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A pill is more than just a pill


Is a pill, just a pill? Most definitely not. In the second of a series of six articles, Organisation of Pharmaceutical Producers of India (OPPI) launches the Know Your Pill initiative, to educate patients on the untold story of the medicine and the intrinsic value of quality that make a pill much more than just a pill

Don’t we all remember the bitter taste that medicines left in our mouth? A paracetamol tablet to manage a fever or dull the pain of a sprained ankle, an antacid to take care of burns in the stomach or an antibiotic to treat an infection. These are all recollections that we own.

How many of us are aware of the complex journey of the tablet as we take it? Is there a curiosity in us as to how this medicine would behave in our metabolic systems after we take it? Will it be destroyed by the strong acidic juices of the stomach? Or will the liver enzymes digest them long before they can reach that painful knee?

There have been examples of people with a weak liver or kidney where an everyday vitamin or painkiller can be dangerous. Unsupervised consumption of painkillers has also led to chronic kidney/ liver diseases in many instances.

Pharmaceutical manufacturers follow a science known as pharmacokinetics, that is the ability to track the movements of a medicine after it enters the human body. They ensure that medicines reach the site of intended action in adequate quantities and stay in the blood stream for an intended amount of time.

Some tablets such as vitamins are coated with a sugary syrup to mask the unfavourable taste, while others such as powerful painkillers are designed so that the actual chemical is released gradually over several hours. Doctors often issue special instructions like – don’t take a strong painkiller on an empty stomach, take a sugar-control pill half an hour before your meal, while an antacid must be taken after a meal! These instructions should be followed meticulously as the pill is manufactured to deliver an intended effectiveness under certain conditions.

Certain other medicines are designed as ‘sustained release’ or ‘delayed release formulations’, which means they are either released gradually into the blood stream or within a short interval of consumption. The former technology is used for short-action chemicals, which lose their effectiveness after a few hours; but when administered through a sustained release formulation, their effect can be extended by a couple of hours.

To illustrate further, delayed release products are often used for medicines that need protection from the highly acidic ambience of the stomach. These drugs are covered by layers of special material which are dissolved slowly as the tablet passes through the stomach to the intestine (gut). They are then absorbed through the intestine walls to reach the bloodstream.

All the above functions of the pill in the metabolic system are covered by what we call the ‘bio-availability’ of a medicine –how much of a medicine which is ingested or injected actually reaches the bloodstream, and travels to the site of action (such as a painful back, or an infected lung).

The other factor that influences the effect that a medicinal product would have in the human body is: breakdown of the biochemical substance within the body, and the way it is excreted from the body. A wide range of pharma products are broken down in the liver, and then excreted through bodily functions.

Because a pill is not just a pill, taking one without a doctor’s prescription and not being supervised by a doctor can be hazardous.  To ensure consistent quality throughout the country, Government of India has mandated the Bioequivalence (BE) study for all drugs. To begin with, BE study has been made mandatory for category II and IV of the BCS system. Where common knowledge could drive us to taking pills out of habit, it is science behind the pill that should be driving the decision.

Issued in public interest by OPPI

Watch this space for the third in the KYP series – ‘Good medicines come in quality packages’

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