WARNING! Do NOT open Strattera capsules!!!

[Palms]

Since I have already read two posts today about parents opening the Strattera capsule to give to their children, I feel there is a need for an attention-getting thread about the dangers of this method. The acid contents of Strattera, when opened, can cause serious damage to the esophagus. The powder in strattera can also cause damage to the eyes and skin if you or your child accidently touch it. This was a warning given directly from the Eli Lily Strattera hotline! Unfortunately neither the doctors, nor the pharmacists know about this and think it is o.k. to open the capsule. It is not!!

[shardstar]

Unfortunately, I don't have a choice right now. We experimented, and 18 mg. was too little, and 28 mg. was too much. I don't think that ALL doctors (some may not)don't know that it's not a good idea to open the pill, rather I think that they know that there is no other alternative to get the dosage correct.

Since you feel so strongly about this, do you have any more information about exactly WHAT damage will come from touching the powder? If so, please share it.

[Palms]

Yes, you do have a choice!!! Why not try the 25 mg or even better, 2 x 10 mg? I personally would never expose my child to such a health risk, but that's just my opinion.
PS. I just checked the Strattera website and it does not say anything about a 28 mg pill. Are you sure it was 28 mg?

[Mayleng]

Where is this information from? With the exception of the inhalation warning, I have never heard of the powder being dangerous when ingested directly. I have read from many parents, including Shardstar, who are successfully using Strattera this way and for quite sometime. I have also heard from doctors and pharmacist that other than taking precautions not to inhale, this was safe. I have not seen any warning in the med specs about it (near as I can tell, that stuffs hard to read!) In fact, Eli Lilly has only ever said that "the med was not studied this way and therefore is not recommended". If its so much more serious I'd like more information on this. While I don't recommend it, I don't discourage it. But I would if it is a serious health risk. Do you have a point of reference?

[Palms]

I have read it several months ago in a magazine in a doctor's office. If you would like more information about it, please look up www.strattera.com. There is a phone number listed for any questions. This information was also given to me by their reps when I called their number and asked them about it.
On this website, it clearly says, and I quote, "Strattera capsules should never be broken and sprinkled on food. They must be taken whole."

[Mayleng]

No I mean about the esophogal dangers. We know why Eli Lilly states it must be taken whole. It is due to the fact that the med wasn't studied out of the capsule form and the FDA enforces restrictions on every move they make in regards to marketing. Eli Lily has warned on the label and through their 1+800 number not to inhale, but if this esophogal is news to me. If this issue is something only recently realized, I would like to warn parents of this. I will have to do some homework, but i'm at work now and duty calls.

[Palms]

This is a post from another ADHD Message board, where another poster has received the same info like I did. Here it is. She posted it in March, so the dangers of this practice have been well known since quite awhile. This is the response she received from the E. Lilly Hotline. Unless she and I have been misinformed by E. Lilly, I would be careful about this issue:

"It is dangerous if inhaled, harmful if powder enters the eyes, and it is possible that it could erode the lining of the delicate esophagus, could cause blistering in the mouth...etc. This medication is meant to disolve in the tougher environment of the stomach."

[shardstar]

You state that "it can cause damage to the eyes and skin if you or your child accidently touch it" but I don't don't see anything about that in your last post. Where do you get that information from??

I have tried many different dosages, and originally we gave my daughter 18 mg. in the morning and 10 in the evening, that worked great until she lost some weight. We talked over the pros and cons of switching to a one day dose of 25 mg. and tried that for about a week and a half, but it didn't seem to be doing that well, so we had to go back to the 18 mg. in the morning and 5 mg. at night which is really perfect.

By the way, I don't feel that I am exposing my child to a health risk! I would never do anything to hurt her, and while I appreciate good advice, I prefer it to come from someone who isn't just quoting some article she read in a magazine in a doctor's office a few months ago.

[SBC91]

When we were discussing Strat. with our Ped. he told us that the reason that the capsules shouldn't be opened was because one of the components of the powder was hydrocloric acid. It does no harm to the stomach, because that is what the acid in your stomach is. I know that for bulimics and others who vomit a lot, the acid can harm their throat and teeth. I'm assuming the same can happen over a long period of time with the powder form.

That's just my guess... we were afraid of how Kyle wa going to learn to swallow capsules. Our Ped. gave us a collapseable cup the Allegra drug reps are passing out that has a basket to put the pill in. We just filled up the cup, had him close his eyes and chug it down. It's worked like a charm!

[swarmJAG]

I'm not real sure about this, but I would assume that the risks are probably similar to those of taking an aspirin without washing it down with a liquid. I would think that as long as it is taken with a drink it would be ok. But then again, I'm not a doctor.

[Palms]

By the way, I don't feel that I am exposing my child to a health risk! I would never do anything to hurt her, and while I appreciate good advice, I prefer it to come from someone who isn't just quoting some article she read in a magazine in a doctor's office a few months ago.

[/quote]

Wow, what a "welcome" I have received on this message board. Since my concerns don't seem to be appreciated/welcomed on this message board, I'd rather stick around with friendlier people on another message board. If you don't want good advice and you prefer it to come from someone else who isn't just quoting an article (like me), then why have you joined this board?? Aren't we all sharing information that we have received one way or another?
P.S. I think you need to re-read my last post. I clearly said that this was another person's post, not mine. Since you are not worried about exposing your child to a health risk, I hope I have helped someone else with my concerns. And as I stated, just call E. Lilly and find out for yourself. I just find it hard to believe that they would be lying to me as well as the other poster.

[Mayleng]

I, for one, would not be surprised to find that the doctors and pharmacists again are in the dark about yet another aspect of this med. Thats my concern.

