Warning: the Color of Your Pill May Influence Whether You Take It

Beauty’s only skin deep, but for many people who take prescription drugs, appearance apparently strengthens the bonds of belief. According to a recent study in Archives of Internal Medicine, people who receive generic drugs whose color varies from one prescription to the next are more than half as likely to stop taking the medicine.

That can mean losing out on a drug’s healing power, all because of its color.

As reported on ScienceDaily.com, more than 7 in 10 drug prescriptions are generic versions of brand name pharmaceuticals. Generics are the bioequivalent of the patented version; that means that although they might be formulated differently from the brand drug, their active ingredients are the same and they are broken down and used by the body in the same way. But generic drugs usually look different from the brand version in shape, color and size.

Most prescriptions require that the medicine be taken according to a certain regimen. Some medicine should be taken at the same time each day, some should be taken with food or on an empty stomach. Some, like antibiotics, must be taken until the prescription is exhausted, even if the symptoms of the infection have subsided. Taking one’s medicine as one is supposed to do is called “compliance” or “adherence.” In many cases, the inability or unwillingness to comply with the regimen can have adverse effects, and sometimes failing to comply can be dangerous or even life-threatening.

As one of the study’s researchers told ScienceDaily, “Pill appearance has long been suspected to be linked to medication adherence, yet this is the first empirical analysis that we know of that directly links pills’ physical characteristics to patients’ adherence behavior. We found that changes in pill color significantly increase the odds that patients will stop taking their drugs as prescribed.”

Studying patients on anti-epileptic drugs, the researchers compared the odds that those who didn’t refill their meds had been prescribed pills that looked different from those in a previous prescription. The researchers compared their subjects with entries in a national database of filled prescriptions.

Interruptions in filling prescription occurred significantly more frequently if the pills were of a different color. As ScienceDaily noted, interruptions in anti-epileptic drug use for even a few days presents an increased risk of seizure.

There are lots of reasons why people fail to comply with any medical treatment regimen. It might be uncomfortable, inconvenient, or cause unpleasant side effects. Sometimes they just forget. This study’s authors acknowledged that medication adherence can be complicated. But they suggest that if measures were taken to permit-or even require-bioequivalent pills to be manufactured with a similar appearance, brand or generic, it might boost patient adherence.

The message for physicians is to explain to their patients when prescribing pills that they might look different from refill to refill. Pharmacists should inform consumers that a change in supplier can result in a change of appearance, but that the medicine is the same.

And patients, as always, should know the name of the drug they’re taking, its intended effect and how long they should expect to wait to see results. They should also ask the doctor and/or the pharmacist about potential side effects if those practitioners have not offered that information.