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The Do's and Don'ts of Tablet-Splitting

Elaine Lindsay TwedtRecently, I was reviewing medications with a patient. He had a vial containing a 3-month supply of tablets with instructions to "take ½ tablet daily." I looked inside the vial and said, "Uh oh, you'll need to get a new vial of medication."

Why? Because the patient had split the entire vial of tablets in half. He didn’t realize that cutting the tablets exposed the medication to oxygen. Because oxygen degraded the exposed surfaces of the tablets, they were no longer as potent as prescribed.

Tablet-splitting is not always a bad choice. It often can help patients save money on their medications, which is an important benefit. However, you may not realize that splitting medications can be both expensive and harmful, if done incorrectly. So, keep in mind the following do's and don’ts of tablet-splitting:

  1. Don't use scissors or kitchen knives to cut tablets—this causes uneven splitting and crumbling, which changes the correct dose.
  2. Don't split extended-release or time-release medication.
  3. Don't split the entire vial of tablets at one time—air degrades the exposed drug.
  4. Do split your tablets only as you need them, to maintain potency.
  5. Do use a commercially available tablet-cutting device.
  6. Do talk to your pharmacist if you have any physical limitation (such as arthritis) that would keep you from splitting tablets accurately, or for any other concerns about tablet-splitting.

By Elaine Lindsay Twedt, Pharm.D., BCPS, CACP, AE-C; Clinical Pharmacy Specialist, U.S. Department of Veterans Affairs, Orangeburg, S.C.