Many people have encountered that oral medications sometimes need to be broken, ground, or only the powder in the capsule due to dosage restrictions. Is this really possible then?
At present, there are two important classifications of oral drugs in clinical practice: sustained-release preparations and controlled-release preparations.
1. Controlled release tablets
Controlled-release tablets are preparations that require relatively high drug release, and are more common in cardiovascular preparations. There is a relatively constant release dose per unit time to maintain a constant blood concentration and a longer-lasting effect.
2. Sustained release tablets
Sustained-release tablets are longer than ordinary tablets in terms of time, and will not be completely released as soon as they enter the body like ordinary tablets. Therefore, the release rate of sustained-release preparations can actually be constant or non-constant. Some sustained-release tablets are used to avoid greater irritation to the gastrointestinal tract and mainly protect them. Therefore, they are mostly used for drugs with greater local irritation.
Common drug analysis
1. Metoprolol sustained-release tablets (Betaloc) Metoprolol sustained-release tablets use a multi-unit microcapsule system, consisting of hundreds to thousands of spherical microcapsules with a diameter of about 0.5 nm or less. Each microcapsule has an independent constant-rate release unit, which will not affect the release of the drug if taken apart.
2. Glipizide Controlled Release Tablets Glipizide Controlled Release Tablets use double-layer osmotic pump technology, are wrapped with a semi-permeable membrane, and contain glipizide and moisture-absorbing ingredients. There are multiple drug-releasing pores on the semi-permeable membrane, and the tablet swells after absorbing water. The inner and outer sides of the semi-permeable membrane form a high osmotic pressure, which promotes the sustained and constant release of the drug. Taking it apart will destroy the structure of the double-layer osmotic pump, causing the drug to be released quickly, causing an instantaneous increase in blood drug concentration and inducing serious adverse reactions. Therefore, it needs to be swallowed whole, not broken, crushed or chewed. Otherwise, risks such as hypoglycemia, coma, convulsions, nausea, insomnia, and tachycardia may occur.
3. Nifedipine sustained-release tablets, controlled-release tablets
Nifedipine is divided into short-acting and long-acting. Long-acting nifedipine includes two dosage forms: slow-release and controlled-release. At present, most of the long-acting nifedipine produced by domestic pharmaceutical factories are sustained-release tablets. The effect is that the drug is slowly released in the body, and the release rate is faster at the beginning, and the blood pressure lowering effect is better; as time goes by, the release speed gradually slows down, and the blood pressure lowering effect gradually weakens.
Nifedipine controlled-release tablets are different. Its action feature is that the drug is released at a constant rate and quantitatively within 24 hours, the blood concentration is maintained relatively stable, and the blood pressure control is relatively stable.
Sustained-release tablets: If you need to reduce the dose, you can completely separate along the center line and take half a tablet.
Controlled release tablets: swallow whole tablets, do not break apart. If the unbreakable Nifedipine Sustained-Release Tablets are taken separately, it is very easy to cause a sudden drop in blood pressure and tachycardia.
4. Isosorbide mononitrate sustained-release tablets
Sustained-release tablet: It is a matrix tablet. The drug and the matrix material are completely uniformly dispersed. It can be broken into half tablets along the center line and swallowed, not chewed. Using an inert substance as a matrix, the drug is evenly distributed in the matrix and is continuously and slowly released from the matrix. Half a tablet can be taken by splitting it along the notch, but it cannot be ground or chewed.
Film-coated tablets: To be swallowed whole, do not break or chew. If the meeting causes a sudden release of the drug, adverse drug reactions such as a drop in blood pressure will occur, and severe cases can be life-threatening.
1. Neither sustained-release preparations nor controlled-release preparations should be pulverized and taken.
2. It is not that sustained-release agents can be broken apart but controlled-release agents cannot. It depends on the specific preparation process of each drug.
3. You can't judge whether you can break it and take it just by whether there is a nick or centerline on the tablet.
4. For the same drug, different manufacturers may produce different preparation processes. For example, some sustained-release preparations can be taken separately from some manufacturers, while others cannot be taken separately. Therefore, the preparation process and manufacturer of the medicine taken by the patient must be determined during clinical use.