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缓释药物到底能不能掰开吃

2019-08-15 马 婧 上海药讯

缓释药物医学知识科普
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1 日常生活中，人们可能会服用各种各样的药物，但是有些药物半衰期很短，容易漏服或错服，长期服用依从性较差，因此药学研发人员绞尽脑汁，通过各种高科技手段将这类药物制成缓控释制剂，以减少每天的服药次数，增加患者的依从性，避免由于漏服或误服导致的不良反应或严重后果。大多数缓控释制剂只需一天服用一次，并且可以控制血药浓度在稳定的范围内，避免血药浓度的波动导致的疗效的改变。缓控释制剂适用于长期服药的慢


上海交通大学医学院附属新华医院药学部  马  婧

1.日常生活中，人们可能会服用各种各样的药物，但是有些药物半衰期很短，容易漏服或错服，长期服用依从性较差，因此药学研发人员绞尽脑汁，通过各种高科技手段将这类药物制成缓控释制剂，以减少每天的服药次数，增加患者的依从性，避免由于漏服或误服导致的不良反应或严重后果。大多数缓控释制剂只需一天服用一次，并且可以控制血药浓度在稳定的范围内，避免血药浓度的波动导致的疗效的改变。缓控释制剂适用于长期服药的慢性病患者。

缓释及控释制剂可以掰开服用吗？

大多数缓释及控释制剂是不可以掰开服用的，因为掰开服用破坏了制剂的工艺结构，导致药物很快释放，不能起缓释或控释的作用，更重要的是由于制剂的含药量大于普通制剂，掰开服用等于把全天的药量一下全吃了，易造成药物中毒，引起不良反应。

但有些特殊注明的缓释及控释制剂是可以掰开服用的，原因是厂家研发的制剂工艺允许掰开或留有刻痕供掰开服用。有的缓控释制剂服用后，其制剂结构(外形)在人体内不被破坏，这些药物会以原形随粪便排出，如果在排泄物中发现整片药，不必感到恐慌。

哪些缓释及控释制剂不可以掰开服用？
  
通用名

商品名

硝苯地平控释片

拜新同

吲哒帕胺缓释片

纳催离

非洛地平缓释片

波依定

甲磺酸多沙唑嗪控释片

可多华

格列齐特缓释片

达美康缓释片

格列吡嗪缓释片

秦苏

格列吡嗪控释片

瑞易宁

双氯芬酸钠缓释片

扶他林

克拉霉素缓释片

诺邦

丙戊酸钠缓释片

典泰

吡贝地尔缓释片

泰舒达

硫酸吗啡缓释片

美施康定

氯化钾缓释片

补达秀

哪些缓释及控释制剂可以掰开服用？

通用名

商品名

美托洛尔缓释片

倍他乐克缓释片

单硝酸异山梨脂缓释片

依姆多、欣康

丙戊酸钠缓释片

德巴金

卡比多巴-左旋多巴控释片

息宁

盐酸曲马多缓释片

奇曼丁

咪唑斯汀缓释片

皿治林

服用缓释控释制剂注意事项

首先要看说明书。如果说明书中有半片药量的用法，就可以将药片掰开吃。如果说明书中提到“整粒吞服”“不可掰开或碾碎”等，则只能整片服用，以免剂量突释后药效过强或发生严重毒副作用。缓控释制剂的服用间隔除说明书中特殊注明外，一般为12小时或24小时服用1次，应注意不要漏服或随意增加剂量。

其次要看药片。观察药片有无刻痕，一般有刻痕即表示为了能整齐地将药片掰开而设计，则可以沿着刻痕掰开服用，在服用半量时一定要沿刻痕掰开，不要随便掰开。

特殊情况：每天大便3次以上的腹泻患者不适合服用控释片。腹泻期间可换用普通制剂，待腹泻痊愈后再接着服用控释片。

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    2019-08-16 184****9840

    学习了，谢谢分享。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=371342, encodeId=d8613e13422a, content=学习了，谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Fri Aug 16 09:26:03 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371335, encodeId=a59a3e133526, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Aug 16 06:48:54 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371334, encodeId=13013e1334b9, content=谢谢了学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Aug 16 06:48:40 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371331, encodeId=19da3e13319d, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Fri Aug 16 05:37:51 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371330, encodeId=c0bb3e13309d, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Fri Aug 16 04:57:49 CST 2019, time=2019-08-16, status=1, ipAttribution=)]
    2019-08-16 txqjm

    谢谢了，学习

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=371342, encodeId=d8613e13422a, content=学习了，谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Fri Aug 16 09:26:03 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371335, encodeId=a59a3e133526, content=谢谢了，学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Aug 16 06:48:54 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371334, encodeId=13013e1334b9, content=谢谢了学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Fri Aug 16 06:48:40 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371331, encodeId=19da3e13319d, content=学习学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Fri Aug 16 05:37:51 CST 2019, time=2019-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=371330, encodeId=c0bb3e13309d, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Fri Aug 16 04:57:49 CST 2019, time=2019-08-16, status=1, ipAttribution=)]
    2019-08-16 txqjm

    谢谢了学习

    0

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    2019-08-16 深海的鱼

    学习学习学习

    0

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    2019-08-16 1e1c07bdm01(暂无匿称)

    好

    0

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