Medicine Sick Day Rules

Updated On March 12, 2025

Important Information for When You Are Unwell

When you are unwell with vomiting, diarrhoea, or a high fever, certain medications should be temporarily stopped to prevent serious complications. These are called the Medicine Sick Day Rules.

 

What Are Sick Day Rules?

Some medicines can affect your kidneys, blood pressure, or hydration levels when you are unwell. If you experience:

  • Vomiting or diarrhoea (for more than 24 hours)
  • A high fever, sweats, or shaking (signs of infection)
  • Dehydration (not passing urine or very dark urine)

 

You should temporarily stop taking certain medications until you are well again.

 

 

Which Medicines Should Be Stopped?

Use the acronym SADMANS to remember the medicines to stop:

  • S – SGLT2 inhibitors (e.g., Empagliflozin, Dapagliflozin, Canagliflozin)
  • A – ACE inhibitors (e.g., Ramipril, Lisinopril, Enalapril)
  • D – Diuretics (Water tablets, e.g., Furosemide, Bendroflumethiazide, Spironolactone)
  • M – Metformin (Used for diabetes)
  • A – ARBs (e.g., Losartan, Candesartan, Valsartan)
  • N – NSAIDs (e.g., Ibuprofen, Naproxen, Diclofenac)
  • S – Sulfonylureas (e.g., Gliclazide, Glimepiride)

 

You should restart these medicines once you are eating and drinking normally for 24-48 hours. If you are unsure, speak to a healthcare professional before restarting them.

 

 

What Should You Do?

  1. Continue drinking fluids – small sips of water if you are struggling.
  2. Monitor your urine output – if you are not passing urine or it is very dark, seek medical help.
  3. Monitor your blood sugar levels if you have diabetes.
  4. Contact your GP, pharmacist, or NHS 111 if you are concerned.
  5. Restart medicines once you are well again unless advised otherwise.

 

 

 

 

 

When to Seek Urgent Help

 

Seek medical attention if:

  • You cannot keep fluids down
  • You are passing no urine for 12 hours or more
  • You feel dizzy or confused
  • You have severe abdominal pain or persistent vomiting

 

For advice, contact NHS 111 or us.

 

 

Further Information

 

For more details, visit:

 

Stay Safe – Follow the Sick Day Rules!