February 7, 2011

China - The bitter-er the better*

I remember on multiple occasions when I was unwell in China, that friends or colleagues would give me Chinese Medicine. Sometimes it came in tablets or capsules, sometimes as powder that just needs hot water to be added, and a couple of times, I have received what looked like pingpong balls covered in wax. When you break open the pingpong ball, a rather large brown something with a pungent smell stares at you, and you just wonder how you'd ever get this thing down your throat. Recently, the pingpong ball packaging has given way to blisterpacks, but the dosage form remains the same. From the pharmacist I learn, that elder folks prefer this dosage form to others. To them, it feels like this medication is really doing something. You have to stick it into your mouth, chew it, and swollow it. The act of taking the medication is definitely more noticeable than quickly swallowing a small tablet or capsule. Is this placebo at it's best? Adding extra effect to an otherwise potent but maybe not as quickly working medication as Western medicine would be? Recently, a study has shown that the act of taking a placebo can have a positive outcome even when patients are aware that they are taking a placebo.

Anyways, to show you more about this dosage form, James helped me document my attempt to take one of them. This one claims to just have general health benefits.
First of all, it's huge. Even bigger than I remembered. Let me break off a little piece. I am breaking rule number 1: stick the whole thing into your mouth. At first it doesn't taste too bad, but then, oh my, there's no way I can take this entire thing. Am breaking rule number 2 as I am gagging and forced to spit it out. I do remember one time though, when I was really unwell, that taking this kind of dosage form had helped me. Depending on how sick I am, am I more willing to endure the nasty experience? And was it the act of taking it and trusting the friend who'd given it to me that unleashed the full placebo effect together with the herbs?

(download)

* Thanks Lucinda! This title is better-er than the original one, 'asking for their bitter medicine'!

January 28, 2011

China - A Chinese take on pediatric dosage forms

When we did a project on pediatric dosage forms in the US, one of the strong push-backs against pediatric-friendly looking or tasting medication was the argument that kids might find it too appealing, think it's candy and overdose while their parents aren't looking. While the pushback seem to be stronger from our client rather the parents themselves who often had great experiences with child-friendly vitamins. These caused no daily struggles and at the end of the day, most parents want to keep vitamines and meds in a difficult to reach place for their kids anyways. Others even took on the stance, explaining that it was more important for parents to teach their kids to respect meds rather than just hide them away. Of course, the age group matters in this respect. On a trip to a pharmacy in Kunming, I was surprised to find the following aisle for pediatric medications. First of all, the packaging struck me as incredibly appealing to children. While all of these where OTC meds mostly for colds, their visual language was all about making it cute looking and appealing to kids.

One dosage form struck me in particular. Chewables like Tums Antacid but in this interesting shape. It reminded me of sugar decoration for cakes in Germany. When I asked the pharmacist about the shape, her candid reply was very pragmatic. Kids only like to put things in their mouths that look appealing in shape and color, this one here is very successful.