It is a scene that is repeated in homes throughout the country. A persistent headache, a more acute menstrual malaise than normal or muscle pain that does not yield. 400 mg ibuprofenthat usual ally of the first aid kit, does not seem to be enough, and the ‘version’ of 600 mg can only be achieved with a recipe Medical Then arises the idea of leaving a tablet in two and taking 400 mg more than 200 mg that gives 600 mg. But it’s not that good idea.
An idea that has had to deny a pharmacist. Through your Tiltok account, @farmaceuticofernandez, responded to a girl’s video which pointed to that an ibuprofen and a half had been taken. Its verdict is quite clear: mathematical logic is not correct. And is that the principle of the active of the medicine andStá mixed with other excipients And this is not equitably distributed in each half of the tablet, so we do not find 200 mg of medicine on each side of the pill. It is in the end a lottery.
In addition, it suggests that some of these tablets have a protective film that covers it with the aim of Protect our stomach or to be absorbed in a specific place of our system. If it starts, this protection effect is lost and can generate more problem than benefit.
The anatomy of a tablet. The fundamental assumption behind leaving a pill is that the medicine is distributed perfectly uniformly throughout its volume, such as dissolved sugar in coffee. The reality, however, is much more complex and looks more like a cookie with chocolate pepitas.
The active substance (Ibuprofen, in this case) are the “Pepitas”, while the rest of the components, called excipients, are the “mass.” When the cookie starts in half, no one can ensure that each piece contains the same amount of chocolate.
The science behind each pill. A tablet It is a pharmaceutical engineering work. In addition to the active substance, it contains a variety of excipients that are essential for its function: diluents To give volume, binders To keep it cohesive, disintegrating to dissolve in the body and lubricants such as Magnesium stearate so that the machinery does not stick during the manufacture.
The most common manufacturing process, known as Wet granulationit implies mixing the API dust with the excipients and a liquid binder to form small granules. These granules dry and then compress at high pressure to form the final tablet. The ultimate goal is to ensure the uniformity of dosing units.
What the box says. With this system, which is guaranteed only that each whole tablet of a lot contains the declared amount of active substance, within a margin of trust. However, this uniformity guarantee applies to tablet as a unit, and the homogeneous distribution of the active substance within each individual tablet is not ensured.
And scientifically demonstrated. A study by pharmacy technicians In controlled conditions, 22 different brands of generic medicines fractioned. The results were surprising, since only 32% of the grooved tablets (designed to be games) and a little 27% of the non -grooved tablets met the uniformity criteria of the weight that are acceptable.
In this way, if professionals with adequate tools cannot achieve precise division, the probability that a patient will do it at home with a kitchen knife is tiny.
The slot is not decorative. If the internal structure of a tablet is a lottery, the presence or absence of a slot on its surface is the signal that indicates whether we can play or not. That small line is not a decorative element or a simple visual guide. It is a legal and scientific statement of the manufacturer that certifies that this tablet It has been designed to be split by that line To have more or less security we take a precise dose.
In order for a tablet to carry a slot, the laboratory must demonstrate to the regulatory agencies that the halves meet the same standards of dose and dissolution uniformity as the entire tablet.
The prospect is important to read it. This document, which we sometimes hate because once we open it you can no longer bend correctly, it indicates what we can do with the medication. If this report details that a tablet can be divided, it is because it has been demonstrated. For example, in the Paracetamol prospect From 1 gram, “the tablets are grooved, which allows to divide the tablet into equal doses.” But the same does not happen in a 400 mg ibuprofen leaflet of the Cinfa brand that is very common
I even had 400 mg ibuprofen at home and I have been able to verify that I did not have any division to leave the pill in two. Something that obviously faces us to be inaccurate.
The doctor has the ‘key’ to have 600 mg ibuprofen. The distinction between the 400 mg ibuprofen and the 600 mg is not just a matter of 200 mg more power; It is a regulatory and security border. In Spain, the presentation of 400 mg can be dispensed without a recipe (although often under the pharmaceutical council), while the 600 mg necessarily requires a medical prescription. This decision, taken by the AEMPS, is not arbitrary, but is based on a exhaustive analysis of the balance between benefit and risk.
The issue in this case is that after comparing the effect of the 400 mg version with the 600 mg is almost the same. This phenomenon is known as analgesic “roof effect”, where major doses They do not produce additional pain in a significant way in mild cases. But what it does cause is that they increase the Side effects considerably. Something that also corroborates the pharmacist from the beginning.
A suggestion effect. The problem we have in this case is the suggestion to which we are exposed. Obviously, a larger amount correlates with a greater analgesic effect according to our own logic. And this can be transferred later to the feeling we have after taking this medicine. But scientific evidence is quite clear with this.
Side effects that are not nonsense. The side effects of taking high doses in a uncontrolled way out of control are very important, and that is why it requires the intervention of a medical specialist. Cardiovascular, gastrointestinal or even renal and liver risk are some of those we face according to the dose at which the medicine is administered.
That is why you should always follow the Medical and Pharmaceutical Council and attend to the instructions included in the prospect (although sometimes it is very difficult to read and understand).
Images | Danilo.Alvesd Petr
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