Attack of the Horse Pills
Why are people still being prescribed giant tablets?
Every now and then, the topics I report on as Editor of The Medicine Maker unexpectedly pop up elsewhere in my life. “I’ll be back for dinner soon. P.s. I have horse pills!” It was a text from my partner.
I presumed he wasn’t speaking literally – it seemed unlikely that he’d somehow acquired a sick horse at work (especially as he is not a large-animal veterinarian). He was on his way home after picking up his prescription and was referring to the size of his tablets. He’s never had an issue with swallowing pills before and it’s the first time I’d heard him balk at a tablet’s size. I inspected the “horse pills” – a commonly prescribed antibiotic for a common infection – and confirmed that they were enormous. But I failed to reassure him about the ease with which he could access their healing powers. “At least they’re coated,” I said, hopefully.
Earlier this year in The Medicine Maker, we discussed the problems that elderly patients can have in swallowing medicines (1), but the text message from my partner woke me up to the fact that the problem is a broader one. With antibiotics in particular, patient adherence is crucial, so I’m left scratching my head as to why such off-putting tablets have become the norm. My partner will take them (and I will play my role: nagging him to ensure he takes the full course). But how many people out there won’t take them or can’t take them? Or will just take them until they feel better?
Smarter solid dosage technologies cost more money, but isn’t there a better balance to be struck for the benefit of patient compliance? Many big pharma companies have just reported their Q3 revenues from 2019 – and there is plenty of profit to be found. Surely, there’s scope to spend a little to make patients’ lives easier.
The change doesn’t even have to be revolutionary. If ODTs or chewable tablets are out of the question, what about simply creating two smaller tablets instead of one giant pill for larger dosages?
We’re just about to enter the third decade of a millenium defined by technological advances – pharma can do better than producing horse pills for humans.
- M Mahdi, S Sutton, “More Than Just a Number,” The Medicine Maker, 50, 23-33 (2019).
Making great scientific magazines isn’t just about delivering knowledge and high quality content; it’s also about packaging these in the right words to ensure that someone is truly inspired by a topic. My passion is ensuring that our authors’ expertise is presented as a seamless and enjoyable reading experience, whether in print, in digital or on social media. I’ve spent fourteen years writing and editing features for scientific and manufacturing publications, and in making this content engaging and accessible without sacrificing its scientific integrity. There is nothing better than a magazine with great content that feels great to read.
