Pill Splitting Guidelines

What Is Pill-Splitting?

Pill-splitting means splitting a pill. There is no danger in splitting pills when your doctor agrees. One should learn to do it properly and split pills only on a recommendation. Pill-splitting will be considered both in the case of giving small doses and multiple doses.

In general, pill-splitting is considered a risky practice. But, medical advisors encourage this, and it should be followed according to the guidelines. Whenever you decide to split a tablet, it is necessary to get consent from your specialist doctor. One should not split the pill in advance. It should be split only during the time of intake.

What Are the Advantages of Pill-Splitting?

• The main advantage of pill-splitting is it is cost-effective. A person can collect less number of tablets and can have them for more days. That is two doses of medicine for the price of one. It is also helpful for people who find it difficult to swallow tablets.

• Pill-splitting is not suitable for all drugs. The tablets which are ideal for splitting will be available pre-scored. That is, a line runs across the pill. But, all lines are not meant for splitting. Mostly round tablets are suitable for breaking.

What Is a Pill-Splitter?

One should not use scissors or a knife to split the tablet. Some tablets will get crushed while breaking. If the tablet does not split into two equal halves, the incorrect dosage may pose health risks. So, it can be done through a simple, inexpensive device called a pill-splitter. In a pill-splitter, the tablet has to be placed and pressed in order to split it into equal halves or quarters or multiple small doses.

What Drugs Are Suitable for Splitting?

1. Drugs Approved by FDA:

The FDA (Food and Drug Administration) has issued a list of drugs that can be split and the warnings and risks. Most of the medicines prescribed for treating high cholesterol (statins), high blood pressure, and depression will be suitable for splitting.

Medicines suitable for a safe split are as follows:

• Atorvastatin.

• Lovastatin.

• Rosuvastatin.

• Pravastatin.

• Simvastatin.

• Amlodipine.

• Atenolol.

• Doxazosin.

• Lisinopril.

• Metoprolol.

• Quinapril.

• Citalopram.

• Clonazepam.

• Olanzapine.

• Paroxetine.

• Sertraline.

• Finasteride.

• Sildenafil.

• Tadalafil.

• Vardenafil.

• Levothyroxine.

• Metformin.

1. Drugs Given a Thumbs-up by the Doctor or Pharmacist:

Before splitting a medication, talk with the doctor or pharmacist and get a nod for splitting it.

Do Scored Pills Mean That They Can Be Split?

Scoring is done in the middle of pills to be split evenly. However, having a score in the tablet does not itself mean that it is suitable for splitting. Do check with your pharmacist or physician before breaking the drug.

What Drugs Are Not Suitable for Split?

Medicines not suitable for splitting are Oxycodone (pain), Omeprazole (heartburn), Cetirizine (allergy), anti-seizure medications, birth control pills, blood thinners such as Warfarin and Coumadin, and chemotherapy drugs.

What Factors Affect Pill-Splitting?

• Hard Outer Coated Tablet - Hard outer coating will make it tough to split, and it will also alter the absorption in our body.

• Extended-Release Pill - This tablet will be formulated such that it will release the medicine slowly in our body throughout the day, and this property will get affected because of splitting. The following are some examples of modified release tablets:

  • Bupropion ER.

  • Venlafaxine ER.

  • Enteric-coated Aspirin.

  • Verapamil ER.

  • Pantoprazole delayed-release tablet.

• Small or Uneven Pills - Small pills, which cannot get split.

• Capsules - Capsules always have to be taken as a whole as it contains gel or powder.

• Vial - One should not break a vial. If the medicine is exposed to oxygen, it may degrade the content and affect the drugs.

What Are the Disadvantages of Splitting Pills?

The following are a few things that can go wrong when splitting pills are considered:

1. Crushed Pills: Few pills may quickly turn into powder form when attempted to crush. In powder form, taking it in adequate doses becomes difficult.

2. Physical Health: In patients with vision impairment or weakness involving the hands, splitting the drugs becomes challenging. In those cases, seeking the help of another individual is needed.

3. Uneven Dosage: While trying to split, some pills may break so that it splits into uneven sizes. When these tablets are consumed, the doses may be altered, which may increase the chances of health issues due to inadequate or overdosage.

4. Overdosing: Some patients may fail to split the tablet before consumption, leading to the intake of one whole pill, thus resulting in an overdose.

5. Miscommunication: Some pharmacists may misinterpret the ½ dosage mentioned by the doctor to 1-0-2, thereby leading to an increased dosage of tablets.

What Should I Do to Split My Tablet Safely?

1. Pill splitters should be used for splitting the tablets. They are a cheap and reliable method for pill-splitting.

2. Some pills may lose potency when exposed to humidity or heat. Therefore, only one drug should be split at a time, or it should be done with the help of a registered practitioner or pharmacist.

3. Clean your hands and pill-splitter before splitting the drug.

Conclusion:

Pill-splitting has a number of risks, and so it should be carried out with caution. Also, be careful of the drug you are splitting because certain drugs lose their effect when split. In some cases overdosing or reduced dosing can result. Do consult with the healthcare provider or pharmacist before you split a pill.