Common misconceptions about medicine Part 1

Through the years I've been a pharmacist, there have been recurring misconceptions about medication that has been plaguing our public. So today, I hope to shed some light on some common misbeliefs.


1. Capsules are made from plastic, and it will clog up our kidneys if we take many of them

Well, we have good news for this myth. NO capsules in this world are made from plastic! :) Really, None, Zero, Zilch. Capsules are generally made from gelatin, a substance derived from the bone of cows or pigs. In Malaysia, almost all animal based gelatins are from Cows (bovine). Non-animal derivatives are also available, and they are called vege-caps. Not all products are compatible with vegecaps.

Capsules also have to pass a dissolution test when they are manufactured. Below is a picture of a machine used to carry out the dissolution test.

Capsules are put into beakers of water heated to 37° C (to mimic our body temperature) and stirred continuously. While there may be a lot of different test standards for different capsule material, generally capsules have to fully dissolve in 20 minutes to pass the test. Therefore all capsules that pass the test will definitely fully dissolve, and not clog up anything.

What if they DON'T pass?? You know, kopi lesen type of QC or something?

Well, not to worry. While we DO get occasional capsules that somehow fail to dissolve fully, any undissolved capsule shells will just pass out your body with your next visit to the toilet (the big visit). Nothing will clog up your kidneys because to reach your kidneys, the capsule will have to fully dissolve FIRST :)

I still feel that if I pour the contents of the capsules out from the capsule, it will be better right? 

Well not really. While for a lot of medicine pouring out the contents of the capsule directly in your mouth may not be that much different from taking the capsule whole, some of the contents of the capsules may cause some problems to the patient. For instance, some of the contents are quite irritating to our stomach, and some capsules are designed to only melt after it has gone into out intestines, bypassing our stomach. If you cut open these capsules, you risk gastric irritation. Another example is when the contents of the capsule are sensitive to gastric acid, and may break down to something else if we take it directly (without the intact capsule).


2. All western medicine will cause kidney failure if taken on a long term basis. That's why it's not advisable to take blood pressure/diabetic medication from western doctors.

While there ARE some medicine that is known to cause kidney failure (prolonged use of pain-killers called NSAIDs), Most blood pressure and diabetic medication DO NOT cause kidney failure. Ironically, they have been known to prevent a lot of kidney disease otherwise caused by hypertension and diabetes. 

You're a pharmacist of western medication, of course you will say that there are no side effects.

That's where you're wrong. ALL medication will have a list of side effects, INCLUDING traditional medication. And what we said was they do not cause kidney failure. The good thing about western blood pressure and diabetes medication is that they have EVIDENCE that they can reduce kidney related complications, not just saying it :)


3. We must always take medicine after a meal, because it will cause gastric pain/stomach wind if we do not.

While certain medication like pain killers in general will cause gastric irritation when taken on an empty stomach, a vast majority of medicine can and should be taken on an empty stomach. An example will be the common blood pressure medicine perindopirl (Coversyl). If you take this medicine after a meal, about 20% of the medicine will not be absorbed, and in turn may cause a rise in your blood pressure. So ask your pharmacists for the correct way to take your medicine if you are unsure :)


4.  If it hurts more, taking double the dose will make it better faster.

This is a very dangerous misconception. While not all medicine can kill you if you double dose on it, there ARE quite a number of medicine that can kill you if you go double/triple the dose. For example, a diabetic medicine called Daonil (glibenclamide) if taken at double the usual dose, can cause your blood sugar to fall below the normal range, and you might very well fall unconscious soon after. If no rescue/medical aid reaches you in time, death is a very probable ending.

Always take your medication as directed, and if it's too near your next dose, skip it rather than doubling up.


5. I have a cold. Please give me antibiotics right now, I want to get better faster.

According to a CDC report, the majority of colds are in fact NOT caused by bacteria. Most colds are caused by VIRUSES, not bacteria. so taking an antibiotic for ALL colds generally makes no sense. This is because viruses cannot be killed by antibiotics (hard to believe? but it's true). So the next time your pharmacist tells you you don't need an antibiotic, chances are, he's right. 

Having said that, there ARE times when antibiotics are needed, especially for more severe cases, and those whom we've identified are in fact been infected by bacteria. When prescribed with an antibiotic, its is important that we take it EXACTLY as directed. This way, we can prevent the ever rising resistance to antibiotics.