Question:
Malabsorption/Medications - What's the real deal?

Hi all! I'm confused and hope others can help me. I know we can not take any extended release medication and I know we must stay away from nsaids (Advil, etc). I'm confused on other medications, though. I'm going through some nerve, back pain etc, and taking various pills (some narcotic and others to try to relieve pain). It seems as though the pills don't affect me the same way they did pre-op. If we take medications and crush them prior, do we still absorb all of their goodness? What about if we don't crush them? While my pain specialist is familiar with gastric bypass, he doesn't know the specific plumbing answers and I realize, now, maybe I don't either. Mu wls surgeon's office is notorious for being difficult to get ahold of and does not return calls. Hope some can provide info provided by their Doctors - not just "what they think". No offense to anyone, just hoping someone has asked a doctor. Thanks in advance.    — Donya P. (posted on December 23, 2003)

December 23, 2003
I am 3 months out and take extended release medication daily and has been just as effective post-op as pre-op. I was told by my doctor not to crush the extended release meds becuase they would lose their effectiveness. Good Luck!
   — Lisa D.

December 23, 2003
I was told to stay away from things with asprin, extended released pills and capsules & gel like capsules because those 2 won't dissolve in our small tummies, ask your surgeon there is usually a list of ones that are ok to take!
   — Saxbyd

December 23, 2003
The besy source is a pharmacist. Call around to different ones until you find one that is familiar with the wls plumbing. Never crush anything unless you check first. Time released didn't work for me. No stomach to melt the capsule and it is pushed through the intestines too fast. I do take advil with good results. I only take it occ however.
   — ZZ S.

December 23, 2003
The pharmacist should knnow every lil thing about any Rx they offer. If they don't know, they should be able to go to their contact at the mfr. But they can perhaps tell in what part of the gut it is absorbed, and if a med is safe crushed or split. You could overdose yourself by getting a full whammy of meds at once, or damage the input. We can break down capsules and the shells of oil filled gels (they are just gelatin), but we can't absorb the oils inside. Tablets are a mixed bag, and to know for sure, you'd have to sacrifice one in a glass of saliva water. But perhaps the pharmacist would do it for you. Personally, I avoid timed release, or take them to my WLS to be adjusted upward to compensate and I do not take things with oil in them, but take the same thing in a dry form. I just swallow pills, do not crush or split. But that's me, and I'm not afraid of pills. They say we cannot break down the "candy coated" type of pills, and I'd tend to agree, but the one I take is Premarin. I'm here to tell you, if I wasn't getting the proper dose, you (and the rest of the world) would KNOW IT. lol
   — vitalady

December 23, 2003
Thank you Michelle for all the info I really appretiate it!
   — Saxbyd

December 23, 2003
Sometimes pharmacists don't know the answers, so you might contact the drug manufacturer and ask the questions, pointing out that you have had gastric bypass surgery. Most sites for drugs or their manufacturers have a way to contact them by e-mail. I really think what is absorbed really depends on the individual. My DH takes Wellbutrin XL and does just fine, whereas he developed some side effects from Wellbutrin SR. I had to up my thyroid medication, not a timed or sustained release, probably because of malabsorbtion. Never crush a medication or open capsules whithout finding out if this is okay. (Some medications are in a pill shaped matrix and the medication is leached out in the intestines. Crushing or even breaking a med like this in two pieces destroys the matrix, resulting in an overdose or a bolus of medication. Some pills like this come through looking intact or somewhat changed but still recognizable in the toilet!)
   — koogy

December 26, 2003
hey girl DO NOT CRUSH your medication unless you talk to your Doctor or Phamacist! If you are on a time released med and you cruch it - it could kill you as you would be getting all the med that is suppoed to be deliveried for 24 hours at one time. This goes for pain meds and blood pressure meds. Actually any meds. Please check with your Doctor or Pharmacist first. Best of Luck and God Speed
   — CATHYSDAN