Can I Crush My Pills, Tablets or Capsules?
Q. I'm having difficulty swallowing my pills. Can I crush my medications?
A. Each medication is different, so it is best to check the drug information leaflets that were provided by your pharmacist, and ask your pharmacist about each medication you'd like to crush. Having said that, there are some warning signs about Not to Crush medications. This also applies to splitting, opening or cutting any of your drugs also.
Some medications, specifically tablets, have a coating on them that prevents the drug from being broken down by the highly acidic environment of your stomach. This is called Enteric Coating (EC). Enteric Coating can be used either to
1) improve the absorption of the medication (a lot of drugs get absorbed past your stomach in your small intestine) or
2) more commonly, to reduce stomach upset caused by certain drugs such as Aspirin and other anti-inflammatories. For these reasons, it is usually best not to crush pills that are enteric-coated (EC) unless otherwise directed by your pharmacist or doctor.
Other medications are designed in a Controlled-Release (CR) format. This means that the tablet or capsule slowly degrades as it passes through your digestive system, so there is more drug in the pill, but the drug is introduced more slowly into your body. This can be a good thing because it may mean you have to take less doses per day, or even may help to prevent side effects. The hazards of crushing a controlled-release medication can be severe and sometimes fatal. This is like giving a drug you were supposed to absorb slowly over as long as one day, all in one shot in a matter of hours or even minutes. You can see why this might be dangerous. So, as a rule of thumb, do not crush or split controlled-release medications. Of course, there are exceptions to this rule, but you should ask about these exceptions individually with your prescriber or pharmacist.
The tricky thing about controlled-release medications are that they do not always clearly state "controlled release" or even "CR". There are some other short-forms that accompany drug names to look out for, that also mean "controlled release":
- -CD (controlled-delivery)
- -ER (extended-release)
- -LA (long-acting)
- -SR (sustained-release or slow-release)
- -XR (extended-release)
- -XT (extended-release)
- -Contin and Eslon are both associated with specific brands of controlled release drugs such as OxyContin
For a more thorough list of medications that should not be crushed, see the Institute for Safe Medication Practices' Do Not Crush List.
Before cutting, crushing, opening or splitting any of your medications ... Ask Your Pharmacist!
