From the Guidelines
Finding Thiola (tiopronin) tablet remnants in stool is generally not a cause for concern, as the active medication is typically absorbed in the upper gastrointestinal tract, allowing the medication to work effectively even though the tablet shell is eliminated intact. This phenomenon is known as "ghost tablets" or "ghost pills" and occurs with several medications that have special coatings or extended-release formulations. The presence of tablet remnants in stool does not necessarily indicate that the medication is not being absorbed or is ineffective, as the coating is designed to release the active ingredient before the tablet is eliminated. According to the medical management of kidney stones guideline 1, tiopronin is a cystine-binding thiol drug that is effective in treating cystine stones, and its absorption is not dependent on the intactness of the tablet. If you're concerned about whether you're receiving the full benefit of the medication, monitor your symptoms and discuss them with your healthcare provider. However, there's usually no need to change your dosing regimen based solely on seeing tablet remnants in stool unless your doctor advises otherwise. Some key points to consider include:
- The special coating on Thiola tablets allows for controlled release of the active ingredient
- The active ingredient is absorbed in the upper gastrointestinal tract, regardless of the tablet's intactness
- "Ghost tablets" or "ghost pills" are a common phenomenon with certain medications, including Thiola
- Monitoring symptoms and discussing concerns with a healthcare provider is the best course of action if there are concerns about the medication's effectiveness.