[Spivak]

I'm sure this is an easy question to answer, but it was bugging me during the whole article.

What's preventing a pill that releases a dose immediately and one after 6 hours? Or something like a diabetic pump that dispenses medication continuously? Surely such systems have the potential to be safer and more effective for patients?

[sloppycee]

Concerta ER does something like that, I'm curious why it isn't more widely used.

"The system, which resembles a conventional tablet in appearance, comprises an osmotically active trilayer core surrounded by a semipermeable membrane with an immediate-release drug overcoat.

The trilayer core is composed of two drug layers containing the drug and excipients, and a push layer containing osmotically active components. There is a precision-laser drilled orifice on the drug-layer end of the tablet.

In an aqueous environment, such as the gastrointestinal tract, the drug overcoat dissolves within one hour, providing an initial dose of methylphenidate. Water permeates through the membrane into the tablet core. As the osmotically active polymer excipients expand, methylphenidate is released through the orifice. The membrane controls the rate at which water enters the tablet core, which in turn controls drug delivery."

[warsharks]

in terms of ADHD Vyvanse/Elvanse/Lisdexamphetamine is more interesting in my opinion, its dexamphetamine bound to lysene. your body naturally strips the lysene away releasing the dexamphetamine over a period of 12 hours.

it doesnt rely on being mixed with something to delay its action or be pressed into a solid pill, in fact you can open up the capsules and eat the powder inside and there is no change in its effects (its also ineffective intranasally or as far as i am aware even if injected) its rate of release is difficult to change, its just how long the average body takes to strip the lysene away from the chemical.

[eropple]

> What's preventing a pill that releases a dose immediately and one after 6 hours?

Being plopped into a bath of hydrochloric acid makes this a little tricky, I am led to understand.

> Or something like a diabetic pump that dispenses medication continuously?

And this led me down a brief Google walk for what these are, and...huh, that's a really good question...

[maxerickson]

Expense and convenience (a thing with access to your blood isn't very convenient).

IV pain management often includes a button the patient can push (that releases a dose and sets a timer for the next dose). Or at least it used to, I don't know if it is still done.

[kuschku]

> What's preventing a pill that releases a dose immediately and one after 6 hours? Or something like a diabetic pump that dispenses medication continuously? Surely such systems have the potential to be safer and more effective for patients?

Nothing. There are such pills for stuff like Adderall and Ritalin already, on the mass market.

[mhb]

Why would it need an automatic pill? What about 1/n dosage taken n times per day? Less convenient sure, but you can pick whatever n works.

[Spivak]

Less about convenience, more about letting patients get a full night's sleep. Maybe the answer is to alter the sleep schedule of chronic pain sufferers, but it would probably require some form accommodation at the workplace.

[slackingoff2017]

There's fentanyl patches.