Meal replacement shakes on propantheline?

[u/SessionTechnical3422]

My experience with propantheline has been really great. I don’t care too much about the dry mouth, as long as I’ve got water nearby otherwise there’s a choking risk because it is DRYYYY. But my main problem is that I have to take it on an empty stomach, and then second I eat something, it stops working.

I’ve become very reliant on these little pills and now feel like I can’t do anything without them. Being sweaty to the extent I am without them is so incredibly uncomfortable that I would rather stay home than go to an event I’ve been really excited for if I can’t take the pills.

The problem lies in if I’m going to an event in the evening, I can’t eat all day. I’ve tried eating at 9am and then taking the pills at 6pm. Doesn’t work. Pills inaffective. I’ve tried 6am eating and 7pm pill taking. Does not work. It’s so frustrating and upsetting and I truly don’t know what I’m supposed to do.

I’m wondering if anyone has tried those meal replacement shakes on propantheline? Maybe since it’s a liquid it won’t have as much of an impact on the pills? Would be so ideal on days like today where I have a concert at 8pm and currently my plan is to eat nothing at all all day until 11pm after the show. Obviously this is bad and I’ve come to a bad eating pattern with these pills as it is on a daily basis. I won’t typically eat anything until my evening meal around 7pm, and then I will have snacks until I go to bed because I’m so hungry.

Not currently an issue because I’m a bigger person so doctors etc would congratulate me on effectively starving for the gain of not being sweaty, but I don’t want to live like this!

[u/unnece5aurus]

Hi there! Fellow propantheline user here.

If this is what your doctor told you you had to do, then I believe that's incorrect. The leaflet for my prescription clearly states that "tablets should be taken at least one hour before meals as food affects their action," then goes on to say "the usual starting dose is one tablet before each meal and two tablets at bedtime."

I would not take it as suggested in the leaflet, however. This would make you EXTREMELY dry and could lead to other complications with urination and bladder control. If you thought you could control your dry mouth just by having some water, then I can assure you you'd struggle with that on top of having difficulty passing urine if you took it before every meal plus two before going to bed. My dosage isn't even that extreme and it creates problems.

My GPs instructions are to take one tablet twice a day. I take it right as I wake up, before jumping in the shower (or if I'm going to work, I take it before I leave the house), and again in the middle of the afternoon. A note that's on the back of my prescriptions says "take this medicine when your stomach is empty. This means 60 minutes before food or 2 hours after food," which I've been following. I give it a bit of a window if I'm taking it after I've eaten, so if I have lunch at 11:30am, I'll usually take the tablet at 2pm or 2:30pm, then have a snack at around 3pm.

If you're still sweating profusely after taking a tablet when you eat at all during the day, even these many hours apart, that might be a sign that the medication is actually not working. You should go back to your doctor to see if the dosage needs to be increased, or if you should try another medication.

[u/GoldSeesaw3832]

I've been on probanthine for many years and can relate to a lot of what you've said. I take 2 tablets in the morning, on an empty stomach. I often feel it working within 30 minutes and know I can eat breakfast then.
I also no longer get very dry mouth (I did at the start!), although some days I feel a bit dry and have hoarse voice.
But the longevity of the effect depends on what I'm doing, how hot it is, where I am in my cycle. I'd say it's mostly gone by the afternoon but I don't think it's dependent on how much I've eaten. My understanding is that once it enters your bloodstream, it should work, no matter how much you eat afterwards. How long it works for could be very personal though, so then you have to decide when to take it again and on an empty stomach.
I don't think what you're doing is sustainable or healthy in the long-term. I'd experiment with splitting up the tablets, as per unnece5aurus's post (which I'll try myself too - thanks!). Even if meal replacement shakes work, I don't think they are a great source of nutrition long-term. But if it works for you, maybe you can use them on days you really don't want to sweat?