Pill splitting - Is it safe?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 23, 2023.

Pill Splitting - Is it Safe?

Pills or tablets that are scored with a line or indentation down the middle are usually okay to split in half. Not all strengths or formulations of the same medicine may be scored. Coated pills or tablets that are slowly released in your body should not be cut. 

• You should only split one pill at a time and use up both halves before splitting another pill. Do not split all your tabs at once.
• Capsules should not be split, crushed or opened unless recommended by your healthcare provider.
• Even if your pill is scored, check with your pharmacist first to be sure you can safely cut it in half before you take it. If you change manufacturers or strengths of medicine, check again before you split it.

Pills with special coating (for example, enteric-coated pills) or that are released into the body in a certain way, like extended-release (ER), sustained-release (SR) or long-acting (LA) medicines should typically not be split, cut, crushed or chewed. This can alter the release characteristics and how fast it is absorbed into your body, which may cause a dangerous overdose in some cases.

Capsules should not be split, crushed or opened unless your healthcare provider has told you it’s ok; for example, that you can open it and sprinkle on food (such as applesauce) to make it easier to swallow.

Tablet splitting should always be done under the direction of your healthcare provider. Check with your doctor or pharmacist first to make sure splitting your pill is a safe and economical choice for you.

How do I know if it's OK to split pills in half?

If your pill or tablet is “scored”, this usually means you can split your tablet in half. A “score” is a line or indentation that is found down the middle of the tablet that allows for easier cutting. 

You can see a few examples of a tablet “score” here:

Splitting your pill in half and taking only one-half will change the dose of your medicine. Only do this if your healthcare provider has directed you to do this.

Ultimately, the uniformity of the active ingredient in your pills will depend upon the standards of quality assurance set at the particular drug manufacturing facility.

Which pills should NOT be cut in half or split?

Examples of medications that should usually not be split in half include:

• film-coated or enteric-coated tablets, controlled-release (CR), extended-release (ER, XR or XL), sustained-release (SR), or timed-release medications
• orally-disintegrating tablets
• oddly shaped pills or pills that are too small to split evenly
• capsules (note: certain medications in capsules can be opened and sprinkled on food for easier swallowing, but ALWAYS ask your pharmacist if you can do this)
• chemotherapy (cancer) drugs
• prepackaged pills
• some combination drugs (one pill that contains two or more medicines). Ask your pharmacist if it’s OK to split any combination tablet.
• oral contraceptive (birth control) pills
• any other medicine where getting the exact dose is critical (drugs with a narrow therapeutic index)

If a tablet is not scored, ask your pharmacist or doctor if it is safe to halve. Also, tablets with odd shapes or sizes may not be safe to split. If you split a tablet in half and it crumbles, splinters, or cuts unevenly, do not split anymore of these pills. Get a prescription from your doctor for the correct strength so you do not need to cut them half.

Extended-release (ER or XR), sustained-release (SR), long-acting (LA) or timed-release medications have a built-in release mechanism to allow the medication to work longer. Note that not all pills with different release characteristics may have the abbreviations, such as “XR” or “SR” after the name of the drug.

If you split, crush or chew it, the medication may release all at once and lead to a dangerous, high dose. Examples of these kinds of medicine include Calan SR  and Effexor XR. Some opioids medicines used for pain also have special release characteristics and splitting them in half and taking them can be dangerous or deadly, as a large dose of medicine may be released all at once.

Check with your healthcare provider and review the product label before you split any combination drug (one pill that contains two or more medicines) in half.

Enteric-coated (EC) pills are coated to protect your digestive tract. Examples of these kinds of medicines include enteric-coated aspirin or enteric-coated naproxen.

Learn more: What are enteric-coated tablets?

Why do people split pills?

People may want to split pills for a variety of reasons:

• to decrease the tablet size and make it easier to swallow
• to save money
• to adjust their medication dose, as directed by their healthcare provider

Will splitting pills in half save me money?

This depends. Not all medicines that are twice the strength are twice the price. Because of this, pill splitting may allow you to buy two doses of medicine for the same price as one - the equivalent to getting two months of medications for the price of one. 

Splitting tablets in half is a practice that some healthcare providers and even health insurance companies may recommend, but it’s always optional for you. For some medicines, cutting tablets in half may save you up to 50% off of the cost of your medication. 

