Misc Generic Effexor being shit out completely intact?

[optimuswind]

So a few days ago I took a look down at my shit, as you do sometimes after taking a dump, and I noticed something white sticking out the side of a chunk of shit. I cleaned my ass, grabbed some plastic bags and fished it out, it turned out to be a whole generic Effexor (Venlafaxine) XR pill. It was completely intact, I broke it open and the contents of the pill was all there too.

Firstly these generic venlafaxine XR pills are hard, round white pills, not capsules like I think(?) the branded Effexor stuff is.

Why didn't anything happen to it and why did I shit it right out?
Since then I've been breaking the pills in half and swallowing them to make sure my stomach acids or whatever can break them down and release the stuff inside, because it seems like the 'shell coating' of the pill was just not able to be penetrated?

Since they are XR "Extended Release", what will doing this before taking them do, release it faster probably, i'm guessing, but since it's an SNRI and like all SSRI/SNRI etc take weeks to build up in your system, what does it matter if it is released slowly over the course of the day or a bit faster? (I don't feel anything after taking them, solid or otherwise)

The label says "swallow whole, do not crush or chew", but if i'm just going to shit them out, what's the point right? So as I said i've been breaking them in half with my teeth first then swallowing with water.

So does anyone know why they were coming out in my shit undigested or whatever in the first place, and will breaking them in half first do anything 'bad' in relation to the treatment they're supposed to give?

 

[Redrawl]

Is it in capsules that you can open?

A lot of medicines (not all!) that come in capsules can you open and mix the content with something easy to swallow (for patients who have difficulty swallowing).
Don't crush the content, because if you do that, you won't have XR release anymore.

I'm not sure if you can do this with your medicine, call your pharmacy and they will let you know.

If not, try a different brand (if available) or a whole different medicine.

 

[optimuswind]

Is it in capsules that you can open?

A lot of medicines (not all!) that come in capsules can you open and mix the content with something easy to swallow (for patients who have difficulty swallowing).
Don't crush the content, because if you do that, you won't have XR release anymore.

I'm not sure if you can do this with your medicine, call your pharmacy and they will let you know.

If not, try a different brand (if available) or a whole different medicine.

I said in my post they are solid hard round pills and not capsules.

Edit:

Extended release

Venlafaxine extended release is chemically the same as normal venlafaxine. The extended release (controlled release) version distributes the release of the drug into the gastrointestinal tract over a longer period than normal venlafaxine. This results in a lower peak plasma concentration. Studies have shown that the extended release formula has a lower incidence of patients suffering from nausea as a side effect, resulting in a lower number of patients stopping their treatment due to nausea

That's all wikipedia has to say about the extended release. So basically the only reason it is extended release is to lower the peak plasma concentration, so people don't get nauseas? Well, I've been splitting the pills in half and eating them for about 2 weeks now and I haven't felt any different, infact I've been feeling better overall, so my guess is the shitty generic pills weren't being absorbed at all and I was shitting most of them out whole without absorbing any of it. Haven't felt nausea at all.

Unless anyone has anything else to add I guess I found the answer to my own question.

 

[sekio]

Some medications are designed so the pill membrane or matrix remains undigested, but the meds still diffuse out. The Concerta XR pills are kind of like that.

Ask your doctor.

 

[optimuswind]

I did ask him, he didn't really have an answer. Also when you say diffuse out, you mean the contents inside would be gone? Because as I said, I broke the pill open and it was still rock solid inside, like a complete normal pill, it looked no different to one popped from the blister pack and broken open.

 

[Redrawl]

Switch medication? If there's no other brand.

 

[optimuswind]

I can see if there's another brand but venlafaxine is the only antidepressant that has worked for me so there's no way i'm switching. i'll just keep cracking them in half before swallowing them, doesn't seem to do any harm anyway.

 

[Redrawl]

Your splitting an XR pill in half, with that you mess with the XR design of that company.
How much it will effect it's half life and effects is hard to say, but if you don't feel any changes in effects and side effects i'm tend to say you don't have to worry much.

Maybe it's an idea to ask your doc, if he can check the amount of venlafaxine in your blood serum, to check if it doesn't dissolve very quick and reach (near) toxic levels, especially short after taking venlafaxine.

In the Benelux we have Effexor and other brands with venlafaxine (XR) in it.
Switching brands can also have a (temporary) change in (side) effects.

 

[optimuswind]

Your splitting an XR pill in half, with that you mess with the XR design of that company.
How much it will effect it's half life and effects is hard to say, but if you don't feel any changes in effects and side effects i'm tend to say you don't have to worry much.

