thanks Doc for clearing up my misunderstanding of the patch use, and Don, you're typing????
Cutting the Scopolamine Patch in 1/2
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fisherdvm
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I agree, you can not remove the patch and save it. Once you removed the waxed paper liner from the adhesive, dehydration and dessication of the adhesive starts to occur changing the permeability of the patch.
Second, exposure of the medication to oxygen occurs, causing unknown changes to the drug.
Third, a small amount of skin, sweat, and oil adhere to the patch, changing its adhesiveness the next time you put it on. Likely, this would greatly decrease the dose of medicine you would get, perhaps by 10 or 20 folds.
You mess with the patch, you'd totally mess with the bioavaibilty of the medicine.
I am a cheapskate myself, and can understand why you'd want to cut a patch in half. But unless you hear differently from a pharmacist knowledgeable in the manufacturing of that particular patch, don't play with it.
Second, exposure of the medication to oxygen occurs, causing unknown changes to the drug.
Third, a small amount of skin, sweat, and oil adhere to the patch, changing its adhesiveness the next time you put it on. Likely, this would greatly decrease the dose of medicine you would get, perhaps by 10 or 20 folds.
You mess with the patch, you'd totally mess with the bioavaibilty of the medicine.
I am a cheapskate myself, and can understand why you'd want to cut a patch in half. But unless you hear differently from a pharmacist knowledgeable in the manufacturing of that particular patch, don't play with it.
OP
Thanks for the responses~ no patch cutting :no . For the post that addressed the cost, it's not a price issue at all.. It just seems wasteful to use a 3 day patch for 1 day. I know they also make it in pill form, as Scopace, so I might give that a shot too..
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Sounds like a plan, MissyP.
For a little info on Scopace v Transderm Scop, see:
Pill vs Patch
http://www.awoosh.com/Doc Vikingo's Resource Page/Scopace_Patch.htm
For more complete coverage, see the DAN "Alert Diver" comparison published in the March/April 2004 issue (pp. 40-41). I have reproduced it below, with permission:
"Scopace Tablets
Here's An Alternative to "The Patch"
for Motion Sickness Relief
By Renée Duncan, Editor
We've all heard about "the patch for divers." In fact, we've profiled it a couple of times in the pages of Alert Diver.* And it works beautifully for many divers and travelers who experience motion sickness.
I'm one of those unfortunates who, given a good whiff of diesel and a quick view of a rolling horizon, will be feeding the fish off almost any boat unlucky enough to have me. Actually, I usually take it in stride, but my involuntary actions have dismayed some of my fellow dive travelers at times.
Unhappily, "the patch" is just too strong for me. I'm on the small side, 5 feet 2 inches (1.57 meters) tall, maybe 110 pounds (49.5 kilograms) without my gear. And putting on a patch practically guarantees I won't recall much of my dive, flight or boat ride (short-term memory loss is one of the side effects).
It doesn't have this effect on all small persons; and, by the same token, it may affect larger persons just as intensely - or it may not be enough. As with many medications, it simply works on each of us individually, and some days (and dosages) can be tougher than others.
What to do? Well, I've pondered. Fed some fish. Postponed dives. Or gone diving off the other side of the boat after a good spew.
Then I heard about a pill I could take for motion sickness. The best thing about it is that I can keep my dosages low rather than enduring the fixed dosage of a patch. And although, I haven't had motion sickness in a while, I almost wish I could get sick again, just to try it.
Divers and travelers who suffer from motion sickness, you have a choice: you can use the scopolamine patch or take it in pill form. For many folks, the pill is welcome news. Scopace, a medication for motion sickness, is available through your doctor - in 0.4 mg tablets.
Scopace contains scopolamine hydrobromide, described by the American Hospital Formulary Service (a drug information reference from the American Society of Health-System Pharmacists) as the "single most effective medicine to prevent nausea and vomiting induced by motion."
So, how do these tablets compare to the patch? To begin with, both have scopolamine, a drug well known for its ability to ease motion sickness.
