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pharmaceutical irritation
Oct. 20th, 2004 09:01 pmThis doesn't quite qualify as a rant. But I'm irritated. As some of you know, some medications are formulated with special time-release coatings on the pills. It's really important not to break these pills, or you let the active ingredient out from the time-release coating and risk a dangerous overdose. (Even if the dose is small enough that it isn't acutely dangerous, messing with one of those high-tech pills makes the drug delivery much less controlled and predictable.) So pharmacists label the bottles of special time-release pills "WARNING: DO NOT CHEW OR CRUSH. SWALLOW WHOLE." The reason for the warning is given in the fine print of the pamphlet published by the drug-manufacturer, that almost nobody reads. So it's important to have the important warning on the pill bottle, right next to the stuff like, "TAKE WITH FOOD."
Most pills don't have any time-release coating. There are a lot of reasons a person might want to break a pill. Someone who has trouble swallowing the whole pill might have no trouble swallowing two halves, or might just crush it to powder and mix it in a spoonful of applesauce to get it down. Someone who was prescribed a 20mg pill, and complained of side effects, so the dr said, "try 10mg at bedtime, and after a week you can taper up to 10mg at bedtime and 10mg in the morning too." Someone who can't afford the cost or side effects of a whole pill except on very bad days. These people like to know know they can rely on the pharmacy to tell them which pills are safe to break, and which are not.
Last year, when I changed pharmacies, my bottles of anti-seizure pills started to be labelled "DO NOT CHEW OR CRUSH, BECAUSE OF BITTER TASTE." I thought this was terribly misleading. It took me more than 3 months to work my way up to the right dose of this stuff. I went more gradually than most people, because I had so many problems with side effects...I'd go from 3 pills a day to 4, and have problems, and drop back to 3.5 for a few weeks to let my body adjust, and then try 4. That flexibility of dosing was well worth a moment of bitter taste! Now, the new bottles are just labelled "DO NOT CHEW OR CRUSH. SWALLOW WHOLE." The stuff hasn't become time-release, or changed in any other way. It's just trying to keep people blindly obedient, to discourage them from thinking about the differences between different kinds of drugs.
Most pills don't have any time-release coating. There are a lot of reasons a person might want to break a pill. Someone who has trouble swallowing the whole pill might have no trouble swallowing two halves, or might just crush it to powder and mix it in a spoonful of applesauce to get it down. Someone who was prescribed a 20mg pill, and complained of side effects, so the dr said, "try 10mg at bedtime, and after a week you can taper up to 10mg at bedtime and 10mg in the morning too." Someone who can't afford the cost or side effects of a whole pill except on very bad days. These people like to know know they can rely on the pharmacy to tell them which pills are safe to break, and which are not.
Last year, when I changed pharmacies, my bottles of anti-seizure pills started to be labelled "DO NOT CHEW OR CRUSH, BECAUSE OF BITTER TASTE." I thought this was terribly misleading. It took me more than 3 months to work my way up to the right dose of this stuff. I went more gradually than most people, because I had so many problems with side effects...I'd go from 3 pills a day to 4, and have problems, and drop back to 3.5 for a few weeks to let my body adjust, and then try 4. That flexibility of dosing was well worth a moment of bitter taste! Now, the new bottles are just labelled "DO NOT CHEW OR CRUSH. SWALLOW WHOLE." The stuff hasn't become time-release, or changed in any other way. It's just trying to keep people blindly obedient, to discourage them from thinking about the differences between different kinds of drugs.
