Like the woman in the new TV commercial for Excedrin, you can find another use for that cup of water -- like dumping it on your two-timing boyfriend -- now that you no longer need it to take your pill.
By the end of December, at least 10 prescription and nonprescription drugs will come in a quick-dissolve-in-saliva formulation that eliminates the need to swallow a pill whole. The drugs include Claritin Reditabs, an allergy treatment; Alavert, a generic Reditabs competitor, due to hit store shelves later this month; Immodium, for diarrhea; NuLev, for symptoms of irritable bowel syndrome; a version of the migraine drug Zomig; the antidepressant Remeron; and Excedrin QuickTabs. Pop one in and it dissolves on the tongue in seconds, like those fizzy candies of your childhood.
The quick-dissolve formulations, usually either mint- or fruit-flavored to mask the taste of disintegrating tablet granules, are absorbed into the bloodstream after being broken down in the gastrointestinal tract, just like their swallow-them-whole cousins. But at least one company, Cardinal Health, has in development a version of the Parkinson's drug Eldepryl (selegiline) that would be absorbed by cell membranes in the mouth and go directly to the bloodstream. That would allow patients taking the medication to realize therapeutic effects with less drug, and therefore fewer likely side effects, says Martin Waymark, head of business development for the company.
Quick-dissolve tablets offer easier compliance (patients don't have to be within easy reach of water) and added convenience, especially for older people who have trouble swallowing generally or swallowing pills, says Steven Heffner, an analyst with Kalorama Research, a New York drug research firm. Some five years after the concepts's sales debut, the company projects the $1.5 billion per year worldwide market for quick-dissolve drugs will grow to $5 billion by 2005.
Don't expect every drug to come in a melt-in-your-mouth option, says John Siebert, president of Cima Labs, whose quick-dissolve technology is used in Alavert and about 20 drug versions in development. Siebert says that for now the technology works only with tablets, not capsules. Also, drug makers tend not to try to recoup the added cost of producing these versions. Drugstore.com's price for 30 tablets (15 milligrams each) of Remeron Soltab, the quick-dissolve version of the drug, is $7 lower than for 30 of the conventional version. Excedrin is an exception, with the quick-dissove formula priced at more than twice the cost of the standard version.
Swallowing quick-dissolve drugs is not advised, says Cynthia LaCivita, clinical affairs associate for the American Society of Health System Pharmacists, especially for drugs like selegilene that may come formulated as a lower than usual dose because little drug is lost in the G.I. tract. Swallowing it may cause some of the needed drug to be excreted, and result in a dose too low to be effective. She also advises consumers to keep the candy-tasting medicines out of children's reach.
-- Francesca Lunzer Kritz