• For example: say you take 10 milligram (mg) of a cholesterol-lowering drug every day, but the 20 mg tablet costs just about the same. The 20 mg pills are scored and can be safely split in half.
• If you buy the 20 mg tablets, cut them in half, and then take that one-half for each dose (now equal to your 10 mg dose), you can double your buying power.

However, your doctor will need to agree to prescribe the higher strength of medicine for you to cut in half. Check with your pharmacist to see if this makes sense for you economically.

Can I split my pills in advance?

Do not split all of your tablets at once and save them for later use. This may lead to deterioration of the ingredients and can lower the medicine’s effectiveness. Heat, humidity, light or moisture content could affect the integrity of the medication.

For scored tablets, you should only split a pill once (unless otherwise directed by your doctor) and use up both halves of the tablet before splitting another pill.

Does splitting a pill in half reduce its effectiveness?

According to the FDA, if there is no information about splitting the tablet in the package insert section “How Supplied”, the FDA has not evaluated it to be sure both halves of the tablet are the same weight, contain the same amount of medicine, or work in the same way.

Research studies have found inconsistencies in the amount of active ingredients in tablet halves.

In one study, researchers found that the active ingredient simvastatin (a common cholesterol medicine) was distributed unevenly in tablets manufactured in foreign countries and purchased online but not in the branded product (Zocor) manufactured in the U.S. This could lead to uneven doses when cutting tablets in half.

Another study found that the USP standard specification was exceeded for more than one-third of sampled half tablets for warfarin, metoprolol, and lisinopril, and was greater for nonscored vs. scored tablets.

• The USP standard for drugs other than warfarin was 90-110% of half the mean values of the whole tablets, and for warfarin was 95-105%.
• Specifically, standards were met for 19 out of 30 halved warfarin tablets, 27 of 30 for simvastatin, 20 of 30 for metoprolol succinate, 26 of 30 for metoprolol tartrate, 25 of 30 for citalopram and 20 of 30 for lisinopril.
• Weight variation appeared to be due to tablet fragmenting, and the authors conclude that splitting tablets in half precisely may help to eliminate the variation. 

However, one retrospective review study found that using half tablets did not appear to affect the clinical outcomes of patients with high blood pressure, high cholesterol levels, or mental health disorders.

Can I split a generic tablet?

Recommendations for pill splitting change frequently, so always ask your pharmacist before assuming it is a safe practice.

If your pharmacy fills your prescription with a generic tablet from a new manufacturer, it may not be safe to split, even if you were able to split it before. Your pharmacist should have access to this information.

If you switch between brand names of the same medication, or between brands and generics, check with your healthcare provider to be sure the new tablets can be safely split if you have done this with the previous pill.

What is the safest way to split a pill?

For the most precise splitting, you should buy a pill splitter at the pharmacy. They work best for round pills that are scored, but may not work for oddly shaped pills. Don’t use a knife or razor to cut tablets as this may splinter or crush pills and can be dangerous.

Use caution and read any directions as most pill splitters contain very sharp razors. Have your pharmacist demonstrate the proper technique. Keep tablet splitters away from children and pets.

Pill splitters are usually inexpensive and cost between $5 and $10 at the pharmacy or online.

Does the FDA say it’s OK to cut pills in half?

The US Food and Drug Administration (FDA) states that pill splitting may be approved under certain circumstances and has published a list of “Best Practices for Tablet Splitting”.

The main points are summarized here:

• FDA-approved tablets that are approved to be split will be noted in the “HOW SUPPLIED” section of the professional label insert and in the patient package insert. The tablet will be scored with a mark indicating where to split it. You can review FDA product labeling here. 
• If this information is not in the label, the FDA has not evaluated the tablet to ensure the two halves would be equivalent when split. The manufacturer has not determined if the one-half is the same in weight, drug content or clinical effects. The FDA suggests that patients talk to their healthcare provider about whether to split pills that do not include this information in the package insert.
• Only split pills as you need them and take the split halves before splitting the next tablet. Heat, light, humidity, or moisture content can affect the integrity of the medication; avoid leaving medication in steamy bathrooms or hot cars.
• Pill splitters may not be appropriate for oddly shaped tablets. Some tablets may not be suitable to split because of their unique shape and size—even if they appear to be scored.
• If you switch between brand names of the same medication, or between brands and generics, check with your healthcare provider to be sure the new tablets can be safely split.
• Tablet splitting should be done only under the supervision of a healthcare professional.

Can I cut a pill in half if it has no line in the middle?

