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Pill Splitting: Know When To Avoid Splitting The Difference

Armen Hareyan's picture

Prescription Drug and Pill Splitting

Splitting pills can make perfect sense when it's done the right way. Some health insurers are even encouraging people to buy the extra strength version of prescription medications they take regularly and take only part of the tablet in an effort to save money. Working with a pill splitter, the patients can cut their pills in half, saving some medical dollars. The problem is, according to Dr. Dana Hammer, director of the Bracken Pharmaceutical Care Learning Center in the University of Washington School of Pharmacy, that some people assume that all pills can be split, thus cutting even more costs. Some medications just shouldn't be split.

"Some slow-release medications are specially designed so that the active ingredients are released slowly into the body," Hammer says. "Cutting into those pills disarms the timed release, resulting in a sudden high level of the drug in the bloodstream that then metabolizes out of the body more quickly than intended. This can result in the patient actually in getting too high a dose, too soon, potentially leading to increased side effects, or even toxic effects."

Both prescription and over-the-counter medications are available as slow-release medications, or may have special coatings. Discussing whether pill splitting is appropriate with your pharmacist or health care provider is always important.

Medications that are sold in capsules can't be split at home, since most people don't have the appropriate means of measuring and dividing the contents of the capsules.

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"There are some medications that just should not be split," Hammer says. "Powerful blood thinners, that can cause excessive bleeding if you take too much, or allow blood clots to form if you take too little, require very precise dosing. Even a slight variation in the dose, such as you might get by splitting the tablet, could be dangerous."

How you split a pill matters. While some of the pill splitters on the market work very well, others may split tablets unevenly. Cutting pills with a table knife or razor blade may have the same results and is not recommended, because the inaccuracy puts the consumer at increased risk. Some health conditions, like arthritis or visual impairment, can make splitting pills difficult or impossible for some people.

On the other hand, some health insurers actively encourage patients to split pills, since the practice can cut pharmaceutical costs.

"If your doctor, your pharmacist and your insurer agree that splitting tablets is a good idea for you, both in terms of your health and your pocketbook, ask for some training," Hammer says. "Your pharmacist should be able to help you select the right tool for your medications and then help you learn how to use it."

Most of all, don't make any changes in your medications or how you take them without first talking it over with your health care provider and your pharmacist.

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