30 minutes before meals on an empty stomach, taken warm, 2 to 3 times daily. The classical instruction is to take it warm (温服) to enhance its middle-warming action.

Chronic use: typically prescribed for 2 to 8 weeks, then reassessed. May be taken intermittently over longer periods for constitutional weakness.

Favor warm, easily digestible, cooked foods such as congee (rice porridge), soups, stewed root vegetables, well-cooked grains, and mild proteins. These support the formula's goal of rebuilding middle burner function. Avoid cold and raw foods (salads, iced drinks, raw fruit), greasy or fried foods, and overly sweet or rich desserts, all of which burden the weakened Spleen and Stomach. Dairy products should be minimized as they tend to generate Dampness. Spicy or acrid foods in excess should also be avoided, as they can scatter the Qi that the formula is trying to consolidate. Eat regular, moderate-sized meals rather than large heavy ones. The classical approach emphasizes gentle nourishment, sometimes described as eating soft foods like porridge on the day of taking the formula.

Zhi Gan Cao (Glycyrrhiza/Licorice) interactions: This is the primary herb of concern for drug interactions in this formula.

• Cardiac glycosides (digoxin, digitalis): Glycyrrhizic acid in licorice can cause potassium depletion (pseudo-aldosteronism), which increases sensitivity to cardiac glycosides and may precipitate toxicity. Concurrent use should be avoided.
• Antihypertensive medications: Licorice can cause sodium and water retention and raise blood pressure, potentially counteracting the effects of blood pressure-lowering drugs.
• Potassium-depleting diuretics (furosemide, thiazides): Combined use with licorice may compound potassium loss, increasing the risk of hypokalemia, muscle weakness, and cardiac arrhythmias.
• Warfarin and anticoagulants: Some evidence suggests licorice may interact with warfarin metabolism, potentially altering anticoagulant effects. Monitoring is advised.
• Hypoglycemic agents (insulin, sulfonylureas, metformin): Glycyrrhizic acid has glucocorticoid-like effects that can raise blood sugar, potentially reducing the efficacy of diabetes medications.
• Corticosteroids: Licorice inhibits the metabolism of hydrocortisone and prednisolone, potentially increasing their blood levels and side effects.

These interactions are dose-dependent and more relevant with prolonged use. In typical short-course prescriptions at standard doses, clinical significance is low but should still be considered.