Maybe it's an idea to ask your doc, if he can check the amount of venlafaxine in your blood serum, to check if it doesn't dissolve very quick and reach (near) toxic levels, especially short after taking venlafaxine.

but this seems to be the only reason why it's extended release:

Extended release

Venlafaxine extended release is chemically the same as normal venlafaxine. The extended release (controlled release) version distributes the release of the drug into the gastrointestinal tract over a longer period than normal venlafaxine. This results in a lower peak plasma concentration. Studies have shown that the extended release formula has a lower incidence of patients suffering from nausea as a side effect, resulting in a lower number of patients stopping their treatment due to nausea

and since I don't get nausea then I see no problem? it's just like taking a non-XR pill? it's still the same amount of the drug in the pill

 

[fairnymph]

You could switch to the IR version, you might just have to dose more frequently. Athough once a day could suffice. As I gradually increased my dose, I never had any problems with once daily dosing at any point, and I started at 17.5 mg. Once I reached the right dosage, 450mg in the morning worked great, although venlafaxine has the most bitter, long-lasting taste of any chemical I've tasted.

If you crush up your ER tablets, with a pill crusher or mortar & pestle, then take the ground up pill, you should be able to absorb it all. I'd do that over just cutting the tablets in half, to make sure you're getting full absorption. Depending on the mechanism it may be all IR or partly ER still. But it should work either way which is the goal. Still, I'd ask to switch to IR so you don't have to go to so much effort. Personally, I found IR treatment far more effective and with fewer side effects than ER, so it might be a therapeutically useful switch as well.

 

[optimuswind]

Well the problem seems to be that the outer 'shell' of the pills just can't be penetrated sometimes or something, so I figured splitting them in half and thusly having the interior of the pill exposed would be fine, no need to crush it up completely etc

Since it's an SNRI, which takes weeks to feel any effects anyway, why does it matter how the daily dose is taken? There's no immediate effect from the daily dose is there, it's just about keeping the drug in your system isn't it?

If it helps, I'm on 225mg, which is 150mg+75mg pills, they're called "VENLALIC XL prolonged-release tablets"

Edit: I googled Venlalic and it seems doctors are prescribing them instead of the better stuff because it's cheaper -.-

 

[fairnymph]

Ah if it's just the outer shell you should be okay, though I'd still be concerned personally. What poor design!

I'm not sure why IR is better, but my doctor at the time is/was a foremost expert in OCD, and a very knowledgeable and experienced psychiatrist. He was the one who recommended IR as being more effective. It's also better for gradually increasing your dose, optimizing tolerance and miminising side effects. Years later I went back on Effexor, in the form of ER capsules, and it just didn't seem to do very much. It's the only antidepressant type drug of many I've tried that displayed a difference between IR and ER. It's possible the effect is only applicable to OCD patients, as we're super metabolisers and need high doses, preferably all at once , to get effects. I think that with higher doses, taking it all at once IR is more likely to achieve DARI effects, as well.

While therapeutic effects take weeks or months to kick in, I personally could feel immediate effects even from 17.5 IR. Similar to a non-recreational MDMA feeling, that I neither particularly liked or disliked. My Dr's instructions were to continue taking that amount until I stopped feeling it, then double my dose and take that dose until I stopped feeling it, then repeat until reaching 300mg which was the threshold dose for me therapeutically. If after 3 weeks at that dose I didn't feel adequate improvement or experienced a decline, I was to increase my dose by 50mg.

 

[optimuswind]

Ah if it's just the outer shell you should be okay, though I'd still be concerned personally. What poor design!

I'm not sure why IR is better, but my doctor at the time is/was a foremost expert in OCD, and a very knowledgeable and experienced psychiatrist. He was the one who recommended IR as being more effective. It's also better for gradually increasing your dose, optimizing tolerance and miminising side effects. Years later I went back on Effexor, in the form of ER capsules, and it just didn't seem to do very much. It's the only antidepressant type drug of many I've tried that displayed a difference between IR and ER. It's possible the effect is only applicable to OCD patients, as we're super metabolisers and need high doses, preferably all at once , to get effects. I think that with higher doses, taking it all at once IR is more likely to achieve DARI effects, as well.

While therapeutic effects take weeks or months to kick in, I personally could feel immediate effects even from 17.5 IR. Similar to a non-recreational MDMA feeling, that I neither particularly liked or disliked. My Dr's instructions were to continue taking that amount until I stopped feeling it, then double my dose and take that dose until I stopped feeling it, then repeat until reaching 300mg which was the threshold dose for me therapeutically. If after 3 weeks at that dose I didn't feel adequate improvement or experienced a decline, I was to increase my dose by 50mg.

