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I take a number of different medications and herbal supplements. Because keeping separate containers in my pocketbook is cumbersome, I've been combining them together in the same prescription bottle. I'm wondering if this alters or diminishes their effectiveness.

The combination includes: regular tablets, some of which have been cut in half; coated tablets; and capsules. The capsules are clear, made of plant-based hypromellose, and are filled with either powdered medication or ground herbs. There are no gel-caps or anything containing liquid.

There's usually some fine powder in the bottom of the bottle, which I assume comes from the broken pills. Other than that, everything appears intact and not misshapen, stuck together, or otherwise compromised.

Is there an overarching rule of thumb for this situation, or would it depend on the specific medications?

  • The capsules are definitely not made of plastic. If not gelatine, they are probably HPMC capsules (made of a cellulose derivative) or something similar. Although solid dosage forms are the most stable forms of medicines, incompatibilities are not impossible (although with coated tablets and capsules they are unlikely). But to know which medication is which and avoid mistakes you would have to pack those that you need for that day each day. I would recommend a small medicine box/pill organiser (those that are devided in several little compartments) to keep different sorts of your meds separate. – Lucky Jun 17 '15 at 12:19
  • Right you are about the capsules! I checked the bottles and edited the correct information into the question, which is now accurate and therefore more useful to the community. Thank you for that, and for your other suggestion as well! – Sue Saddest Farewell TGO GL Jun 17 '15 at 20:11
  • @Lucky - "incompatibilities are not impossible". Can you think of any examples? I'd be surprised (OP stated no liquids). If they aren't incompatible in a patient's body, why would they be incompatible in a bottle? – anongoodnurse Jun 17 '15 at 23:36
  • @anongoodnurse incompatibilities are unlikely, but it all depends on the composition of every medicine and the period of time during which they are all kept together. The first thing that comes to mind is an uncoated tablet that contains a hygroscopic substance in touch with a capsule (if the tablet has crumbled the surface of contact increases) - HPMC capsule wall contains 2-7% water which can be absorbed by the hygroscopic powder from another medicine. The possibility is merely theoretical but I just wanted to suggest an alternative (neater) solution for the OP – Lucky Jun 18 '15 at 1:06
  • @ Sue it's great question, and since there are no more plastic capsules in it, +1 from me :-). @anongoodnurse is right to challenge my claim about incompatibilities - I don't think they are likely and if there were any they probably wouldn't affect medicines' effectiveness, but I'm one of those somewhat overly-sceptic people who doubt everything that isn't proven by a specific study (I'm terrible as a patient). The picture of a bunch of different medicines rolling in one bottle just doesn't sit well with my pharmaceutical pedantry; but convenience is important if it improves compliance – Lucky Jun 18 '15 at 1:18
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No, this does not alter them, or make them less effective. There are problems with a scant amount of medicine crumbling, as you've noticed.

The only real concern I'd have for anyone doing this is regarding the authorities: for example, while traveling out of the country, it's good to keep your medicines in their original prescription bottles because it supports you're assertion that the medicines are all prescribed to you. In my entire life, I had only one border agent question my medications. So even there, it's rare.

As long as you can tell which pill is which, this is perfectly safe.

One way to decrease crumbling of a pill is to put a piece of cotton in your container, so that when you close it, the pills don't rattle around in your purse. That's the reason many medications come with a cotton ball stuffed into the bottle.

  • That's a great point about the potential ramifications of not being able to provide proof of what you have and dosing instructions. I keep a card in my wallet with those details, but that doesn't mean doctors would adhere to it. It also occurred to me that since the drug names aren't on the pills, an emergency situation could hinder the doctor's ability to provide proper care. I also appreciate the advice about the cotton. I often end up throwing pieces of pills away because they're no longer the right size for the dose! – Sue Saddest Farewell TGO GL Jun 1 '15 at 15:01
  • @Sue - if you carry around your med list with dosages, a doctor will most likely believe you (as long as there aren't drugs with a high abuse potential); I would. Also, all drugs sold in the US are identifiable by size+shape+color+markings. For example, a mysterious, simple orange pill marked WW112 on one side is generic doxycyxline 100 mg. (Google "drug WW112" and you'll see), so that doctors can quickly identify overdoses and accidental ingestions. This is not true for all supplements, though. :-) – anongoodnurse Jun 17 '15 at 23:26
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The integrity of the pills themselves should be fine with a few exceptions. I won't ask you what you take, but note that there are situations where this powder can cause problems. Though, it is rather unlikely.
The only thing I will add to this, as a pharmacist, is keeping all your pills in a single container makes identifying them difficult/time consuming for a third party. If you were in a situation where you or a loved/trusted one was unable to list your medications, having them all together makes this situation much more difficult and potentially harmful to you.
By law, all prescribed medication marketed and sold within the US are required to have a stamp on them for identification purposes (see: FDA's Code of Federal Regulations). If there are many different medications in a single container it is easier for a single pill to be missed in the sorting phase (as many pills are small, white, and round making them look incredibly similar). This could hurt you in the short and long run. Better to get a cheap pill box to separate them at least by what you take each day to cut down on some of this.

  • Hi, user52181, welcome to Health! Here, references are strongly encouraged in answers to back up points made therein. Unsourced material may be downvoted or deleted - and is certainly frowned upon. Can you add citations to support what you've written here? Thanks! – HDE 226868 Jan 1 '16 at 15:09
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    Updated. Hopefully this is what you are looking for. Obviously I am new to the Exchange and trying to follow the rules! – JKA99 Jan 1 '16 at 16:07
  • Hi! After posting the question, I consulted my prescribers who said even though the half pill remains effective if properly cared for, it may not be easy to identify. My ER trauma doc said it's not his job to search through a bottle of pills and match them to a list. In Massachusetts, some, like seizure meds, can't be administered without the label, and he's had to let patients go into withdrawal until he can reach the prescriber. That's scary, so I only mix the supplements and otc now! Thanks for the answer, and for coming to the site. Have fun here! – Sue Saddest Farewell TGO GL Jan 1 '16 at 19:51
  • Hi Sue! Wow, that ER doc is really strict! It's super easy today with computers to identify even half a pill. Any doctor who would allow a patient to go into withdrawal because he couldn't identify a pill is, well, something I won't write here. However, having a prescription bottle is different from having a pill; you can get a pill from anyone; it doesn't mean it was prescribed to you. :_) – anongoodnurse Jan 1 '16 at 20:02
  • Hi, Sue! This is good stuff. Thanks for the feedback! :) – anongoodnurse Jan 1 '16 at 20:03

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