In general, do NOT split tablets that are unscored unless your doctor or pharmacist has given you the okay to do this. Some tablets may be extended-release, enteric-coated or have other characteristics that might affect how the tablet is absorbed or works if you cut it in half. 

Even if a tablet is scored, it’s best to ask your healthcare provider before you split it.

What is the safest way to split a pill?

In general, it’s safer to use a pill splitter that you can buy at the pharmacy than trying to use a kitchen knife or separate razor. Ask your pharmacist to demonstrate how to safely use it.

• Pill splitters tend to work best on round pills that are scored. Some pill splitters themselves can be dangerous as they may contain a sharp razor within the tool, so use caution and keep away from children.
• Do not use a knife, razor or other sharp object as you risk the chance of injury, and your pill may crumble or split in uneven halves.

Speak with your pharmacist if you have questions or need a recommendation about a good pill splitter.

Is it safe for anyone to split tablets in half?

It may not be safe for certain people to split tablets on their own, especially those:

• with memory problems, who may forget to split their tablet and take a double dose of medicine, or may split the wrong tablet
• with vision problems
• who have arthritis in their hands
• who need daily help with their medicines
• with a movement disorder or tremors
• with health conditions or impairments
• that are children. Adults should split tablets for children.

Which medicines can be split in half?

Always check with your pharmacist or doctor, look at the package insert, and / or call the manufacturer to be sure you can split your tablet in half. The following is NOT a complete list of all medicines that can be split. 

NOTE: Only certain strengths or formulations of the following medicines are scored and can be split in half. Not all strengths, formulations, generic or brand products, or medicines made by different pharmaceutical companies may be scored and / or can be split in half. ALWAYS ask your healthcare provider.

ADHD medications

• Adderall (amphetamine and dextroamphetamine)
• Ritalin (methylphenidate)

Antidepressants

• Celexa (citalopram)
• Effexor (venlafaxine)
• Lexapro (escitalopram)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Pexeva (paroxetine)
• Zoloft (sertraline)
• trazodone

Anti-anxiety medications

• Xanax (alprazolam)
• Ativan (lorazepam)
• Buspar, Buspar Dividose
• Valium (diazepam)

Anti-Nausea

• Promethazine

Antibiotics

• Penicillin V potassium

High Blood pressure

• Cozaar
• Diovan
• fosinopril
• Lopressor HCT
• metoprolol
• propranolol
• Zestril (lisinopril)

Diuretics (water pills)

• Lasix (furosemide)
• hydrochlorothiazide

Pain / Fever 

• aspirin (but NOT enteric-coated aspirin)
• acetaminophen

Parkinson’s disease

• Sinemet (carbidopa / levodopa)

Thyroid medications

• Levothyroxine

Muscle Relaxer

• Methocarbamol
• Zanaflex (tizanidine) tablets

Weight loss

• Adipex-P (phentermine)

Corticosteroids / Anti-Inflammatory

• dexamethasone
• methylprednisolone
• prednisone

Bottom Line 

• Many tablets can be split in half, especially if they are scored. Always check with your doctor or pharmacist first to make sure splitting your pill is a safe and economical choice. Using a whole tablet for the dose you need is the safest way to be sure you get the most accurate dose.
• Splitting your tablets may be helpful if you need to adjust doses (as directed by your doctor) or if it makes it easier to swallow the medication. Only split one pill at a time, and take both halves, before you split another pill. This will help to prevent deterioration of your medicine.
• In some cases, splitting a higher dose tablet in half can save you money, but it depends on the cost of the medicine and the dose you need. Speak with your doctor and pharmacist about the best way to save money on your prescription medicines. 

See also

• Are expired drugs still safe to take?
• Common Drug Side Effects
• Does grapefruit juice interact with my medications?
• Generic vs Brand Drugs: Your FAQs Answered
• How do I remember to take my medications?
• How do I stop my medication safely?
• How to Safely Dispose of Your Old Medications
• Imprint Code FAQs - For Oral Medications
• Injection Types and Sites
• List of Prescription Abbreviations: What Do They Mean?
• Medical Conversions - How many mL in a teaspoon?
• Top 5 Ways to Avoid Drug Errors
• Top 9 Ways to Prevent a Deadly Drug Interaction
• What are pharmaceutical salt names?
• What are the risks vs. benefits of medications?
• What is the half-life of a drug?
• What is the placebo effect?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer