The Pharmaceutical Journal
Vol 280 No 7490 p214
23 February 2008

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• Emeritus status
• Community pharmacy
• EHC (3)
• Dispensing
• The profession (2)
• Manufacturing
• Supply

Letters to the Editor

Manufacturing

Tablets within capsules — unwelcome and inconvenient

From Dr S. Carey, MRCPsych

As health care professionals, it may be easy at times to view the internet and patient power as added burdens, but when viewing the world from the perspective of a user things may well seem different.

I have been prescribed omeprazole capsules containing enteric-coated granules by my GP for a number of years. I have always adjusted the dose to the minimum required by removing some from the capsule (and recycling the excess, of course). I have recently discovered that my recent “capsules” do, rather oddly, contain one smallish, brown tablet inserted into a significantly larger capsule shell, which makes such titration impossible.

The label on the box indicates that they are made by Almus, but the leaflet carries the Dexcel Pharma logo. My internet searches on this have found the helpful letter from Lynne Woodburn highlighting this issue and its associated response (PJ, 26 May 2007, p610).

I note the current BNF54 indicates on p49 that capsules, in the case of omeprazole, contain enteric-coated granules and I suspect often for the good reason that swallowing may be difficulty for some with the conditions for which they are commonly indicated.

The BNF lists one “tablet within a capsule” of omeprazole made by Dexcel (Mepradec) under “tablets” on page p50, but does not mention any product made by Almus. I have a few of the old capsules left in a suitcase upstairs which gives me a week to try to sort this out, but this discovery is unwelcome and inconvenient. How can it be reasonable to brand medicines as capsules in this way?

I would like to think that we, in psychiatry, do not often repackage our therapies in this way — but maybe we do. As Rabbie Burns might say: “O wad some Pow’r the giftie gie us To see oursels as others see us.”

Stephen Carey
Consultant Psychiatrist
Stratheden Hospital

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