sustained released drugs (ER,SR etc)

Does anybody know or who to ask about if  sustained released drugs can be taken after the full blown old style RNY surgery. Where they actually cut down the middl of the abdomen. Cant see to get the same answer from every medical person I ask. If I remember if was a no go because the drug released all at one time. Or some of it but in a place where the digestive tract was removed. If anyone knows a reliable place please let me know. I'm very tired of having to deal with this for so long now.

Thank You

The way they get in (open or laparoscopically) doesn't change the surgical procedure they do once inside (well beyond the typical minor changes made for an individual's needs, health issues. adjustments like that) so with malabsorptive procedures which is what RNY (aka Gastric Bypass) is there is the potential medications that are ER or SR extended or sustained release may have to be adjusted. You'll want to chat with your Dr about your drugs... and as you lose and as time progresses adjustments may be needed again. Here's a pretty good summary of all the factors scroll about halfway down. You'll see a lot of issues come into play. http://www.pharmaceutical-journal.com/learning/learning-arti cle/bariatric-surgery-prescribing-issues/10038700.article

Edited to add: And... you may want to be reassessed post-op for whatever condition you are being treated for with medications. WLS has the potential to resolve many conditions so perhaps a particular drug may no longer be required.

I'm wondering this same thing about my metformin ER. I can't take the immediate release version due to severe GI side effects. My endocrinologist thinks I probably won't even need it after surgery, but if I need it again later even after I can swallow pills again, I'm a little worried just because of the size of those suckers!

I just read something specific to Metformin on Dr. Sharma's blog... http://www.drsharma.ca/obesity-gastric-bypass-increases-metf ormin-bioavailability maybe something to read & share with your Dr's.

Very interesting, thanks!

What Michelle said.

The basic problem is that part of your intestine has been bypassed, and so there isn't enough intestine left where the drugs can get absorbed for you to absorb all of an extended release medication.  It has not been fully absorbed by the time it gets through the shortened digestive tract.  RNYers absorb some of those medications, but not all.

Most non extended-release drugs are designed to be absorbed in the non-bypassed part of the intestine. So they don't generally pose a problem post-op.

I'm honestly surprised that you're having trouble getting an answer to this because this is very common knowledge and is well documented in the medical literature.  Any gastric bypass surgeon or pharmacist should be able to explain it.

Having said that, though, some people are able to take some types of ER/XR meds.  They often just have to adjust the doses after RNY.  The problem arises when the medication doesn't come in the exact right dose to allow the doctor to adjust it for you malabsorption... So you either don't get enough of a smaller dose or you get too much of a much larger dose.

Lora