Is it safe to split pills? FDA warning says not usually–even when you think the dosage is correct

by James Hubbard, M.D., M.P.H.

The FDA released a public statement that pill splitting may be hazardous to your health.  They advise against the growing practice of asking your doctor for a tablet twice the strength you need, then halving it to make two doses. My Family Doctor has advocated this in the past as a way to save money.

They cite four reasons “why splitting is risky.”

  1. You might get confused about the correct dose.
  2. Equal distribution of medicine in split tablets is questionable, even when they have a score down the middle.
  3. Some tablets are hard to split, too small or crumble.
  4. Not all pills are safe to split, such as capsules or time-release tablets.

Actually, some drugs have been approved by the FDA for splitting and it reads so in the package insert.  They advise to talk to your doctor or pharmacist regarding each individual drug.

I agree, and we advise that when we give splitting as an option.  I’m not sure how else you’re going to be prescribed twice the strength without talking to the doctor anyway.

Actually, I’ve had patients try to extend their prescription by taking half the dose prescribed to them.  Bad idea, and dangerous.

As far as the FDA reasons for not splitting, I would hope no one would try it without the mental faculties to remember to always split.  Maybe taping a sticker on the bottle, or writing on the top to “always split” might help, or splitting all tablets immediately after receiving them.

With some medications, like blood thinners and heart medicine, splitting is not an option,  It is very important to take an exact dose of these.  Others though, not so much.  Your doctor should know.  Of course, it’s a given that time-release or capsules can’t be halved accurately

The only splittable tablets are the uncoated ones with a score down the middle.  Buy a pill splitter with a sharp blade for a few dollars.

In past articles, My Family Doctor has ideas other than splitting to save money on drugs.   Do you know any?

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James Hubbard, M.D., M.P.H., is the publisher of My Family Doctor, a magazine written by health-care providers for the general public.

 

As with all information on this site, this article cannot replace professional, personal medical advice. Read more here.

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2 Responses to “Is it safe to split pills? FDA warning says not usually–even when you think the dosage is correct”

  1. WarmSocks Says:

    *Don’t put a prescription through your insurance if it doesn’t save you any money. It’s better to pay $3.80 cash than the $5 copay for an inexpensive drug like ibuprofen. Some insulin is also less expensive than the co-pay. Always ask.

    *If the doctor writes a prescription for tid or qid, but gives instructions to take it bid, you’ll save money.

  2. James Hubbard Says:

    Thanks WarmSocks,

    Great ideas.

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