Dosing Flexibility
The patch and the pill differ, however, in dosing flexibility. The patch delivers a fixed dose to all persons who don it. And therein lies the problem. Because a fixed dose is formulated for individuals of average weight, it may be excessive for smaller individuals and not enough for larger persons. This means a small person could encounter side effects from absorbing too much of the drug, while larger individuals may still get motion sickness because they're getting insufficient amounts.
With tablets, you can adjust the dosage to the lowest level you find effective. Granted, this may mean a couple of trial-and-error runs, but it beats the dizziness and blurring of vision if you're sensitive to the patch.
Skin Considerations
Then, there's the issue of skin. Topical absorption of a medication - such as what you find in a scopolamine patch - is dependent on certain skin characteristics. These factors include skin thickness, patch adhesion (that's why instructions tell you to apply the patch to clean skin) and blood circulation within the skin.
If the skin is too thick, the medication may penetrate too slowly. With hairy or sweaty skin, the patch may not adhere properly. If circulation is poor or if blood flow is shunted away from the skin (this can happens in cold conditions or during episodes of extreme nausea), drug levels may remain diminished because of reduced drug passage into the blood.
Ingesting the Tablets
Next, there's speed: in order to work, tablets have to melt. If you wait until you're already ill, you may get quicker relief with the patch.
Quality guidelines published by the United States Pharmacopoeia, an organization that works closely with the Food and Drug Administration (FDA), the pharmaceutical industry, and the health professions to establish authoritative drug standards, specify that scopolamine tablets must disintegrate within 15 minutes. According to Craig R. Sherman, M.D., Medical Director, Hope Pharmaceuticals (the manufacturer of Scopace), ongoing testing confirms that Scopace tablets meet or exceed this standard.
Whichever method you prefer, remember to dose yourself at least an hour before you dive, travel or go boating.
Side Effects
The incidence of side effects associated with the two dosage forms of scopolamine can differ. If you have experienced any negative effects with the patch, you may want to give the pills a try, or vice versa.
The primary side effect of scopolamine tablets at the intended doses is reduced salivation, says the manufacturer. That's dry mouth in diving terms, and it's not fun. But it's not dangerous, either. More serious side effects can always happen with any medication. The manufacturer points out, however, that the more serious side effects with the tablets tend to be infrequent because you can adjust your dose to the lowest level you need.
Another consideration is the duration of possible side effects. If a side effect occurs after you ingest a tablet, you can suspend subsequent doses while your body metabolizes the pill. In contrast, side effects associated with topically applied medicine may be prolonged after it is removed because of continued absorption into the blood from the skin.
To reinforce the drug's safety, Hope Pharmaceuticals also provided this study result for the scopolamine tablet:
A study conducted for NASA evaluated whether oral scopolamine impacted operational proficiency. Scopolamine was tested in two doses - 0.25 mg and 0.5 mg. The researchers concluded that neither dose produced any loss of proficiency performing selected tasks. Furthermore, the incidence of drowsiness and blurred vision associated with the drug did not exceed that associated with placebo.
Just like the scopolamine patch, Scopace can cause inability to urinate in men with enlarged prostate glands, and can exacerbate certain types of glaucoma (excessive pressure in the eye). It can also cause drowsiness, which could be dangerous while performing certain activities such as driving a car.
It's Your Trip
No one wants motion sickness to spoil a trip. At the same time, you don't want to over-medicate yourself: it's just as bad. If you have a tried-and-true method of dealing with motion sickness, stick with it. If you're not happy with your present solution, perhaps you'd like to discuss a prescription for Scopace with your doctor.
For other, non-medical ways to prevent motion sickness, see Dan Orr's July/August 2003 Incident Insights report on "Mal de Mer."
Pay attention to what your body's telling you about motion sickness or drugs."
Regards,
DocVikingo
For a little info on Scopace v Transderm Scop, see:
Pill vs Patch
http://www.awoosh.com/Doc Vikingo's Resource Page/Scopace_Patch.htm
For more complete coverage, see the DAN "Alert Diver" comparison published in the March/April 2004 issue (pp. 40-41). I have reproduced it below, with permission:
"Scopace Tablets
Here's An Alternative to "The Patch"
for Motion Sickness Relief
By Renée Duncan, Editor
We've all heard about "the patch for divers." In fact, we've profiled it a couple of times in the pages of Alert Diver.* And it works beautifully for many divers and travelers who experience motion sickness.
