How can 2 pills be the exact same size but one is 2mg and one is 5mg?

[Moonlight85]

I have got Adaflex for my son (melatonin) for his awful sleeping habits. The 2mg pill wasn't enough so we have been moved to 5mg.
But the 5mg pill looks exactly the same size, width, height etc as the 2 mg. (Even though it has 5 imprinted on each pilI) I also looked up online and they have the exact same dimensions.
How is this possible for a pill that is supposed to be more than twice the dosage of the 2mg?
I also have him the 5mg last night and it didn't work as well as I had hoped.

More active ingredient and less filler?

pills are usually made up of the actual medication plus chalk. One pill will have more chalk in.

the majority of a pill is "filler". So something completely harmless and basically doesn't do anything.

To put it into perspective... 2mg is quite grains of sugar. You couldn't pick it up!

So just because they are the same size one could still have more active ingredients in it?
I'm used to taking anti depressants and there is a noticable difference in the size of the pills the higher mg you get.

Active ingredient.
I've had 500mg painkiller instead of 250mg (prescription) and they are the same size.

That is mostly to show there is a difference in dosage rather than a need for it to be a different size. It’s not even really for your benefit it’s for people who dose and administer the medication the same way packs for different strengths have for example a different coloured box for different strengths. It’s purely a precautionary thing rather than it has more medicine so it needs to be bigger

The size of the pill isn’t always related to the concentration of the drug. Your 5mg tablet will have less filler in it - a bit like making a cappuccino with a double shot vs a single shot of coffee, the stronger cappuccino just has less milk but might be served in the same size cup.

Correct

I'm on a few different meds and the brands tend to switch month to month. The pill sizes change a lot even though the dose stays the same.

There is filler in along with the actual drug and then some preservatives to stop it going off. Some drugs are unstable so have stabilisers added etc. Dye for colours and stuff to help it hold it's shape so the markings printed on them stay clear and readable. Some drugs have coatings to mask the bitter taste of the drugs or other flavourings too - ever noticed how ibuprofen is sweet?

My daughter takes slenyto 5mg melatonin and it's the smallest pill I've ever seen if that helps at all.

Same as a pint of water v a pint of vodka.

Bad design.

Many pills have filler, often lactose or similar. The actual pill size does not tend to indicate the amount of the active ingredient component.

I take Levothyroxine, 2 pills one is 50 and the other 100. Some brands there is an obvious size difference, others they are the same. If I want to double check I have to look at the strange markings on them.

Yep, my 25mg of levothyroxine is much bigger than my 100mg

That’s just based on what one manufacturer will do. Very often if you flip between different brands the tablet size bears no relationship to the dose.

Now I want to know of there is such a job as a pill designer.

Who gets to decide what shape and size each pill is.

@Iudncuewbccgrcb there will be an engineer and designer who work with a product manager at the pharmaceutical company who decide the shape, colour, size, how that varies with strength, and the packaging. It’s based on lots of factors including how people perceive colours as even in placebo, red tablets have more effect than white ones for instance

Are you kidding me ? It is extremely simple.
You have two identical glasses of water.
One has 20 ml of water and the other one has 50 ml.
What is so baffling about it?

This can’t be a serious question… have you ever bought calpol? 5ml of the infant calpol is half the strength of the 6+… the ratio of the active medication to the filler ingredients is simply different.

Yes, more inactive filler ingredients. I take tablets for my cancer treatment. They come in 2mg and 0.5mg sizes. I used to take 2mg (1 round pill) and now I take 1.5mg (which is 3 pills that are roughly 4/5 the size of the 2mg). So it seems like I take nearly 3 times more, but I take 25% less. 🤷🏻‍♀️

Even more funny, the 0.5mg ones only are packaged 7 to a bottle. But the 2mg ones are 30 to a bottle. So now instead of 1 bottle a month, I’m now need 12 bottles a month. I look like I’m running a pharmacy from my kitchen.

When a planet, for example earth, collapses, it becomes a much, much smaller ball, but has the same mass. It's just squished into a smaller space. So, if it weighed a million tonnes at the size it is not, it would still weigh about the same in a smaller ball

Depends on % filler used and what type of filler it is. Some of my medications are different sizes for different strengths, some are the same size for different strengths. I even have one medication where the 20mg tablets are 1/3 the size of the 10mg tablets.

Eta: if you look at commonly available over the counter pain killers like ibuprofen and paracetamol you'll sdd they come in many different sizes and shapes for the same dose.

Are you unaware of how small even 5 milligram is? You could fit a thousand doses on a teaspoon so could barely even see either 2 or 5 mg.

Both pills will be 90%+ filler anyway but it will also mean they only need one machine configuration whatever the dose of tablet they're making as the pill size is the same and they only need to change the concentration of the active ingredient.

The same way a mug of tea is the same size with no sugar, 2 sugars or 5 sugars.