Splitting pills can affect therapeutic effect

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The practice of breaking a tablet in half to achieve the dose prescribed by your doctor may impair the treatment or expose the patient to a superconcentração remedy, leaving it vulnerable to toxic effects.

A survey conducted by the pharmaceutical industry manipulation shows that half of the tablet obtained in the partition have a range of content beyond the recommended limits.

Analyzed two diuretics - the furosemide 40 mg and 25 mg spironolactone. The study shows that the partition results in "significant difference" in mass between the parties and loss of particles.

The tablets are analyzed in the study sustained-release, or after ingestion, are absorbed slowly by the body.

"This kind of medicine should not be a party to any condition," said Vanessa Pinheiro, the research coordinator and member of the Technical Chamber of Anfarmag (association representing the industry manipulation).

According to Vanessa, however, not suitable break in any case, even when the medicament is manufactured with a groove for facilitating the partition. "We have seen that the dosage (indicated doses) has compromised when the drug is broken," she said.

According to the director of the Faculty of Pharmaceutical Sciences, USP, Terezinha Andreoli Pinto, the most scored tablets does not lend itself to a division "perfect".

When broken, besides the lack of uniformity, the medicine may change the content or degrade into substances that are toxic. "In some cases, there is a very narrow threshold between the loss of the therapeutic value and a toxic insult," said Therese, who says he sees a 'serious risk', especially when the break occurs without medical advice.

The research on partition of pills did not examine the effects of half-doses in patients. "We can not specify the evils that this practice causes, but surely there is a loss in treatment," says Vanessa Pinheiro.

Problems

The pharmacist-in-chief of the Incor-SP, Walter Garcia Santos, has already had cases of patients who bought pills in inadequate concentrations, had to break them and committed treatment. "Some suffered from hypertension, and as they left the remedy could not adequately manage the pressure."

For an infectious disease specialist and adviser to the Cremesp (Regional Council of Medicine of São Paulo) Caio Rosenthal, it is always best to avoid breaking the tablets, even though he is obliged to prescribe doses fragmented. The argument is that the doctor has no choice in certain cases.

"The doses are recommended for people with average weight of 70 kg. If you have a patient and another 50 kg to 120 kg, it is clear that you need to make an adjustment," he says.


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Second font

Cut pills can compromise treatment





When broken, medicine may change the content and even give rise to toxic substances.

Breaking or splitting tablets is a practice adopted for many years by patients who want to get the recommended dose of a medication. What many do not know is that this may impair the treatment or expose the individual to a substance superconcentração, leaving him prone to toxic effects. This is what shows a survey conducted by the pharmaceutical industry manipulation, revealing that, from the pill, the effectiveness of the medication is not guaranteed and may compromise treatment and patient health.

According to the researchers, the lack of uniformity after breaking the drug may be related to different factors such as size, shape and presence or absence of grooves. The tablets, even in the presence of such markings, it is difficult to break into two parts of equal size. Pharmacists also warn that the presence of the grooves does not always indicate that the patient can break it. "It should only be considered from the drug when medical recommendation in this regard," says Gerson Appel, owner of Dermus pharmacy, pharmacy first Master of St. Catherine.

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The reasons that lead patients to break the tablet are different: when there is no market in the recommended dose, for a fraction of the drug treatments in cases of gradual increase or decrease the dose to start treatment with the least possible dose - with the intention of reducing side effects - to evaluate the response that your body will be under the influence of medication, or simply have difficulty swallowing the tablet. Also common are cases where the patient elects to a prescribed dosage from considering the price of the drug in different steps.

In the right dose
An alternative suitable for overcoming the division is to use compounding pharmacies are able to produce capsules containing the drug in the dosage required for each individual, prescribed by the doctor. "The pharmacies have the advantage to personalize and individualize treatment. Besides getting the exact dosage, the patient avoids waste, "argues Karen Denez, pharmaceutical and owner of Dermus.

Stay tuned:

1 - Why break pills became common practice?
In some cases, a box 50 mg tablets costing roughly the same as a 25 mg. The user then saves buying the 50 mg and breaking in two. But beyond the economic aspect, he must think of the effectiveness of treatment.

2 - When the partition is not recommended?
Breakage may be detrimental especially if the tablet has action on a specific area of ??the body, and in particular when the tablet is a sustained release, ie when its content is released during the day. In this case, the medication is ineffective or even detrimental. Dosage forms tablets, coated tablets and capsules can not be broken.

3 - No pill can be broken?
Under certain conditions, the break is feasible and can be beneficial, but should always be discussed between doctor and patient. You should have as much care with small tablets, given the difficulty of split it exactly in half.

4 - What happens when the tablet is broken?
Studies show that breaking the tablet disintegrates and there is significant variation between the two halves. Generally, the partition affects the indicated doses. In addition, part of the tablet that was to be used at another time may change if it is exposed to moisture and / or oxygen in the air.


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