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 Marcia Purse

To Split or Not to Split Breaking Prescription Pills in Half

By July 21, 2009

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OK, show of hands ... How many of you have pills you split, that you break in half? I do. I have a couple. One is prescribed by my doctor to take one pill with breakfast and a half with lunch. Another was required by my insurance company, which will only cover the higher dose so I take half a pill each day. It's common practice. Nothing unexpected, right?

Well according to a Consumer Update posted today by the U.S. Food and Drug Administration (FDA), tablet splitting is a risky practice. "Regarding the practice of splitting tablets, the Food and Drug Administration (FDA), the American Medical Association, and other medical organizations advise against it unless it's specified in the drug's labeling." The update lists specific reasons such as confusion about correct doses, equal distribution of medicine in each half, difficulty breaking tablets and the safety of medicines meant to be time released.

Is anyone else confused? I looked up the prescription for which my insurance company requires the higher dose pills to be taken in halves. I can't find that it was approved for splitting. Nor is the one prescribed by my doctor to split. So what are we, the baffled consumers supposed to do?

I think a modicum of common sense goes a long way in this. First and foremost, discuss your concerns with your doctor about splitting specific medications. Generally medications that are taken on a daily basis work by keeping a certain amount of the drug active in your body so minor variations in the amount of drug from one half to the next probably doesn't present a serious health concern and your doctor can reduce any worries you have if you ask.

Very inexpensive little pill splitters are available in every drug store to help with those hard to break tablets and to make the division closer to equal. Dr. Michael Bihari, the About.com Guide to Drugs, offers some guidelines for How to Split Pills.

If you are concerned about forgetting the actual dose, have your doctor rewrite the script to reflect that you are taking a half at a time.

Now for those of you who are splitting pills to extend the time between refills and to save money, another concern addressed in the consumer update, you probably want to think about some better options. If you are taking half the recommended dose, you aren't reaching those needed levels in your body. Again, talk to your doctor. He can prescribe a less expensive alternative or perhaps she can offer some sample packages to alleviate some of the financial burden. There are also prescription assistance programs available through every major pharmaceutical company. ~Kimberly

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July 22, 2009 at 4:53 pm
(1) John Thompson says:

If you are splitting your prescribed dose, your doctor has no way of telling what the real therapeutic dose is.

I find that if you look up the prescribing information or ask your doctor or your pharmacist for the complete info that comes with the prescription, it will specifically say, “Do not split this pill” if, in deed there might be an issue with irregular distribution or some other consideration. Much of the information is available on line at the manufacturer’s site.

July 24, 2009 at 1:17 am
(2) zoe says:

While there can be many reasons your pills say do not break or crush (i.e. slow release) – the best way to find out why is to get an answer from the phamacuetical company. My example (I think it was topomax, but maybe seroquel) – however, for dosage reasons I needed to cut the pill and had a pill cutter at home – of course, this drug said not to take crushed. So I went to my pharmachist to see what they could tell me. They called the pharmacuetical company themselves and the only reason for this restriction was a possible bad taste. Like that’s really something to be worried about? When in doubt always ask questions and I find my pharmacist is the best when it comes to my drugs.

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