For patients with chronic diseases, the way of taking medicine needs to be exquisite. Some people have a habit of chewing on medications. So some patients asked, is it better to chew up the hepatitis B antiviral treatment drug and eat it, or swallow the whole grain?
On the question of whether the drug can be chewed, I would like to briefly introduce it in three categories, not limited to antiviral drugs.
01
Never chew it
One category is absolutely not chewable, such as various palliative dosage forms, enteric-coated tablets or capsules, enzyme drugs, such as aspirin, losec, Demethorn and so on.
In order to make the drug slowly and smoothly released to achieve long-term effect, sustained-release tablets and controlled-release tablets often use special structures such as membrane-controlled, osmotic pump or skeleton type. The drug does not maintain a long-lasting effect after chewing. Therefore, slow and controlled release tablets cannot be chewed;
There is a layer of enteric coating outside the enteric-coated bread, which will not be dissolved in gastric acid, and its role is to protect the gastric mucosa from drug irritation, and the second is to ensure that the drug enters the small intestine after encountering alkaline intestinal fluid before releasing the drug;
Enzyme drugs, such as pancreatic enzymes, can damage the oral mucosa in the mouth, which may lead to mouth ulcers, and the protection of pancreatic enzymes losing enteric coating will be destroyed by gastric juice, affecting the efficacy.
Therefore, the above drugs can not be chewed.
In addition, some drug instructions have the prompts of "swallowing whole grains", "not to be broken or crushed", "not chewable", and can only be taken in whole tablets. I'm sorry, but your loneliness is still good to swallow.
02
Must be chewed
The second category is that must be chewed, and some drugs are chewed and taken after chewing, so that the drugs can be absorbed faster and the efficacy can be better exerted.
Such as some stomach drugs: such as sucralfate, aluminum magnesium carbonate, etc., suitable for chewing and taking, the drug is dispersed into tiny particles after chewing, covering the mucosa of the digestive tract to form a protective film, promoting the ulcerated mucosa to heal as soon as possible.
There are also some calcium agents: the amount of calcium lost is very large, and most of it is excreted without waiting for absorption. Chewing can increase absorption. Common are various calcium tablets.
There are also drugs that promote bowel movements, and if the guide is used to treat constipation, the effect is more pronounced after chewing.
03
Class III drugs
The third category is that most drugs, such as some hepatoprotective drugs, antiviral drugs, anti-liver fibrosis drugs, etc., do not belong to the controlled dosage form, enteric-coated capsules, enzyme drugs, and the instructions are not specifically noted, and can be chewed up and taken. In particular, if the instructions listed in the "half a tablet" or the tablet has a notch on it, it can be broken open to take or chewed. However, based on the increase in contact area between the drug and the digestive tract such as the oral cavity and esophagus after chewing, various digestive enzymes, parasitics, etc. may have potential reactions with the drug. Therefore, there is no specific indication of the drug to be chewed, or it is recommended to swallow the whole capsule.
As far as anti-hepatitis B virus drugs alone are concerned, the latest edition of the 2019 China Chronic Hepatitis B Prevention and Control Guidelines takes "strong and low drug resistance" as the principle of "strong and low drug resistance", and includes entecavir fumarate (ETV), tenofovir fumarate (TDF) and propofol tenofovir fumarate (TAF) as the first-line recommended drugs for the treatment of chronic hepatitis B antivirals. Of course, there are still some patients taking adefovir dipivoxil, lamivudine, telbivudine and other drugs, and have not been replaced for the time being. But these drugs belong to the third category and can be chewed and eaten, but it is best to swallow.
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