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Sustained Release medicine



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I had my sleeve around 5 months ago an I'm down 115lbs. Which is great, but had a quick question. I know bypass patients can no longer take extended releases medicine. Does the same go for us sleevers? I was recently put on Wellbutrin SR twice daily. The doctor knows I have had the gastric sleeve but just wanted to make sure the medicine is working as it takes 4+ weeks to notice effects from it. Curious if anyone else has had issues with SR or XR medications? Thanks

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Since I work in pharma - specifically on extended release medications, this is a question I asked my surgeon about when deciding between the sleeve and bypass. He indicated that one of the advantages of the sleeve is that since the intestinal tract remains completely intact, there is no impact on absorption of extended release medicines. Immediate release medications all release in the stomach and he indicated even with the reduced stomach volume, even poorly soluble immediate release drugs won't be impacted.

From the science aspect - some SR/XR (and MR) medications have a mechanism that just slowly releases over time (often due to a matrix in the formulation that swells when you ingest it and slows down the escape of the active ingredient out of the tablet/capsule. For others, they have a coating on them that will only dissolve when it hits a certain pH - so they won't dissolve in stomach acid but wait until higher pH levels. They can be targeted to release at different points in the intestines based on what pH the coating will dissolve.

Hope this helps.

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for the drinking - you absorb faster because there isn't as much volume of stomach Fluid diluting it and also you typically aren't eating while drinking anymore. The alcohol is already a liquid so there isn't any wait for it to dissolve to become available for absorption.

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I was on Wellbutrin SR twice a day before surgery, and I had to change to regular Wellbutrin three times a day after surgery. My surgeon explained that it was because your stomach is so much smaller it may not produce enough acid to break down the coating on the pills. It's a little bit of a hassle taking it three times a day, but Wellbutrin works well for me so it's worth it!

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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