Delayed vs extended release pills

I went to the nutrionist last week. 
I had been taking Pepcid AC chewables, but was gagging everytime. 
She said it would be ok for me to go back on my prilosec capsules (swallow them)..So, I did, and I am having no problems, but I just found out they are DELAYED RELEASE...
I called the phamacy becasue I had not realized that, and they said they are Delayed not Extended...Is Delayed ok??  I know we (RNYs) are not suppose to take exteneded release, but is it ok to take delayed release???

Help, I am so worried I am hurting my  pouch...I will call the DR. tomorrow, but I am worried tonight!!

I don't know what the difference is between delayed release and extended release.  How long is the release delayed?

Kelly

It's not a matter of it hurting your pouch.. the question is in the fact that RNY'ers don't create a large quantity of Intrinsic Factor, which is what is used to regulate meds in extedned-release formulations.

Here's a quick rundown:

The United States Pharmacopeia (USP) defines delayed-release tablets as enteric-coated to delay release of the medication until the tablet has passed through the stomach to prevent the drug from being destroyed or inactivated by gastric juices or where it may irritate the gastric mucosa. USP defines extended-release tablets "formulated in such a manner to make the contained medicament available over an extended period of time following ingestion." The delayed-release formulation of Depakote is enteric-coated. Depakote ER is not enteric-coated. They are not interchangeable.


Enteric coating is fine.  It just is a coating that adds to the time it takes for the body to break it down.  ER meds won't work as well for us as the body has no way to regulate when the medication will be used.

Hi Andrea,
  I have a question along the same lines. I just got results from my 1 yr post RNY labs.
  My iron was 66 at my 6 month check up, so they had me increase to 2 tablets a day. I take each with a Vitamin C and take them 2 hours away from my calcium. (and another 2 hours away comes my multi-vit, so that I can get the iron from that too).
  I was somewhat disappointed that my iron was only up to 78. Now I am wondering if it is because it is Slow Release (Walgreens brand...ferrous sulfate 47.5 mg).
  Do you think this slow release is hindering my absorption?
  Thanks for your help,
  Dee

Dee,  You should be using ferrous fumerate and not sulfate.  We don't absorb sulfate very well.

It's a possibility -- one of many.

Some just don't absorb supplements well.  I'm one of them.  Even after going a few months without any extra iron due to some stomach issues, my ferritin has stayed the same abysmal 7, and my hct and hgb are very good.. so all the time I was taking iron supplements (3 different types, even), it does not appear any of them were absorbing at all.

The slow absorption, yes, may be an issue.  I wonder if it's slow absorbing due to an enteric coating -- it's a possibility that by the time it gets to where we need to absorb it, it's gone past the prime absorption area.  Or if it is something that requires IF to absorb, and you create less than some other RNY'ers then that could be a problem as well.

Additionally, if you aren't getting a good mix of copper and zinc, then that could affect your iron.  The three metals live in a very close relationship.  That's something that could affect your iron.  Also b-vitamins are needed to properly absorb and utilize iron stores -- this is why some RNYers get something called pernicious anemia -- a disorrder in which b-12 and iron-based anemia live side-by-side.


So you can see why this is such a tricky subject.  What are your hct, hgb, ferritin, and tibc numbers and compared to what they were last time?

 These do not appear to have a coating, but may try something else on the off chance that is why it is not absorbing.
  Hematocrit is 34.9  (35-45 normal)
  Hemoglobin is 12.1 **** 15.5 normal)
  my b-12 was 1072  (200-1100 normal)
  I dont see ferritin and if they did tibc...i dont know what that is

  Thanks,
  Dee

At this point, it doesn't look like anything to be concerned about.  Honestly.  These look like pretty good numbers to me.