Weight loss surgery can change the way medicines work

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Australia; SA
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Australian experts say the doses of some medicines may need to be changed after bariatric (weight loss) surgery, as the surgery changes how drugs work. This is because the body's ability to absorb drugs decreases after the surgery, so the experts say patients may need to up the dose to achieve the same effect. They suggest crushing tablets or taking drugs in liquid form, which makes them easier to absorb. Birth control pills are affected, so other methods of birth control should be considered, they add, as well as recommending patients avoid aspirin and ibuprofen because these irritate the stomach. Other changes associated with weight loss surgery include absorbing alcohol more rapidly and expelling it more slowly, so patients should be very careful when driving, the experts say. Patients are likely to need vitamin and mineral supplements for the rest of their lives, they add, but may need less medication as they lose weight.

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From: NPS MedicineWise

Weight loss surgery can change the way medicines work

Around a third of Australians are obese and some require surgery to help with weight loss. However the surgery can change the way medicines work. In Australian Prescriber, weight loss experts Dr Teresa Girolamo and Rosemary Allin from Adelaide discuss how the doses of some medicines may need to be changed after bariatric (weight loss) surgery.

In Australia there are around 100,000 weight loss surgeries done each year. Some operations make the stomach smaller so you eat less, and others reduce the absorption of food.

“Like food, your body won’t absorb medicines as well after surgery,” says Dr Girolamo. “If you are taking mood stabilisers or antidepressants, you may need to take more to have the same effect.”

“After surgery, you may not be able to absorb slow-release medicines as well. You may need to crush some  tablets or chang them into a liquid form to help with absorption. It is also important to avoid medicines that affect the stomach lining like ibuprofen and aspirin,” she says.

“After weight loss surgery, alcohol will be absorbed more quickly and cleared from the body more slowly. This could affect driving,” says Dr Girolamo.

“Birth control pills may not be reliable due to reduced absorption  so you should consider other birth control methods.

“Also, you will need to take vitamin and mineral supplements for the rest of your life.

On a positive note, Dr Girolamo says you may need less medicine for blood pressure, diabetes, pain or depression as you lose weight.

“A lot changes after weight loss surgery. Your doctor, pharmacist and dietitian can help you adjust to the changes,” she says.

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