We often get asked whether it's okay to split or crush a pill. This might come up because of a need to reduce the dose, or because of difficulty swallowing the pill whole (think sulfa antibiotic or potassium replacement).
Generally, pills that have a score or line imprinted into them are intended by the manufacturer to be safely and easily splittable. Also, pharmacies will put an easily visible sticker on the bottle telling you not to crush or split the medication if this is an issue.
Pill splitting devices are easily and cheaply obtained at supermarkets, drug stores and pharmacies and are much easier to use than using a kitchen knife on the counter-tops!
If it interests you to know why some pills should not be crushed or split, there are a number of reasons (h/t Art Gonzalez, Pharm.D., Marshall Hospital Pharmacy Department):
- Crushing pills meant to dissolve under the tongue (sub-lingual) such as nitroglycerin for chest pain or angina can cause them not to work.
- Extended-release formulations of medicines often are designed to have an outer coating that allows the medicine inside to be slowly absorbed into your bloodstream over a long period of time. Spitting or crushing these can allow 12-24 hours worth of that medicine to get into you in a few hours: this would not be good. Often, these medicines have abbreviations after their names such as CR, LA, SR, XL, XR, CD, etc.
- Crushing or splitting pills with potential to be cancer-causing (carcinogenic) or birth-defect causing (teratogenic) can cause the medicine to be released into the air and can be positively dangerous to patients and their family members. Examples would include chemotherapy pills and hormonal pills.
- Sometimes the pill bottle will be labelled not to crush or split the pills because they are fragile, taste bitter, or might stain your teeth or irritate your throat.
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