medication absorption

How does Roux-en-y surgery affect medication absorption

It depends on the medication. Your best bet would be to ask your pharmacist where in your intestinal tract your particular medication is designed to be absorbed, whether it needs stomach acid to break it down, and things like that.

As the previous poster said, it depends on the medication and if you have questions a both specific meds, you should ask a pharmacist (many physicians don't know).  

Some meds are not affected at all.  Others -- such as most controlled-release (time-release) meds -- are not absorbed quite as well (but are still absorbed to some degree) because they are not in the intestine long enough.  Some are absorbed much less for RNYers than for someone with a normal intestinal system.

It depends on 1) what kind of coating the med has (some coatings dissolve in just the liquid you use to take them while others require the environment of the upper intestine to start to dissolve, and a few require the specific environment of the lower intestine to dissolve and absorb), and 2) where the med is absorbed. Some have coatings that dissolve in plain water but the medicine itself doesn't get absorbed until much further down in the intestine.

Lora 

I take percocet for back pain, but it never shows on the urine screen if it has been more than 6 hours since taken the med. My doctor doesn't understand why it doesn't show in the urinalysis.  I think it is because it is either not fully absorbed or absorbed and processed quicker through the body.So my doctor doesn't think I am taking my medication.  But I cannot help it if it doesn't show in the urinalyisis.  Any ideas?

I don't understand, either.  Some people (myself included) report that pain meds don't work as well (or for as long) after RNY, so they may very well not be fully absorbed post-op, but it should still show up in your urine well beyond 6 hours later.  At one point I searched medical/scientific journals for articles/studies documenting malabsorption of opiates and was unable to find anything particularly useful.

Metabolism of opiates varies somewhat from person to person, because it can be affected by certain enzyme levels in the body and liver function. How much gets excreted in a particular timeframe also can vary somewhat depending on kidney function, dosage, and how much water you drink.  Percocet (oxycodone) should show up in almost any drug test (some are much more sensitive than others) for 72 hours (3 days) after taking it, though.

It does, however, take LONGER than 6 hours for it to show up in a drug test if you haven't been taking it on a regular basis.  It takes about 24 hours for a first dose to show up (a bit earlier on more sensitive tests) so if a drug test comes up negative six hours after you last took it, it is basically telling the doctor that you haven't been taking it all along, because it would be the doses you have taken over the past 2 -3 days that would be showing up, not what you took 6-12 hours ago.

There isn't anything about the RNY that would alter how drugs are metabolized or excreted after they are absorbed, so that is why your doctor is suspicious.  

Lora

The only way to really be sure is to take thee pill in control environment - like as doc office - and have therm test your blood once an hour and urine (as it comes out)  

I don't feel my pain pill work after 3-4 hours but I am sure thast itg is still in my system, just like alcohol.  Both hits me very hard after ingestions but it feels like thery are "gone" after just a few hours.  It is not so.   

In my experience it does really vary... not only by type of medication, coating on pills, time of day taken, etc. It is definitely an adjustment and something you will want to discuss with your Dr until you figure out how it affects you, some extended release type pills might have to be switched to regular and divided up throughout the day for example.

Best to you,

~Michelle "Shelly"

I am so nervous about this one ! I don't want to go through anything from my pain meds because my body is not absorbing them! I have been taking pain pills for over 2 years for my arthritis. This is a big fear of mine !