Mrs ABC  who was recently started on metformin for diabetes called in panic state. She was observing the tablets in stool. The tablets were intact. She was worried whether this will affect her diabetes control.
"Doctor I am loosing tablets can you just guide me what to do?"
She was not the first person to ask this question. It is common problem with certain type of tablets. 

All tablets have two parts- active part which is actual medicine and the outer packing part.The phenomenon of passing intact tablet in stool is known as ghost pill. Just like ghost don't have soul the ghost pill don't have its soul I.e. active part of tablet.
 So ghost pill is the outer packing part.
   By changing the  structure of outerpart we can control the rate at which active drug is released in stomach and intestine.
  So in immediate release formulations the active part is released faster and in modified/ extended release formulations its is released slowly . To achieve these differences the outer layer needs to be modified. Due to this in some tablets the  outer layer is hard to be broken but the active inner part gets absorbed into body.
  So some patients observe the intact tablet in stool which is known as ghost pill. It does not affect the effect of drug.
  So in short ghost 👻 pill can be scary but it will not affect your health...

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