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Extended Release Tablets: Everything You Need to Know

Heard about extended release tablets and wondering whether they are right for you? Here is what you need to know.

A significant drawback to medication is its side effects. After taking a dose, the amount of medication in the bloodstream quickly spikes and is then flushed away after a few hours. Unfortunately, these spikes may result in adverse reactions and side effects.

One solution to this is extended release tablets. They are often marked with an ER or XR and are explicitly designed to mitigate the issues of immediate release medication.

Here’s what you need to know.

What Are Extended Release Tablets?

Extended release tablets are one of the modified release tablets which help to release the active ingredient of medications slowly and consistently. Extended release tablets are usually taken once daily, and they are formulated to keep your dosage at steady levels for longer periods. This is why they are often recommended to people who are not responding effectively enough to their medication.

How Do Extended Release Drugs Work?

Usually, medication is broken down by the liver or kidneys, meaning that after taking a dose, your body begins to move the medication out of your system naturally. But as the name suggests, extended release tablets have special coatings or mixers that ensures the medication takes longer to leave your system. Today, many common medications are available as extended release; there are over 30 for pain relief alone.

The graph below, published by the DailyMed, shows blood concentrations of pain medication after taking the immediate release version (white dots) every six hours, versus the extended release version (black dots), taken every 24 hours.

You can easily see how the immediate release drugs spike in the bloodstream. Extended release tabelets remove this problem. Although XR versions usually have a slightly slower onset than their immediate release versions, they maintain more consistent drug levels in your body. This means better treatment outcomes for longer and fewer chances of side effects. Another advantage to extended release drugs is you don’t have to take the pills as often, which works for people who tend to forget to take their medication, especially when multiple doses are needed throughout the day.

Immediate Release vs Extended Release Tablets

Immediate Release Medications:

  • Released into the system quickly
  • Relieve pain quickly
  • Don’t last as long (typically a few hours)
  • Users often experience a rollercoaster effect (meaning they need to take multiple tablets)

Extended Release Medications:

  • Generally only taken once a day (twice a day in some cases)
  • Specially made tablets designed to provide the correct dosage for the day, which eliminates the rollercoaster effect
  • Users don’t need to take as many pills

Are Extended Release Drugs Expensive?

So why doesn’t everyone just take the extended release versions?

Well, typically due to their cost. Usually, extended release formulations undergo new drug approval with the FDA and pharmaceutical boards, and are thereafter granted an additional patent as a new drug. Meaning that normally the XR version has no generic alternative, making it more expensive. Some XR counterparts cost nearly ten times more than generic alternatives.

But this is not always the case. Extended releases of common medications like Xanax are available in generic form and aren’t much more than twice their regular version’s cost. Depending on how often you take your tablets, it might work out cheaper when you factor in the number of pills. Also, keep in mind that some health insurance plans only cover traditional immediate release medication, so check with the pharmacist or your insurance provider.

Are Extended Release Drugs Right For Me?

If you are taking prescription meds on a daily basis, you should consult with your doctor to make sure you are taking the proper medication for you. You should always monitor your side effects and, if necessary, get a blood test to better understand what the highest and lowest concentrations of the drug are best for you.

There’s also a small chance that your body might not be able to break down the slow release coatings or ingredients fast enough to hit the targeted therapeutic level in the bloodstream, so make sure you speak to your doctor about these concerns.

What Are The Other Modified Release Tablets?

The purpose of using modified release tablets is to achieve a more consistent blood concentration of the active ingredient(s) throughout the day. Thereby maintaining a steady therapeutic effect and reducing the frequency of dosing. This can be particularly beneficial for medications that need to be taken regularly or for drugs that have a narrow therapeutic window.

There are different types of modified release technologies used in tablets, including:

  • Delayed-release (DR): These tablets have a coating that resists dissolution in the stomach but releases the drug in the intestines. This is often used to protect medications that are sensitive to stomach acid or to deliver drugs to a specific site in the gastrointestinal tract.
  • Sustained-release (SR): These tablets release the drug gradually over an extended period, maintaining a relatively constant drug concentration in the blood.
  • Controlled-release (CR): These tablets are designed to release the drug at a controlled rate, typically to maintain therapeutic levels of the drug over a longer period.

If you would like to speak to a professional medical doctor, either online or in-person, Air Doctor has a network of global medical providers and can connect you with a doctor near you in as little as two hours.


Jenny Cohen Drefler

Jenny Cohen Derfler

Air Dr CEO & Co-Founder

Jenny is the CEO and one of the Co-Founders at Air Doctor. She spent more than 20 years at Intel, most recently as general manager of its manufacturing facility in Israel and before that in various engineering and manufacturing roles in Silicon Valley. Air Doctor is her second startup having previously founded electric vehicle company ElectRoad.