I don't recommend opening the capsules, I recommend getting kids to swallow the pill. But I also understand the problems and frustraitions that come with trying to get our kids to do some pretty simple things. So when I see someone posting about opening the capsule, I let them know of the dangers I know of and leave it at that.

I am wondering why some of us didn't get this info when calling Eli Lilly. I searched the internet for anything with the word STRATTERA and ESOPHAGUS and didn't find anything about this. But as I said before, nothing surprises me anymore and we have to do our own research and find out just what the risks are. I would hope that if this powder was so dangerous, it wouldn't be in an openable capsule (I made up a word!) I would think the FDA would demand that, especially since it is primarily a childs medicine. But I guess we need toget a call into Eli Lilly tomorrow and find out for sure.

Everyone is becoming more and more aware of how just a few mgs can make a difference. Being that they don't manufacture this in less than 10mgs, we have often joked about how some of us are becoming chemists and must soon go out and buy drug scales to make our own capsules in the mgs we need it. Shard star is in good company. If there is a real risk, and the company isn't making it in the right mgs and then putting the med in an unsecure capsule, somethings really really wrong.

[shardstar]

Well, Palms, the great thing about this board is that all of us can really relate to each other, because we all have children/grandchildren etc. with ADHD and know how hard it can be. We all come here to lend support to each other, share, and give advice without judgment or criticism, not to tell each other we are wrong for how we are going about things.

[Mayleng]

Palms said:

Yes, you do have a choice!!! Why not try the 25 mg or even better, 2 x 10 mg? I personally would never expose my child to such a health risk, but that's just my opinion.
PS. I just checked the Strattera website and it does not say anything about a 28 mg pill. Are you sure it was 28 mg?

Palms, I am sorry that you feel unwelcomed here. We are a very friendly and supportive board here. We appreciate any input from all members. I think what happened here wasn't so much the information that you were trying to get across that was not well received but the Tone it which it was delivered. Knowing us, moms, we are struggling to help our kids and have the best interests of our kids at heart and we get a bit sensitive when advice is given with this type of comment quote: I personally would never expose my child to such a health risk, but that's just my opinion. unquote. Shardstar has been doing everything to help her child and I guess, in her shoes, I would be a little upset when it seems someone is accusing her of exposing her child to health risks.

I guess what I am saying is, we know you mean well and do appreciate your warnings, which I am sure Millermom or myself will look into it as we try and substantiate everything we learn as best we can, but we have to remember to be sensitive to other's feelings so that misunderstandings like this don't happened. Dealing with ADHD is not the easiest thing in the world to do.

Meantime, please know that you are welcome here and understand that emotions do get heated sometimes.

And if Millermom and I asks lots of questions when something is posted, it is not because we are not friendly but we are only trying to find out and verify as much info as possible so that we can give the members the correct information. Thank you for bringing this to our notice.

[svh]

Our pedi-neuro spoke to Lilly about this early on, on their doctor line (the one we normal parents can't access), and was told about the inhalation risk, plus not to get it in your eyes, and that that was the reason not to open the capsules. As I have a child w/ a severe gag reflex who cannot swallow pills no matter what (not to mention mini M&Ms or anything not totally mushified....), the neuro and I agreed that if I was very careful when opening it, and as long as I completely enveloped the powder in whatever medium I chose (peanut butter), we should be fine.

You do what you have to do. Intelligent people are able to assess risk, given adequate information. Everything is a risk-benefit analysis in this medicating game.

[Mayleng]

svh, thanks for your input. It is funny, because I was just "talking" to millermom about how the ones that do open the capsule mix the meds with peanut butter, yogurt etc, and thus would have, as you said, enveloped it with some "medium" anyway. So even if it is true about the esophagus theory, the peanut butter etc. would have formed some kind of protection.

addadhdblog.com/strattera-my-son-cant-swallow-the-pill/?doing_wp_cron=1485572438.9530661106109619140625

[jclark]

Hey moms, dads, and grandparents. I read that some of you are considering this or may have already begun. I have never registered for any sort of forum/message board but felt the need to share my recent experience. For the past 2 days I have felt like there is something stuck in my throat. Last night I experienced heartburn and reflux (even some involuntary regurgitation of whole pieces of food after eating dinner). this has not been uncommon in my past, but I have managed to greatly reduce this issue for the past 4-5 years mostly Through dietary adjustments. I have never experienced the feeling of something being stuck in my throat like this. Just under an hour ago, I had a very intense pain in my lower esophagus that lasted for about 10 seconds. Before the pain, I had already begun searching for plausible reasons that I'm having this feeling in my throat. I have been taking strattera 80 mg for 8-10 months but switched to Vyvanse 2 days ago bc it has worked much better for me in the past. I was prescribed a weeks worth of 40 mg to allow my body to transition off. For some reason this week long supply was going to cost $250. So, I said, "No, thanks." I decided to open one of the remaining 80mg capsule and sprinkle half the med in my mouth and wash it down with water. I didn't feel any burning sensation at the time ,and it was in my mouth for at leastt 5--10 seconds before I drank water. I have now come across others sharing the exact same experience and one person said their dr told them that the symptoms may not go away. I am now wondering if I have done permanent damage to my esophagus. Please, be careful and make certain that you are well informed before doing what I did with your children.

[healthy11]

jclark, thank you for sharing your story, and giving us all an important reminder about only swallowing Straterra "whole."

I am sorry that you are experiencing discomfort and pain now. I hope that reading sites like the following will provide encouragement and a sense of optimism that your esophagus can improve and heal itself: www.healingwell.com/community/default.aspx?f=45&m=3072740


(As a side note, especially from the perspective of a forum moderator, it's great to know that even "older posts," like this one that was started in 2003, still have value and can provide useful information many years later! Thank you again, jclark, for taking the time to register on Millermom's forum, and may you feel better soon.)