I'm one of those unfortunates who, given a good whiff of diesel and a quick view of a rolling horizon, will be feeding the fish off almost any boat unlucky enough to have me. Actually, I usually take it in stride, but my involuntary actions have dismayed some of my fellow dive travelers at times.
Unhappily, "the patch" is just too strong for me. I'm on the small side, 5 feet 2 inches (1.57 meters) tall, maybe 110 pounds (49.5 kilograms) without my gear. And putting on a patch practically guarantees I won't recall much of my dive, flight or boat ride (short-term memory loss is one of the side effects).
It doesn't have this effect on all small persons; and, by the same token, it may affect larger persons just as intensely - or it may not be enough. As with many medications, it simply works on each of us individually, and some days (and dosages) can be tougher than others.
What to do? Well, I've pondered. Fed some fish. Postponed dives. Or gone diving off the other side of the boat after a good spew.
Then I heard about a pill I could take for motion sickness. The best thing about it is that I can keep my dosages low rather than enduring the fixed dosage of a patch. And although, I haven't had motion sickness in a while, I almost wish I could get sick again, just to try it.
Divers and travelers who suffer from motion sickness, you have a choice: you can use the scopolamine patch or take it in pill form. For many folks, the pill is welcome news. Scopace, a medication for motion sickness, is available through your doctor - in 0.4 mg tablets.
Scopace contains scopolamine hydrobromide, described by the American Hospital Formulary Service (a drug information reference from the American Society of Health-System Pharmacists) as the "single most effective medicine to prevent nausea and vomiting induced by motion."
So, how do these tablets compare to the patch? To begin with, both have scopolamine, a drug well known for its ability to ease motion sickness.
Dosing Flexibility
The patch and the pill differ, however, in dosing flexibility. The patch delivers a fixed dose to all persons who don it. And therein lies the problem. Because a fixed dose is formulated for individuals of average weight, it may be excessive for smaller individuals and not enough for larger persons. This means a small person could encounter side effects from absorbing too much of the drug, while larger individuals may still get motion sickness because they're getting insufficient amounts.
With tablets, you can adjust the dosage to the lowest level you find effective. Granted, this may mean a couple of trial-and-error runs, but it beats the dizziness and blurring of vision if you're sensitive to the patch.
Skin Considerations
Then, there's the issue of skin. Topical absorption of a medication - such as what you find in a scopolamine patch - is dependent on certain skin characteristics. These factors include skin thickness, patch adhesion (that's why instructions tell you to apply the patch to clean skin) and blood circulation within the skin.
If the skin is too thick, the medication may penetrate too slowly. With hairy or sweaty skin, the patch may not adhere properly. If circulation is poor or if blood flow is shunted away from the skin (this can happens in cold conditions or during episodes of extreme nausea), drug levels may remain diminished because of reduced drug passage into the blood.
Ingesting the Tablets
Next, there's speed: in order to work, tablets have to melt. If you wait until you're already ill, you may get quicker relief with the patch.
Quality guidelines published by the United States Pharmacopoeia, an organization that works closely with the Food and Drug Administration (FDA), the pharmaceutical industry, and the health professions to establish authoritative drug standards, specify that scopolamine tablets must disintegrate within 15 minutes. According to Craig R. Sherman, M.D., Medical Director, Hope Pharmaceuticals (the manufacturer of Scopace), ongoing testing confirms that Scopace tablets meet or exceed this standard.
Whichever method you prefer, remember to dose yourself at least an hour before you dive, travel or go boating.
Side Effects
The incidence of side effects associated with the two dosage forms of scopolamine can differ. If you have experienced any negative effects with the patch, you may want to give the pills a try, or vice versa.
