Sustained Release medicine

Twoods196 · November 22, 2016

I had my sleeve around 5 months ago an I'm down 115lbs. Which is great, but had a quick question. I know bypass patients can no longer take extended releases medicine. Does the same go for us sleevers? I was recently put on Wellbutrin SR twice daily. The doctor knows I have had the gastric sleeve but just wanted to make sure the medicine is working as it takes 4+ weeks to notice effects from it. Curious if anyone else has had issues with SR or XR medications? Thanks

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heidikat72 · November 22, 2016

Since I work in pharma - specifically on extended release medications, this is a question I asked my surgeon about when deciding between the sleeve and bypass. He indicated that one of the advantages of the sleeve is that since the intestinal tract remains completely intact, there is no impact on absorption of extended release medicines. Immediate release medications all release in the stomach and he indicated even with the reduced stomach volume, even poorly soluble immediate release drugs won't be impacted.

From the science aspect - some SR/XR (and MR) medications have a mechanism that just slowly releases over time (often due to a matrix in the formulation that swells when you ingest it and slows down the escape of the active ingredient out of the tablet/capsule. For others, they have a coating on them that will only dissolve when it hits a certain pH - so they won't dissolve in stomach acid but wait until higher pH levels. They can be targeted to release at different points in the intestines based on what pH the coating will dissolve.

Hope this helps.

Twoods196 · November 23, 2016

Does that depend on how much of the medicine is absorbed in the stomach. Similar to drinking, now very little era me drunk but it also disappears just as quick.

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heidikat72 · November 23, 2016

for the drinking - you absorb faster because there isn't as much volume of stomach Fluid diluting it and also you typically aren't eating while drinking anymore. The alcohol is already a liquid so there isn't any wait for it to dissolve to become available for absorption.

kurigotmoxie · November 24, 2016

I was on Wellbutrin SR twice a day before surgery, and I had to change to regular Wellbutrin three times a day after surgery. My surgeon explained that it was because your stomach is so much smaller it may not produce enough acid to break down the coating on the pills. It's a little bit of a hassle taking it three times a day, but Wellbutrin works well for me so it's worth it!

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