Is it okay to take Effexor without its capsule?
May 16, 2009 7:22 AM   Subscribe

Is there any particular reason that Effexor comes in gelatin capsules?

Inside the capsule there are a number of small pellets.

I'm a vegan so I've just been pulling the capsules apart over my mouth, with my head tilted back, and tossing the capsules in the garbage.

I haven't noticed any difference in mood after doing this for a month or so. The only difference I have noticed is that the pellets are extremely bitter (so discovered after having one of them catch in my teeth).

But why aren't the pellets just one solid pill, like bupropion? Is it the bitterness, or does the capsule actually do something (and if so, what)?
posted by anonymous to Health & Fitness (10 answers total) 1 user marked this as a favorite
Effexor XR (extended release) comes in capsules. Regular old Effexor comes in a tablet. My guess is that the capsule and pellets release the drug more slowly over time.

I've taken both and while I think you're supposed to take the non extended release tablets more than once a day, I never did and didn't notice any difference in effect. Maybe you can ask your doc to prescribe you the non extended release ones next time. You're probably minimizing the "extended release" effect by opening up the capsule anyway.
posted by dchrssyr at 7:31 AM on May 16, 2009

In Effexor XR, the XR is for extended release. However, the extended release is a property of the pellets and not the capsule. Many people crack them open and sprinkle it on their food. What you are doing won't hurt you.
See this first google hit for reference
posted by GleepGlop at 7:32 AM on May 16, 2009

Thanks for pointing this out. I never read the package insert on what the capsules are made off. I am pretty sure the capsules of my former anti-depressant were made off cornstarch.
posted by jfricke at 8:42 AM on May 16, 2009

For future reference, if you open up and consume extended release medicine from its capsule because you don't want to consume the gelatin you could really do yourself some harm. From now on ask your pharmacist if they are a compounding pharmacy or if there is one nearby they can recommend. A compounding pharmacy will likely be able to re-formulate your medicine so that it is not in a gelatin capsule. Don't do it again. Seriously, people die from doing this kind of boneheaded self-dispensing.
posted by SassHat at 10:26 AM on May 16, 2009 [5 favorites]

My understanding is that the presentation of taking a pill (capsule, solid, etc.) is designed for the way the stuff in it is meant to be best absorbed. Usually pills either need to be broken down in the stomach (take with food to get the digestive acid acting on them) or must pass through to the digestive tract undisturbed so they can be absorbed more slowly there (take with water, etc.).
My Effexor caps say take with a meal, so that would mean that taking just the contents is probably okay, but just ask your pharmacist about it next time you pick up your prescription. Mine is always quite happy to explain the workings of things to me.
posted by Billegible at 11:01 AM on May 16, 2009

The capsule should control the release of the drug. I don't know how much of a difference it makes in Effexor, but to be on the safe side, you should be able to buy empty vegan capsules and transfer the pellets before you take them if you can't find a pharmacist to do it for you.
posted by emilyd22222 at 11:12 AM on May 16, 2009

Mod note: This is a reply from an anonymous commenter.
IANAD, SassHat's overreacting as far as Effexor is concerned. I just dug up a supplemental information sheet I received with Effexor from my pharmacy and it said that it's okay to take the contents of the entire capsule sprinkled over food, as long as nothing is chewed. Swallowing the contents of the capsule the way you're doing it may pose some problems in terms of the smaller, faster release pellets getting stuck in your teeth and not properly absorbed into your bloodstream, but if you sprinkle the contents over a tablespoon of applesauce or yogurt you'll have a better chance of digesting all the pellets. The capsules do aid somewhat in the extended release effects, but there are a whole lot of people who can't/won't swallow any sort of capsule, and considering that there is no liquid or injectable form of any SNRI available, clearly the non-capsule route is working for someone.

The issue with taking pellets sans capsule is particularly related to taking a fractional amount of pellets from a capsule in order to wean yourself off the drug. Because the pellets are of different sizes, it's difficult to make sure that you're taking the right proportion of pellets and this can wreak havoc on your reaction to the drug.
posted by cortex (staff) at 12:30 PM on May 16, 2009

I take Effexor XR. The insert I get from the pharmacist says if you don't want to ingest the capsule itself, you're to sprinkle the bits into a tablespoon of applesauce.
posted by deborah at 8:20 PM on May 17, 2009

You should really just ask your pharmacist when it comes to splitting pills. Heck, you probably don't even need to call your pharmacist, just call any ol' drugstore's pharmacy counter with the exact info from your pills. It would not take much more time than typing up a question for Ask Metafilter, and you could be a lot more confident in the answer.

If your Effexor is a 1x per day dose, it's probably the extended release, and I do think it's worth being more cautious with extended release pills. I don't think SassHat is overreacting at all ... maybe (and I don't know this) Effexor is safe to split because the pellets inside the capsule are extended release, and not the capsule itself, but sometimes there is an actual coating on the tablet or capsule that slowls the absorption.
posted by tastybrains at 1:17 PM on May 18, 2009

Effexor and other medicines give you the all-clear to open the capsule, and I was not arguing otherwise. My point was that as far as the asker was concerned, this was something they were doing to avoid the gelatin capsules. In this case it was fine, because the medication insert says so. The asker did not include this information and even the answers which indicated it was ok said so because "many people do this". Even if you knew a hundred people who did this safely, it doesn't mean that it is safe for you, unless you are taking it as directed by a physician and following the manufacturer's and pharmacist's instructions.

Believe me when I say it is not an overreaction, this is one of the many ways people make themselves sick or dead from their own legally-prescribed medication. Memail me if you're interested in why I say this. The point is, the asker shouldn't have to ingest non-vegan medicine, and any good pharmacist will be prepared to provide information about their medication and refer them to a compounder or provide instructions on whether/how this can be done safely. This is their job. There is no reason why any person should "guess" at how/when to take their medicine.
posted by SassHat at 12:17 PM on May 25, 2009

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