Pill Splitting - A Safe Way to Save Healthcare Dollars?
Why split tablets?
Use of medications for chronic illnesses, such as hypertension, diabetes, or high cholesterol - all common U.S. conditions - can often run into the thousands of dollars per year. Rising healthcare costs often force consumers to try innovative ways to save a portion of their healthcare dollar.
- Splitting tablets in half is a practice that some patients, employers, healthcare providers, and even health insurance companies may recommend.
- Splitting tablets - actually cutting them in half - may save you up to 50% off of the cost of your medication.
- Tablet splitting should only be done under the direction of a healthcare provider. You should always check with your doctor or pharmacist first to make sure splitting your pill is a safe and economical choice.
But it’s important to note not all pills can be split safely, and not all medical experts agree that it is a good practice. Also, some drug companies oppose pill splitting.
How does pill splitting work?
Pill splitting allows the consumer to buy two doses of medicine for the cost of one dose - the equivalent to getting two months of medications for the price of one.
- 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.
- If you buy the 20 mg tablets, cut them in half, and then take only one-half (now equal to 10 mg), you can double your buying power.
Many pills that can be safely split have a “score”, a line down the middle of the pill, that allows for easier splitting. However, be aware that not all tablets that are scored are safe to split in half, so ask your pharmacist first.
On the other hand, some tablets that are not scored can be safely cut in half. For precise splitting, consumers 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.
Does the FDA agree with pill splitting?
The U.S. Food and Drug Administration (FDA) has put out a list of “Best Practices for Tablet Splitting”.
The main points are summarized here:
- FDA-approved tablets that can be safely split will be printed in the “HOW SUPPLIED” section of the professional label insert and in the patient package insert. Also, the tablet will be scored with a mark indicating where to split it. You can review FDA product labeling here to see if your tablets can be safely split in half.
- 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 FDA suggests patients talk to their healthcare provider about whether to split pills that do not include this information in the label.
- Only split pills as you need them and take the split halves before splitting more tablets. Heat, humidity, or moisture content can affect the integrity of the medication; avoid leaving medication in steamy bathrooms or hot cars.
- Discuss with your doctor or pharmacist if you need to use a tablet splitter to cut your pills in half; pill splitters are inexpensive and can be found at most pharmacies or online for under $10. Pill splitters may not be appropriate for oddly shaped tablets. Don’t use a knife or razor to cut tablets as this may splinter or crush pills.
- 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 and your doctor decide tablet splitting is a good choice for you, don’t forget to split your medications right before taking them. If you forget, you may take a dose twice as high as you should which may lead to possible unintended side effects.
Can I split any tablet?
No. Certain medications are not safe to take if they have been cut in half. The recommendations change frequently, so always ask your pharmacist before assuming it is a safe practice and check the drug label or product information. Your pharmacist will have access to this information if you do not.
Examples of pills that should usually not be split include:
- enteric-coated tablets, extended-release (ER or XR), sustained-release (SR), or timed-released medications should not be split. These medications are either coated to protect your stomach or have a built-in release mechanism to allow the medication to work longer. If you split or crush it, the medication may release all at once and lead to a dangerous, excessive dose. Examples of these kinds of medicine include enteric-coated aspirin or enteric-coated naproxen.
- orally-disintegrating tablets
- oddly shaped pills and most capsules
- chemotherapy drugs
- oral contraceptive pills
- blood thinners, like warfarin (Coumadin)
- medications used for seizure control
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.
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- U.S. Food and Drug Administration (FDA). Drugs. Best Practices for Tablet Splitting. Updated 8/23/2013. Accessed April 21, 2021. https://www.fda.gov/drugs/ensuring-safe-use-medicine/best-practices-tablet-splitting
- Enderle L. News: FDA Takes on Unsafe Pill Splitting. Pharmacy Times. Sept. 2011. Accessed April 21, 2021. https://www.pharmacytimes.com/news/fda-takes-on-unsafe-pill-splitting
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.