chewing pills for quicker effect

[bpesta22]

Got into a debate with a few people on whether chewing a pill leads to quicker absorption into the blood stream-- or results in more potent effects-- versus swallowing it.

Ativan or Xanax, for example. Would the best effect be to swallow it, as was intended, or to chew it. Or, would the effect be the same in either cases.

In both cases, these are legal uses of prescription meds, so I'm not trying to promote the best way to get buzzed here.

Anyway, an MD insists that the effect would be weaker by not swallowing it (the argument being they were designed to release in the stomach-- for optimum effect). A friend insists just the opposite (in fact, he says that dissolving it under the tongue is even better for a fast effect).

Just curious if my friend is experiencing a placebo effect or if chewing pills meant to be swallowed speeds up the response.

TIA

[shandyjan]

Some tablets are enteric coated, theyre meant to be swallowed. Some tablets are time release, so obviously wouldnt be good to mash or chew!
Enteric coating
"An oral dosage form in which a tablet is coated with a material to prevent or minimise dissolution in the stomach but allow dissolution in the small intestine"

[gerdbonk]

What does you friend do with suppositories?

[Bikewer]

Some carry specific warnings; "do not take broken tablets".

[JoeyDonuts]

Wish I'd known that when I used to snort Ritalyn cut with Pixy Stix.

[thull]

Depends on what drugs.

If it can be absorbed in the mouth cavity, then yeah chewing or placing the pill beneath your tongue will get the drug into the bloodstream quicker. Nitro, aspirin (both for quick help with heart troubles) and hormones are the main ones used that way. These are usually in much lower doses than a person would swallow for the same effect.
Most drugs could likely be altered to be absorbed in the mouth more readily, but if the pill is designed to be swallowed it was intended to be absorbed in the stomach or in the small intestines.

[Modified]

Even if it is absorbed by the stomach, it will probably get into your bloodstream a lot quicker if you chew before swallowing, unless it is a pill that dissolves almost instantly anyway. I notice that cetirizine pills will start to dissolve in your mouth if you don't swallow them quickly.

[theneedtoknow]

I think the best thing to do is just follow the instructions in the leaflet...It's not like a drug company is going to create a pill which would be more effective/act faster when chewed and then go ahead and tell you to swallow it so that you have to wait longer for the benefits...that wouldn't be very smart on their side in terms of customer retention/satisfaction.

[Camillus]

It depends on the drug. The mouth is very vascular and drug absorption is usually rapid. It can also be an advantage that drugs absorbed through the mouth don't pass through the liver on their way into the circulation while those that are swallowed do because of the way the blood flows from the stomach.

However some drugs require a pass through the liver in order to be effective, i.e. it is the metabolite which is active rather than the substance that you take in the tablet. On the other hand some drugs have their edge taken off if they pass through the liver first so are more potent when chewed and not swallowed.

[the_smasher]

Anyway, an MD insists that the effect would be weaker by not swallowing it (the argument being they were designed to release in the stomach-- for optimum effect).

Just a nitpick, but not all finished product drugs are designed for "optimum" effect. An extended release tablet usually means fewer are taken per day.

[pgwenthold]

Just a nitpick, but not all finished product drugs are designed for "optimum" effect. An extended release tablet usually means fewer are taken per day.

I say they give the "advertised effect." Optimum depends on the situation. However, in order to get pills to do what they are claimed to do, you have to follow the label directions.

It is never safe to use drugs in ways that they were not designed to be used. If you need a faster acting agent, get one that says it is faster acting.

[godless dave]

If you're trying to get the intended medical effect from the drug, you should take it as directed. Chewing time-release pills defeats the time-release coating. The only reason to do this is if you are intending to use the drug for something other than medical treatment.

[Miss_Kitt]

Case in point: the gel-cap version of Aleve. This is designed to break down quickly in the stomach, and will make you wish you'd never had tastebuds if you try to chew it.

I'm just saying. MK

[KingMerv00]

I've worked as a chemist for pharma companies and have addressed this exact issue. I'll give you two answers: "Absolutely yes", "I don't know".

Absolutely Yes: If you chew a tablet you increase its surface area and thus, without a doubt, you increase the rate of dissolution. The change will be particularly obvious in gel capules and "time release" formulations.

I don't know: The concentration of the drug in your stomach will definitely be greater if the pill is chewed in advance. However, I am not a biology expert so I'm not sure how much it can affect the rate of a specific biochemical pathway.

In any event, USE AS DIRECTED! (The default assumption is that pills are swallowed whole. They define chewable pills as such for a reason.)