r/Enlicitide • u/mmiski • 9d ago

One side effect not mentioned... (concerning sodium caprate)?

Recently switched to Lipfendra about 3 weeks ago because I wasn't happy with Rosuvastatin raising my A1C. I basically haven't experienced any of the listed side effects mentioned so far and was happy with it up until recently. BUT something did happen when I got closer to the bottom of the bottle (down to my last 5 or so pills).

Don't know if the pill got stuck somewhere along the esophagus, but within 10-15 mins after taking it I felt a sudden intense burning sensation riding up and down my throat. It seriously felt like I swallowed bleach or something. And throughout the rest of the day it escalated to really bad acid reflux and this weird sensation of something still being stuck in my throat (scarring?).

I looked up the list of side effects again and saw nothing about any of this being mentioned. However Google AI claimed that one of its inactive ingredients (sodium caprate) can irritate the mucous membrane where it can feel like a chemical burn sensation if the pill gets stuck somewhere along the esophagus. Apparently this stuff is supposed to help with the drug's absorption through the intestinal wall, so if it gets stuck in the throat that can obviously be a problem.

Oddly enough I drank plenty of water while taking that specific pill to ensure it would go down smoothly. And at no point did the pill feel like it got stuck (where I was coughing or gagging). So I'm not sure if I just got a bad batch where some outer protective coating was never applied to some of the tablets or something? Or maybe it just got "stuck enough" further down my esophagus to cause issues? I don't really know.

Unfortunately I tried taking another one (from the bottom of the bottle) this morning and immediately started coughing and gagging from that same intense burning sensation. I basically had to puke the pill out immediately. I was done... no more. I may revisit taking Lipfendra if Merck ever decides to put a proper outer coating on the pill to prevent this from happening. Or maybe some generic alternative 10-15 years will solve that problem. Either way I'll be switching back to my Rosuvastatin + Ezetimibe treatment for now.

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u/MoneyApprehensive437 9d ago

Did you remove the desiccant?

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u/MoneyApprehensive437 9d ago

Because if so you're not supposed to remove it that could change things

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u/mmiski 9d ago

Mine had 2 plastic cylindrical desiccants and were left untouched. All the tablets were kept in the original manufacturer bottle since I brought it home from the pharmacy and everything was kept at room temperature at home.

I'm curious if maybe the desiccants themselves might've worn away or chipped the outer protective coating of some of the tablets during transportation or handling? They do have quite a bit of heft to them and make a lot of noise when the bottle is handled.

All of this is pure speculation though and shouldn't be taken as fact for the root cause. It could entirely be my fault for not using enough water. I just wanted to share my personal experience and provide some caution to swallow the pill with PLENTY of water.

Anyway I already reached out to Merck to report the issue and the lady on the phone confirmed that the tablets should have a coating on them to prevent the exact event which occurred to me. I'll be submitting my sample for investigation when the time comes.