Concerta, Ritalin, and Adderall are stimulants. They increase your metabolic rate at the cellular level and affect temperature regulation, which can lead to increased sweating and dehydration. Stimulants also cause tremors and agitation, which can increase your risk of injuries. 

Staying well-hydrated during your workouts is especially important if you are taking ADHD meds.

Wrapping up

Keep in mind that every person is different. You may not have the same effect with medication as someone you know. Also, your response to medication and its effect on your workouts may change over time. If you suspect that your medications are affecting your exercise routine, talk to your doctor about possible solutions or other treatment options.
 

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126440/
  2. https://www.ncbi.nlm.nih.gov/books/NBK470159/
  3. https://www.nhs.uk/conditions/antihistamines/
  4. https://www.nhs.uk/conditions/beta-blockers/
  5. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/side-effects/
  6. https://www.nhs.uk/conditions/nsaids/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887997/#
  8. https://www.mayoclinic.org/drugs-supplements/cyclobenzaprine-oral-route/side-effects/drg-20063236
  9. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/art-20048129
  10. https://www.frontiersin.org/articles/10.3389/fphar.2022.990241/full#:~:text
  11. https://www.ncbi.nlm.nih.gov/books/NBK539896/
  12. https://www.vasculitisfoundation.org/mcm_faq/what-is-steroid-myopathy/