Take your medicine -- but in what form?

Apr 21, 2013

It can be overwhelming  -- even for a well person -- to stand in the cold and flu aisle at the pharmacy wondering what version of a medication is best to take. Powdered packets, syrups, capsules, chewable tablets, gel tabs, dissolving tabs, coated pills -- there are endless options of ways for you to take your medicine. This week on “Take Care,” Dr. Lindsay McNair helps us understand the significant differences in how these formulas work.

(click on "Read more" for the podcast of this interview and more information)

Dr. Lindsay McNair is a pharmaceutical physician who works in drug development and marketing and is also an adjunct assistant professor at the Boston University School of Public Health. 

Often, one of the first questions that come to mind upon entering the medicine aisle is how to know what product to choose when there are five different ways to take the same over-the-counter medication. Are there differences between the multi-symptom cold medicines in pill form and the liquid multi-symptom cold medicines? What about vitamins? Is it better to swallow them whole or are those little gummy bears just as effective?

Dr. McNair says all of these different forms evolved to meet different needs. “There are a lot of people that have trouble swallowing large, hard pills,” she said. “Some formulations don’t have pills to swallow at all, like chewable pills or those tablets you dissolve in water.” She explains that some pills are meant to start acting quickly, like gel capsules, and some are meant to release the dosage slowly over a period of time.

The way in which medication is consumed can also play a key role in its effectiveness. Dr. McNair says the various forms of medication are designed to be consumed specifically in the way that they are prescribed and failing to follow these guidelines could reduce their success.

“If the pill is designed to be swallowed then you don’t want to, for an example, crush it and mix it into apple sauce and chew it. You want to get it to the place it is designed to be dissolving, which is inside your stomach,” she explains. If the medication is designed to be chewed, it is because the chewing is needed to help it dissolve more quickly once it reaches your stomach.

Similarly, certain pills are designed to be split and taken in smaller dosages if needed. Those pills will have scores down the center of them to ease the break. If they do not have the score, they are most likely not meant to be taken in alternative dosages.

Finally, Dr. McNair emphasized the importance of carefully examining the active ingredients in each kind of medicine to be sure you aren’t treating something you don’t have. “You may not have a fever and may not need the acetaminophen that’s in the pill,” she says. “So reading the package and taking it as prescribed is really the best advice.”