How should you make the medicine go down?

Sep 1, 2013

Capsules, chewable tablets, gel tabs -- Over-the-counter medications now come in so many different formulations, it's difficult to figure out what to take. Lorraine Rapp and Linda Lowen....hosts of WRVO's health and wellness show "Take Care," Spoke to Dr. Lindsay McNair, a pharmaceutical physician and professor at the Boston University School of Public Health, about how to best take your medicine.

Lorraine Rapp: There are so many forms that these over the counter medications come in. What was behind their development?

Dr. Lindsay McNair:  There are certainly a lot of options. The different forms of medications really evolve to meet different needs that people have. For example, there are a lot of people that have trouble swallowing large, hard pills. So coated pills were developed, which have a coating on the outside that gets slippery when it’s mixed with water and makes it easier to swallow. Some formulations don’t have pills to swallow at all, like chewable pills or those tablets that you dissolve into water or juice and then drink. Gel capsules usually describe capsules that are made of a soft gelatin and they have the medication inside of them in a liquid form. And then when you swallow the soft capsule, the gelatin dissolves in your stomach and then the liquid medication can be absorbed by your body quickly, so the medication can actually start to act faster. Extended release pills, which are sometimes called sustained release pills or time release formulations, were designed to release the drug into your body more slowly so that they work for a longer period of time without having to take additional pills.

Lorraine Rapp: If swallowing a pill wasn’t a problem for you, which is the one that would just be the quickest acting, if that’s one of the choices?

Dr. Lindsay McNair: Well, that depends a little bit on the medication itself and how it’s formulated even within the pill. But sometimes it would be the gel capsules which have the liquid inside them that would start to act most quickly.

Linda Lowen: I find it difficult to get pills down. So, I often think, ok a coated tablet will help. But then, the coating wears off. Am I reducing the efficacy if it’s designed to dissolve in my stomach and it starts to dissolve in my mouth?

Dr. Lindsay McNair: Not really if it just starts to dissolve in your mouth, but what you should do is try to take the different formulations as they’re designed to be taken. So if the pill is designed to be swallowed then you don’t want to, for example, crush it and mix it into applesauce and chew it. You want it to get it to the place where it’s supposed to be dissolving, which is inside your stomach. But dissolving a little bit into your mouth isn’t a problem.

Linda Lowen: In terms of pill splitting, what would then be the best choice for the consumer?

Dr. Lindsay McNair: There are some pills that are scored; they actually have kind of a groove in them so that you can break them apart more easily. But you would still swallow each part of the pill as opposed to chewing the part of the pill if it’s meant to be swallowed. So kind of, capsules that have the little beads in them are not meant to be pulled apart and have those beads swallowed individually. They’re meant to be swallowed as a whole. And then the outer shell will dissolve.

Lorraine Rapp:  Is there any problem when you break it with your hands and it’s not scored?

Dr. Lindsay McNair: There probably isn’t but for the specific medication you could always check with your pharmacist or your healthcare provider to make sure for that specific medicine. But it’s probably fine as long as you’re still taking it in the way it was meant to be taken in terms of swallowing it.

Linda Lowen: We should really note the labels and take as advised.

Dr. Lindsay McNair: Yes, I would definitely do that. I think reading the package and taking it as prescribed is really the best advice.

More of this interview can be heard on "Take Care," WRVO's health and wellness show Sunday evenings at 6:30 p.m.  Support for this story comes from the Health Foundation for Western and Central New York.