That's a really good question and definitely one to address with both your bariatric surgeon and the doctor who prescribes these meds. We GBS people obviously have different absorbtion issues to consider that may affect how our medications get into our systems.

I know I'll have to change from a long-acting pill to a child's version of the same medication because the long-acting one can't be crushed or chewed and won't fit through the new stomach opening.

Thanks for bringing up this important topic! I for one would be interested to hear what you find out.

Yes, you will have to change the time release medications. I have some collected info on this somewhere, I'll see if I can put my hands on it.

But your medicines won't stay in your new pouch long enough for the time release to work

When discussing this with your Dr., also have him/her check to see if any of these meds fall into the NSAIDS list. NSAIDS are called pouch burners because they will ulcerate your pouch.

I'll be back as soon as I can with the time-release info
God Bless
Janelle

This is one of my ref. materials I found, I'm still looking...

Ok as a RN and an Effexor patient, lol...my 2 cents: The reason time release is less effective (note I didn't say doesn't work) is that with this little pouch we have now, pills and liquid pass relatively quickly, and there is not as much stomach acid to degrade or "use up" your medication. Time release and/or long acting medications work by having an outer coating or capsule that degrades slower in your stomach acid or digestive juices during digestion. Since we WLS patients have 1. smaller stomachs, with 2. Less digestive juices, and 3. our pathway of digestion is altered, these types of long acting medications may have partial to NO absorption for us. This from a recommendation for primary care physicians now caring for post-op bariatric patients: "Clinicians should not prescribe extended-release drugs because reducedtransit times and changed intestinal anatomy influence the amount ofmedication that reaches the bloodstream. In the immediate postoperativeperiod, medications with small therapeutic windows, such as lithium oranticoagulants, should be monitored closely, and dosing changed as indicated.Clinicians should not prescribe nonsteroidal anti-inflammatory agents, whichincrease irritation and bleeding. " Link to this article: http://docnews.diabetesjournals.org/cgi/content/full/3/7/14 Bottom line though hon, work closely with your physicians. They and you, know your case history and should be making the best and appropriate choices for your medications and treatment.

This is from Barbra Thompsons newsletter for WLS. I believe it was Feb. of 2006.

http://www.wlscenter.com/

Timed and sustained release medications may no longer be the best choice if you have had gastric bypass surgery. These are designed to slowly break down in the stomach and intestines. Because of the change in your anatomy, they may not be absorbed correctly. Immediate release medications seem to be better suited for gastric bypass patients. Talk to your doctor about this.

Also, be sure that your primary care physician understands how rapidly you will be losing weight. Many conditions are drastically improved soon after weight loss surgery including high blood pressure. Your physician needs to monitor your medicationsso that they are correct for your changing needs. A patient from my local support group was on blood pressure medication and about a month or two after surgery started complaining of dizziness and feeling faint. When her problem was isolated, her doctor discovered that her high blood pressure medication was now too strong for her, causing her blood pressure to drop too low, making her feel faint.

You can also check with your phamracist. I had all my meds checked by mine and reported back to my psychologist what they recommended. I'm sure all the docs can get you the best forms of meds that will work for you.

I'm doing okay with time released meds. I thought I would have to change, but I'm glad I held off and waited to see how things would go. Ask your dr. but you might want to see how things go for a while.

I had my surgery in August and I am still taking my Effexor XR. I've noticed no difference in how I feel, but I haven't ben back to my primary yet. I will say that if I miss a dose of Effexor SR, I notice it, I get dizzy and loopy and can't work. So I would think if I wasn't absorbing the medicine properly I would definately notice.