The primary side effect of scopolamine tablets at the intended doses is reduced salivation, says the manufacturer. That's dry mouth in diving terms, and it's not fun. But it's not dangerous, either. More serious side effects can always happen with any medication. The manufacturer points out, however, that the more serious side effects with the tablets tend to be infrequent because you can adjust your dose to the lowest level you need.
Another consideration is the duration of possible side effects. If a side effect occurs after you ingest a tablet, you can suspend subsequent doses while your body metabolizes the pill. In contrast, side effects associated with topically applied medicine may be prolonged after it is removed because of continued absorption into the blood from the skin.
To reinforce the drug's safety, Hope Pharmaceuticals also provided this study result for the scopolamine tablet:
A study conducted for NASA evaluated whether oral scopolamine impacted operational proficiency. Scopolamine was tested in two doses - 0.25 mg and 0.5 mg. The researchers concluded that neither dose produced any loss of proficiency performing selected tasks. Furthermore, the incidence of drowsiness and blurred vision associated with the drug did not exceed that associated with placebo.
Just like the scopolamine patch, Scopace can cause inability to urinate in men with enlarged prostate glands, and can exacerbate certain types of glaucoma (excessive pressure in the eye). It can also cause drowsiness, which could be dangerous while performing certain activities such as driving a car.
It's Your Trip
No one wants motion sickness to spoil a trip. At the same time, you don't want to over-medicate yourself: it's just as bad. If you have a tried-and-true method of dealing with motion sickness, stick with it. If you're not happy with your present solution, perhaps you'd like to discuss a prescription for Scopace with your doctor.
For other, non-medical ways to prevent motion sickness, see Dan Orr's July/August 2003 Incident Insights report on "Mal de Mer."
Pay attention to what your body's telling you about motion sickness or drugs."
Regards,
DocVikingo
I'm going to defer to DocVikingo and say that it shouldn't be done, but of course I didn't have Doc with me when I used to cut them in 1/2.
I'm one of those people who can get sick just sitting on a boat in the harbor, but using a full patch used to make my vision blurry so I started cutting them in 1/2. Never had a problem with delivery. I also used to take them off after a day of diving and reuse them the next day without a problem.
Should it be done? No, I guess not. Just sharing my experiences though.
I'm one of those people who can get sick just sitting on a boat in the harbor, but using a full patch used to make my vision blurry so I started cutting them in 1/2. Never had a problem with delivery. I also used to take them off after a day of diving and reuse them the next day without a problem.
Should it be done? No, I guess not. Just sharing my experiences though.
sardiver
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As said before DO NOT cut a patch!!
However, good news for all of you...
A company called Hope Pharmaceutical produces an oral scopolamine pill.
The dose is 0.4 milligrams so titrating the dosage for an individual is a snap.
Also time for effective uptake is about 1 hour or even less if you chew it
. The pill tastes vaguely sweet and is not bitter. In fact, the flavor is pretty subtle.
I never used to get seasick NEVER, but after a serious 3 year sinus infection, bone loss in my sinuses and 30% reduction of the thickness of my right orbit (eye socket) complete bi-lateral removal of all the tissues in my sinuses plus several years of antibiotic and anti fungal agent therapy, I have a slight balance problem and sometimes have problems in heavy seas. I'm not so bad, but my friend who get sick in the slip has been in 10 footers with no feeling of nausea and I have used this stuff in seas over 20' (never used to bother me {:-( ) with great results.
Not all pahrmacies carry it so look up Hope Pharmaceuticals online, print out the info and go to your doctor and druggist for a bottle of these. They aint cheap, but on a per trip basis are a bargain compared to the patch. As for re-using a patch?
Nope, don't do it!! You can take it off to dive and put it back on due to the half life of the drug, but on subsequent days? No good!!
However, good news for all of you...
A company called Hope Pharmaceutical produces an oral scopolamine pill.
The dose is 0.4 milligrams so titrating the dosage for an individual is a snap.
Also time for effective uptake is about 1 hour or even less if you chew it
. The pill tastes vaguely sweet and is not bitter. In fact, the flavor is pretty subtle.
