I was on one and my surgeon said most of it is released in the small.  It was a 12 hour release medication. 

She said not to worry about it. 

Richard. 

Many extended release meds are poor choices for a J-poucher. They are targeted to release at various parts of the GI tract, but can overshoot their target under some circumstances (e.g. short transit time). I avoid them.

Agree with Scott. My extended release meds are truly unpredictable. Surgeon said they weren't recommended.  GI said it should not matter but pharmD said it makes sense. Likely you will have to see how each Med works for you 

I made the tragic discovery when they started me on epilepsy meds...I kept having seizures until one day I got woozy, fell asleep and didn't wake up for 48h... turned out that the meds were accumulating at the bottom of my pouch and then 1 day I must have eaten something that was acidic enough to disolve the coating and they all dissolved at once.

Being a k poucher I use a tube to empty out my pouch and often find pills (or vitamins, especially vit B's) caught in the holes of the tube. It could just be that I have a rapid transit time but I no longer take the chance...for those meds that do not come in capsule format or liquid I either bite them in 4 or crush them.

Sharon 

Thanks for all of the responses.  

Just FYI, I messaged my gastroenterologist as well, and here is her response (based specifically on my situation):

"Overall, there's a possibility of malabsorption of some vitamins or minerals, like vitamin b12 or Vitamin D. You still have an extensive amount of small bowel remaining, so there shouldn't be an issue with malabsorption."

"...all your medications should have no issues with absorption, including the extended release medications."

Sharon, for what it's worth, I read somewhere online that one should be especially cautious of crushing/biting  extended release meds because they are not formulated to be absorbed so quickly. 

Thanks Mary,

I had a long conversation with my pharmacist and he informed me that the meds that can be cut in half (they have a line through the middle) can be quartered too...so I quarter some of them but I do avoid most like the plague...his rule? If you take the pill and it comes out whole on the other end, then you are not absorbing what you need from it.

When I can I get the normal kind or peel the gastro-resistant film off of them.

Sharon

Essentially, it all depends on your transit time. Most extended release tablets will release the second dose 4-6 hours after you take it. The first dose is immediate release.

Jan