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Does Not Needing to Crush Pills = Not Enough Band Restriction?



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I take 4 small prescription pills a day (all just under tick tack size). I've never had to cut or crush them to get them down. I pop all 4 in my mouth take a swig of Water and it's all good. I've only had 1 fill (6 cc's in a large sized Lap Band) so far. Is the pill issue a good barometer of the need for more fills/ restriction?

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No, not in the least. Those pills are TINY and if you couldn't swallow them, it'd mean your stoma was almost completely closed. That would be a VERY bad sign.

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I dont know but my surgeon wants us to crush our pills because a whole pill could get caught in the skinfolds of the stomack. If it happens, the pill stays there and could cause erosion, he has seen it many times. For this reason, i am very carefull when it comes to pills.

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no, the ability to take 4 small tic-tac size pills all at once has little to do with appetite suppression .. which is what you should be aiming for.. not restriction.

You may want to start getting the habit of taking them one at a time though, because eventually taking all 4 together may be difficult.

I take several normal to largish sized capsules and tablets a day and have no issues.. and I have very good appetite control. Had Breakfast @ 7am, post-workout snack @ 11am, lunch @ 2pm.. and not severely hungry between meals.. just natural, normal hunger. :) I'll have another high Protein snack around 5pm as I'm going to a Yoga class at 6..and I believe in fueling my workouts... otherwise I probably wouldn't be hungry again until 7 or 8pm.

I do take said capsules/pills one at a time.. and with plenty of Water or coffee (am doses).

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Absolutely not! I am very happy with my restriction and can take something as large as a Tylenol caplet without issues.

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don't go with the doctor on this... go with your pharmacist.

there are various formulations of 'pills' on the market and you'd be doing yourself a very big disservice by breaking or crushing them.

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Here's what I learned in pharmacy school:

Breaking or crushing pills will interfere with getting the correct amount of medicine in the correct amount of time. pills are designed and manufactured to dissolve at a particular rate. Some are made to dissolve in the stomach while others are designed to begin dissolving in the stomach but not to the point of releasing any medication until they get to the intestine. Breaking or crushing the pills makes them dissolve faster, meaning you will receive a higher dose initially and nothing later.

Bottom line: NEVER break or crush pills (unless you are given one with a cutting line and told to take only half - those are guaranteed to contain half the dose on each side). Instead, ask the pharmacist if there is a liquid formulation available. He can call your doctor to have the prescription changed to liquid form.

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Here's what I learned in pharmacy school:

Breaking or crushing pills will interfere with getting the correct amount of medicine in the correct amount of time. pills are designed and manufactured to dissolve at a particular rate. Some are made to dissolve in the stomach while others are designed to begin dissolving in the stomach but not to the point of releasing any medication until they get to the intestine. Breaking or crushing the pills makes them dissolve faster, meaning you will receive a higher dose initially and nothing later.

Bottom line: NEVER break or crush pills (unless you are given one with a cutting line and told to take only half - those are guaranteed to contain half the dose on each side). Instead, ask the pharmacist if there is a liquid formulation available. He can call your doctor to have the prescription changed to liquid form.

Where did you go to pharmacy school? I'm actually a P3 student at Mercer.

I would hesitate to say NEVER break or crush pills... it really depends on the formulation. I do agree that you should NEVER break controlled release, sustained release, enteric coated, etc but many pills for cardiovascular diseases have such a high first-pass metabolism anyhow so that breaking them and thereby increasing its surface area and increasing the dissolution will not have that great of an effect.

It all depends on how your pill is formulated. Your surgeon will not have near as much knowledge as your local pharmacist in this aspect... so don't take any of our word and go talk to your pharmacist.

However...when I spoke to my surgeon about this... he told me that swallowing pills shouldn't be a problem even when I do have plenty restriction. In case of polypharmacy, take your pills one at a time.

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Where did you go to pharmacy school? I'm actually a P3 student at Mercer.

I would hesitate to say NEVER break or crush pills... it really depends on the formulation. I do agree that you should NEVER break controlled release, sustained release, enteric coated, etc but many pills for cardiovascular diseases have such a high first-pass metabolism anyhow so that breaking them and thereby increasing its surface area and increasing the dissolution will not have that great of an effect.

It all depends on how your pill is formulated. Your surgeon will not have near as much knowledge as your local pharmacist in this aspect... so don't take any of our word and go talk to your pharmacist.

However...when I spoke to my surgeon about this... he told me that swallowing pills shouldn't be a problem even when I do have plenty restriction. In case of polypharmacy, take your pills one at a time.

I went to PCP&S (now USP).

Perhaps I should have stated "NEVER break or crush pills without talking to your pharmacist first". The point I was trying to make was for people not to do this of their own accord, but to ask questions of the pharmacist first. At that point their pharmacist can advise them of what they can and can't do.

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As a nurse, I know that most pills can be crushed or the formula can come in a liquid form. It is the extended release formulas you should not crush. Pills that are coated to protect the stomach should not be crushed. When in doubt, ask the pharmacy. My surgeon asks that all pills be crushed, or ask for liquid form. Keeps you out of the ER due to a big Vitamin getting stuck. My family doctor is aware of this and checks the medications before prescribing them to make sure I can take them. I take two flintstones chewables. It has been almost 3 years and no medication issues.

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