That's interesting to hear that you can feel immediate effects from such a low IR dose. The only side-effects I've experienced since being on these about 6 months now is somnolence, which happened for a couple of weeks between dosage increases

 

[greywoodfoxhall]

Well the problem seems to be that the outer 'shell' of the pills just can't be penetrated sometimes or something, so I figured splitting them in half and thusly having the interior of the pill exposed would be fine, no need to crush it up completely etc

Since it's an SNRI, which takes weeks to feel any effects anyway, why does it matter how the daily dose is taken? There's no immediate effect from the daily dose is there, it's just about keeping the drug in your system isn't it?

If it helps, I'm on 225mg, which is 150mg+75mg pills, they're called "VENLALIC XL prolonged-release tablets"

Edit: I googled Venlalic and it seems doctors are prescribing them instead of the better stuff because it's cheaper -.-

Very true... why would SSRIs or SNRIs need to be XR? Very odd. The drug companies (thanks to the DEA and the media letting addicts scapegoat Rx medication) are doing weird things to pills now. The OP OCs can be put in a table clamp and when removed, look like a Skittle you stepped on. Want to scare yourself, read this:

http://www.drugdetox.org/druginfo/prozac.php

America's "Happy Pill" has withdrawals that look damn near identical to opiate withdrawals. Off topic, but I had to share it (I'm helping a friend in Brazil as he gets of Methadone and Prozac).

Have you tried Remeron (mirtazapine), optimuswind?

 

[fairnymph]

That's interesting to hear that you can feel immediate effects from such a low IR dose. The only side-effects I've experienced since being on these about 6 months now is somnolence, which happened for a couple of weeks between dosage increases

Oh, I remember now. My Dr told me the IR would be more stimulating (I had the tired sort of depression), if taken in the morning. Again to do with dopamine, I believe. I did find that to be true; I had more energy but still slept well. The immediate effects were very mild and rapidly became less noticeable.

 

[optimuswind]

Very true... why would SSRIs or SNRIs need to be XR? Very odd. The drug companies (thanks to the DEA and the media letting addicts scapegoat Rx medication) are doing weird things to pills now. The OP OCs can be put in a table clamp and when removed, look like a Skittle you stepped on. Want to scare yourself, read this:

http://www.drugdetox.org/druginfo/prozac.php

America's "Happy Pill" has withdrawals that look damn near identical to opiate withdrawals. Off topic, but I had to share it (I'm helping a friend in Brazil as he gets of Methadone and Prozac).

Have you tried Remeron (mirtazapine), optimuswind?

I tried Mirtazapine before this, and it made me feel nauseous as hell after taking it, the longest I could manage was 4 days, even taking it right before sleep was impossible because the effects were almost immediate and then I couldn't sleep. It felt like being incredibly drunk or something, really horrible feeling. The Venlafaxine made me throw up the very first night I took it, and then the only problem since then has been somnolence after upping from 75mg to 150mg (no changes going from 150mg to 225mg).

It's definitely helped my social anxiety and resulting depression, so switching to anything else at this point after all these years of looking for medication that works isn't really something I want to try. I can ask my doctor if it's possible to get Effexor instead of generic, but I don't know if we even get it here in the UK(?). Either way it's been about 2 weeks since I have been splitting the pills in half before swallowing them, and I haven't had any withdrawal symptoms occuring which I should definitely have if the drug wasn't getting absorbed, so I think it's like you say, why do they need to be XR in the first place? I guess one answer is fairnymph's where he says he took it for OCD, so it must make a difference for different problems, and in my case it doesn't matter?

 

[sarahnich]

Hi there, I know this subject you posted couple of years ago, but I hope you can let me know the conclusions as I have experienced e,actly the same. Basically I am checking my kids and myself for thread worms, and as u did, saw a white lump sticking out and realised was my venlafaxine generic tablet. My Dr surgery started prescribing the tablet form generics ti save money. Before was taking effexor capsules. Did you change to. Immediate release and if so, did you notice a difference? Thanks in advance for your thoughts. Best regards.

 

[Rybee]

Hi there, I know this subject you posted couple of years ago, but I hope you can let me know the conclusions as I have experienced e,actly the same. Basically I am checking my kids and myself for thread worms, and as u did, saw a white lump sticking out and realised was my venlafaxine generic tablet. My Dr surgery started prescribing the tablet form generics ti save money. Before was taking effexor capsules. Did you change to. Immediate release and if so, did you notice a difference? Thanks in advance for your thoughts. Best regards.

As seiko touched on in post #4, the XR pills are designed to do this and it's perfectly normal. It would be abnormal to not find the shell in your excretion. I used to take Venlafaxine/Effexor and had the same problem so asked my GP who explained it to me. It's just the way that specific time release mechanism works for them particular pills. The external wax shell remains in tact, whilst the inner contents are slowly diffused out from the centre of the pill, stopping the contents all being diffused at once, which is how the XR mechanism works.

You should find plenty of information on this exact concern if you Google it.