Monday, September 23, 2013

Now Available in a Handy Chewable Tablet!

That's not something one really expects from one's oral contraceptive. Having lost one of my ovaries last year along with the grapefruit-sized mass sitting on it, my gynecologist and oncologist both agreed that I should keep taking my ultra-low-dose oral contraceptive as a mild hormone replacement therapy so I wouldn't go through "The Change" (duh-duh-DUUUUUUNNN) too soon. I'm only 44, so yeah, I'm on board with that.

I'd been on this particular pill, which was the lowest-estrogen product on the market, for several years; imagine my surprise when I got a notice from our pharmacy benefits company that the pharmaceutical company had discontinued it. They were, instead, going to offer almost exactly the same thing except that it's now, WOWEE, a handy chewable tablet.

Their patent was due to expire in the spring. Anyone conversant with the brilliance of Big Pharma knows why they tweaked it thus: to keep selling it at a high price while the non-chewable version was snapped up by everybody and their pet cat as a generic. There are a many things I'm willing to take as a generic, but something involving precisely-calibrated hormone doses is not one of them. (The thing about generics is that the per-dose active ingredient has to be 'in-range', ergo, it does not have to be exact. That's not really something most women are looking for in a contraceptive, I think, but I digress.) Otherwise, it's exactly the same drug as before, but the chewability makes for a brand-spankin' new patent.

The thing that bugs me the most about it is, well, what if it doesn't dissolve very well? Does that mean I'll be running around with estrogen stuck in my molars all day until it bothers to dissolve? That doesn't sound like a very effective delivery method for a drug that by virtue of its on-label use, needs to be delivered in full at almost exactly the same time on a daily basis. If I were using it for actual contraceptive purposes, I'd be a little upset.

Furthermore, do adults really require chewable tablets? While I realize that the relative age of people engaging in the Horizontal Mambo is dropping precipitously, are they so young that The Pill has to mimic a Flintstone Chewable Multivitamin? These are pills the size of a baby aspirin, folks, not the horse pill size of some broad-spectrum antibiotics I could name.

This morning I hauled myself out of bed and took my first dose of this wonder drug. It's mildly sweet (I'm wondering what they used as the sweetener- if I get a headache later, I'll be pretty sure it's aspartame), crunchy, and no, it did NOT completely dissolve. I swished some water around in my mouth to rinse the rest of the dose down. Most of all, I felt a little stupid. I've been able to swallow pills since I was a small child and taking one version of The Pill or another since I was eighteen- this just felt, well, patronizing.

Next on the horizon, I'm sure: chewable Viagra, although it would be far more patronizing were it a soft chew.

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