Posted by ed_uk2010 on January 17, 2015, at 13:52:35
In reply to Splitting pills. Reliable or not? (@Ed and others), posted by europerep on January 16, 2015, at 15:21:41
> Hey all, and hopefully also hey Ed ;-)
Hi!
>I don't really want to start a debate about med sensitivity, I just see the drastic improvement I have experienced recently and I must be doing something right.
There's a very large variability in the blood levels of tricyclic antidepressants in patients given the same dose, probably due to genetic differences in hepatic metabolism. It makes sense that dosage requirements for these drugs are very variable.
>As far as I know, there is no nortriptyline extended release available anywhere
I've never heard of such a product either.
>Other ingredients consist of pharmaceutical excipients lactose monohydrate, maize starch and magnesium stearate...
Some nortriptyline tablets have a thin 'film' coating. Do yours not? You've not mentioned any ingredients used to coat tablets above. Have you listed all the tablet ingredients? If you have, your tablets are not coated. Coated tablets may have ingredients such as glycerol and methylhydroxpropyl cellulose (or another similar polymer). Many manufacturers choose to add a film coating to help mask the taste of the drug. With tricyclics, film coating may also reduce the temporary numbness that occurs when the drug comes into contact with the lining of the mouth.
Lactose is a diluent. It wouldn't be possible to make 10mg of drug into a tablet without diluting it. Thorough mixing ensure even dispersion of the drug. Starch is used to bind the tablet together and to help it disintegrate quickly in the digestive tract. Magnesium stearate is a lubricant used in tablet manufacturing. Tablets are made by compressing a pharmaceutical powder under high pressure. A lubricant allows the powder to glide through the machinery.
>I have halved pills before without a problem, but what I want to do is to go from 10mg to something like 9mg. Is it possible to simply cut off a bit of the pill at the side, or is the active ingredient concentrated somewhere in the "core" so that this will have either no effect or make doses with little reproduceability? I do have a fine scale I could use to verify the weight if that helps, but it's of course not an analytical scale. (It measures single milligrams with a reproduceability of +/- 2mg.)The nortriptyline should be evenly distributed throughout the tablets unless they are film coated, in which case things are slightly more complicated because the coating is 'sprayed' onto the tablets near the end of the manufacturing process and therefore contains little drug substance. Breaking fragments off uncoated tablets may produce more accurate dosages (compared with coated tablets) because the drug is evenly distributed throughout the entire tablet. On the other hand, film coatings are extremely thin, so it probably wouldn't make any clinical difference. It's hardly important for the dose of nortriptyline to be consistent to the microgram level!
If you do break fragments off the tablets it's best to dispose of the unused portion. Keeping lots of 'bits' may be a bad idea because they could absorb moisture from the air and degrade over time.
Does this answer your Q?
poster:ed_uk2010
thread:1075154
URL: http://www.dr-bob.org/babble/20150102/msgs/1075187.html