splitting tablets

Splitting Tablets In Half – Okay, Or Not Okay?

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Is splitting tablets the right (and safe) thing to do when taking your tablets?

In some cases, yes, when absolutely necessary. However, it does come with a risk of wrong dosing.

We have seen that sometimes it just may be necessary to break a tablet. A study found that almost 25% of tablets are broken before administration.

There are many reasons why one might split tablets. It is usually a cost-saving practice. But it has its disadvantages.

One major problem is splitting a tablet that should not be split can lead to a ‘loss of weight‘ of the tablet. This means the drug is unevenly distributed within the tablet, and the wrong weight of the medicine may be taken by the patient.

Which Tablets Can We Split?

Some tablets come with a score line, which means it can be split in two equal halves for the patient’s convenience. This mark or score line even provides assistance to perform a clean half cut for dividing the tablet.

Look for the score line on a table before cutting it.

You can also read the medication label or patient package insert to know more about your pill before splitting it.

Generally, the “How Supplied” section of the leaflet contains the information on splitting the tablet into two. However, some pills contain the score line but are not intended for splitting.

So it is advised not to split every tablet with a score line. Consult your doctor or your pharmacist before you split the pills.

Pills That Should Not Be Split

Pills without a score line indicate a strong signal that they are never to be split into two; this medicine generally comprises of:

Extended-release pills

This pill is manufactured to slowly release the medicine into the body, which means, that the entire dosage might get dumped at once after splitting into two halves.

These pills have the suffix ‘XR’, ‘MR’ and ‘ER’ sometimes.

The entire dosage might get skipped when you take the second half.

Both of these are very dangerous. So never split such pills.

Liquid- or bead-filled capsules

These medications include liquids or beads inside them. Splitting such capsules can be a tedious process, and the chances of spillage of the drug are high.

It is advised not to attempt to open or split such capsules.

Asymmetrical pills

Tablets with asymmetric shapes are practically impossible to cut into two equal halves; hence do not even try to cut such tablets.

It is rare to get such tablets these days. But if you do come across them, then avoid splitting them.

Tiny tablets

Some pills are extremely small and require precise cutting, which is difficult to do. Try your best not to cut tiny pills.

How Can We Split Tablets Safely?

For proper splitting, the right equipment is necessary. Just doing it by hand may not be the right thing, though it is quite easy to do.

A specialized pill cutter can be bought from the pharmacy or online.

These cutters are specifically designed with a V-shaped pill holder and a retractable blade. The blade can slowly press down the tablet, and the pill can be split with a swift downward motion.

These pill cutters often provide better precision and are available at a low cost. Anything to prevent the tablet from crumbling really.

People are often seen cutting pills using fingernails, and knives or simply biting off a half, which can be a risky procedure concerning the dosage form and the dose.

Tips For Cutting Pills Accurately

So here are some tips that you can use for splitting pills when absolutely necessary:

Cut a single pill at a time

Do not cut multiple pills and store around you, resulting in difficulty identifying the pills. In addition, FDA reports say that pills stored after dividing into two parts may be less effective due to exposure to heat, humidity, and moisture.

Make Sure Your Hands Are Clean

Maintain proper hygiene, clean and wash your hands, and wear gloves before splitting a pill to avoid chemical reactions. Also, clean the cutter before and after breaking the tablet.

Do not assume that it is safe to split a pill

Try not to assume that a tablet can be divided into two before administration; even if in the past you have divided a pill, it doesn’t mean that you can do it again.

Manufacturing methods may change now and again, and it may be that the new pill cannot be split in half.

Risks Of Pill Splitting

Is it difficult to split a pill in half? Most of you might think it’s not.

However, a study found that 1 in 8 split pills were off by more than 20 %, implying that tablets are not divided into equal halves with precision.

This uneven splitting can lead to dosage errors, either an overdose that can result in toxic effects or an underdose that can lower the intended benefits.

So the next time when you are splitting the pill, you might not get the exact dose intended by your prescription, and this can have serious consequences.

Do You Need To Split Pills In The First Place?

There are a few reasons in which a pill may just have to be divided; the most common explanations include:

Getting More Doses From Lesser Tablets

Let’s say your doctor has prescribed you a 10 mg dose of a tablet per day, whereas the pills available in the market are 20mg.

Often the 20 mg tablet cost will be lesser than 2 of the 10 mg tablets together.

In such cases, splitting the 20 mg pill will save you money and extend the treatment without adding any further cost.

Unavailable Doses

A pill that is not available as per the prescribed dosage may have to be divided to get the exact dosage given by your doctor. This is rare though.

Hard-To-Swallow Pills

Studies have shown that nearly 4 out of 10 patients have difficulty swallowing large pills and tablets. In such a case, splitting the medication is the only way possible.

That being said, pharma companies are doing their best to reduce pill size, but some medicines like diabetes and multivitamin pills can be difficult to keep small.

Conclusion

It is always better to talk to your doctor or pharmacist before splitting tablets. There can be ways a doctor can adjust your medication to give you the exact dosage of pills without splitting them.

Please seek medical advice before you consider splitting the tablets.

Dr Vivek Baliga B
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1 thought on “Splitting Tablets In Half – Okay, Or Not Okay?”

  1. Excellent article Dr. Vivek. Can I try translating it and sending it to a kannada weekly like Sudha or Tharanga ?

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