I never used to get seasick NEVER, but after a serious 3 year sinus infection, bone loss in my sinuses and 30% reduction of the thickness of my right orbit (eye socket) complete bi-lateral removal of all the tissues in my sinuses plus several years of antibiotic and anti fungal agent therapy, I have a slight balance problem and sometimes have problems in heavy seas. I'm not so bad, but my friend who get sick in the slip has been in 10 footers with no feeling of nausea and I have used this stuff in seas over 20' (never used to bother me {:-( ) with great results.
Not all pahrmacies carry it so look up Hope Pharmaceuticals online, print out the info and go to your doctor and druggist for a bottle of these. They aint cheap, but on a per trip basis are a bargain compared to the patch. As for re-using a patch?
Nope, don't do it!! You can take it off to dive and put it back on due to the half life of the drug, but on subsequent days? No good!!
shakeybrainsurgeon
Contributor
One universal truth, patch, pill or otherwise
FOLLOW THE DIRECTIONS
believe it or not, sometimes drug companies aren't always out to rip you off, sometimes they just don't want to KILL you
Getting creative with prescription drugs is not recommended
FOLLOW THE DIRECTIONS
believe it or not, sometimes drug companies aren't always out to rip you off, sometimes they just don't want to KILL you
Getting creative with prescription drugs is not recommended
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Yeah, if you ignore the directions and make up your own procedures with the drugs, your family can't sue the drug companies when you die.
Okay, but it's been clearly explained to be a bad idea. Glad you didn't down or anything. It looks very bad when the Instructor drowns....
bkyaffe
Contributor
Hmm, so not to beat a dead horse... The docs and the manufacturer clearly say "Don't cut the patch in half!" This makes sense as it hasn't been tested in an altered configuration and no medical pro would want to be held liable for that. However, I just spoke to a coworker who happens to have been one of the clinical project managers for the Transderm Scop patch when they were being developed in the 70s... He pointed out that the patch is made by laminating several things together... from skin to backing it's roughly:
(skin)
Adhesive
Diffusion Membrane
Gel Drug Reservoir
Backing
The manufacturing line laminates this into a big sheet, from which the individual patches are simply stamped out. The rate of release is controlled by the surface area of membrane on skin. There isn't a fluid reservoir to pop similar to some of the "ketchup packet" transdermal systems. Put another way... the current shape is pretty much cut with a(n automated) pair of scissors as it is, so you cutting it in half would just halve the delivery rate.
Of course, you don't really know who I am, or who my coworker is. And I could have just made this up. Welcome to the internet. So this isn't medical advice (I'm not a doctor or anything of the sort) and you shouldn't believe anything I've said and go use it in your own life.
Cheers,
Ben
(skin)
Adhesive
Diffusion Membrane
Gel Drug Reservoir
Backing
The manufacturing line laminates this into a big sheet, from which the individual patches are simply stamped out. The rate of release is controlled by the surface area of membrane on skin. There isn't a fluid reservoir to pop similar to some of the "ketchup packet" transdermal systems. Put another way... the current shape is pretty much cut with a(n automated) pair of scissors as it is, so you cutting it in half would just halve the delivery rate.
Of course, you don't really know who I am, or who my coworker is. And I could have just made this up. Welcome to the internet. So this isn't medical advice (I'm not a doctor or anything of the sort) and you shouldn't believe anything I've said and go use it in your own life.
Cheers,
Ben
sardiver
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LOL!!
There was a sign on the wall of the music classroom at my junior high school that said...
"When all else fails, follow directions!"
I thought it was great fun {:-D
Doc V,
I bow to you, as I see you beat me to the info on Scopace.
Where did you learn of it's existence?
I'm trying to remember where I first heard of it!
Might have been an article in Salt Water Sportsman? *scratches head while looking wistful*
Originally posted by DandyDon
"Yeah, if you ignore the directions and make up your own procedures with the drugs, your family can't sue the drug companies when you die."
Don,
I have been hypothesizing that if you don't tell anyone you are ad-libbing, the lawyers can't ask you under oath when you are dead, so they should still be able to sue {:-D
BTW, did you know that last winter was so cold, I saw a lawyer with his hands in his own pockets?
Happy diving,
John
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