A woman fell into a coma after taking her medicine in pieces! Never take these five types of medicine in pieces, otherwise...

Recently, a piece of news like this appeared online: Ms. Zhang (pseudonym), a 40-year-old woman from Fuzhou, bit off a blood pressure pill with her teeth and ate half of it. Within half an hour, she suddenly felt dizzy, broke out in cold sweat, and her legs became weak and she collapsed on the sofa! She had no strength to open her eyes, and her blood pressure was almost undetectable. Her family rushed her to the hospital.

Taking the most common antihypertensive drugs will also have such risks? This is not an exaggeration. Some drugs really cannot be taken apart. Today, I will explain to you the drugs that cannot be taken apart . If these 5 types of drugs are taken apart, the drugs will be ineffective at best, and poisoning may occur at worst. Everyone must pay attention!

1. Controlled Release Drugs

Let's take the drug that Ms. Zhang took in the news as an example. According to reports, the drug that Ms. Zhang took was nifedipine controlled-release tablets. Putting aside the ingredients of the drug, we should focus on the three words "controlled -release tablets ". The so-called "controlled-release tablets" simply means that through some special processes, the drug is released at an ideal speed in the body. The purpose of this is to make the concentration of the drug in the body both lasting and stable.

The concentration of most common drugs in human blood is wavy, sometimes high and sometimes low. However, controlled-release preparations can almost reach a stable straight line in the body, which is perfect for certain diseases, such as those that require long-term maintenance of effective blood drug concentrations, such as cardiovascular disease, hypertension, etc.

Isn't it very advanced? This high-end special process usually uses osmotic pump technology or membrane control technology to achieve precise drug release. The content of this type of drug is usually much higher than that of ordinary drugs . For example, one tablet of the nifedipine controlled-release tablets taken by Ms. Zhang is equivalent to the dosage of three ordinary nifedipine tablets. Taking it once a day is equivalent to taking it three times a day, which reduces the number of times the drug is taken and reduces the fluctuation of blood drug concentration .

Once we bite, break, or grind the medicine, the controlled-release tablet technology will be destroyed. The medicine will no longer be controlled, and a large dose of antihypertensive drugs will be released into the body instantly, causing a sudden and significant drop in blood pressure, with disastrous consequences. In addition to nifedipine controlled-release tablets, other common products on the market include glipizide controlled-release tablets, which are used to treat diabetes; doxazosin mesylate controlled-release tablets, which are used to treat symptomatic treatment of benign prostatic hyperplasia, hypertension, etc. Be sure to pay special attention!

2. Sustained-release drugs

Sustained-release drugs are slightly different from controlled-release drugs. Although they are not released at a constant rate, they can release drugs slowly. The initial release amount is large, and then gradually decreases. By slowing down the drug release rate, the drug's effect time in the body is prolonged, thereby achieving the purpose of reducing the number of medications. Since the number of medications is reduced, the amount of medicine in it must be higher than the dosage of ordinary drugs .

Sustained-release drugs are suitable for situations where the drug effect needs to be maintained for a long time, such as painkillers, antibiotics , etc. Similarly, avoid breaking, crushing or chewing the pills when taking them . This will destroy their sustained-release structure and cause large doses of the drug to be released quickly, leading to adverse reactions.

This type of drugs includes: verapamil hydrochloride sustained-release tablets, felodipine sustained-release tablets, indapamide sustained-release tablets, potassium chloride sustained-release tablets, gliclazide sustained-release tablets, glipizide sustained-release tablets, glipizide controlled-release tablets, buflomedil hydrochloride sustained-release tablets, diclofenac sodium sustained-release tablets, clarithromycin sustained-release tablets, piribedil sustained-release tablets, morphine sulfate sustained-release tablets, rofencodeine sustained-release tablets, mizolastine sustained-release tablets, etc.

Most controlled-release and sustained-release tablets cannot be broken apart for consumption, but there are some special cases where they can be taken apart. These drugs usually have a feature - a scratch in the middle of the tablet, which makes it easier to break apart . Although these drugs can be broken apart, be sure not to chew or crush them before taking. Usually there will be a mark in the instructions, so be sure to read the instructions carefully before use and follow the doctor's advice .

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3. Enteric-coated preparations

Some drugs are easily affected by gastric acid, which reduces their efficacy or irritates the stomach, so they are made into enteric-coated dosage forms. This prevents the drug from being absorbed when it passes through the stomach, but is absorbed after reaching the small intestine.

There are also some drugs that have little effect on the stomach, but are only intended to treat intestinal diseases, and are also designed as enteric-coated drugs. To put it bluntly, we want these drugs to be released only in the intestines, so they cannot be broken up and taken. Once broken up, either the adverse reactions increase or they fail to work .

Common enteric-coated drugs include: erythromycin enteric-coated tablets, midecamycin enteric-coated tablets, pancreatic enzyme enteric-coated tablets, etc.

4. Coated Tablets

It is not difficult to understand that "coating" drugs means putting a layer of clothing on the outside of the drug, which can prevent moisture and light for easy preservation. It can also cover up bad odors and reduce the irritation of drugs to the oral cavity, esophagus, gastrointestinal mucosa, etc. In short, there are many benefits.

Since it is coated, it is not difficult to understand why it cannot be broken and taken. If the clothes are torn, wouldn't it lose its meaning? The enteric-coated drugs mentioned above are strictly speaking also a kind of coating, which can also be called enteric coating. In addition to enteric-coated drugs, there are also sugar coatings and film coatings.

There are too many such drugs to list here. We can distinguish them by the "properties" column on the drug packaging or drug instructions.

Film-coated drug

5. Chemotherapy drugs and targeted drugs

This type of medicine should also be taken care to avoid breaking it up and taking it. Especially chemotherapy drugs, which are usually more toxic, must be used with caution and follow the doctor's advice .

In short, whether the medicine can be broken or not is not up to you, but your doctor. In addition, before taking the medicine, you need to pay attention to whether the medicine is cracked. Sometimes the medicine is damaged or cracked due to improper storage or quality problems, which is equivalent to being "broken", and there are also risks .

Finally, let me tell you a piece of common sense. After the drug ingredients in some sustained-release drugs are absorbed, the "skeleton" on the outside will be excreted intact with the feces. At this time, you don't have to doubt that the medicine you took has exerted its due therapeutic effect. As for the "skeleton", just let it go.

Planning and production

Author: Liu Ziqi, Chief Pharmacist, First Affiliated Hospital of Harbin Medical University

Reviewer: Tang Qin, Director of the Science Popularization Department of the Chinese Medical Association, National Health Science Popularization Expert

Planning丨He Tong

Editor: He Tong

Proofread by Xu Lai and Lin Lin