The Do's and Don'ts of Tablet-Splitting

Recently, I was reviewing medications with a patient. He had a vial containing a 3-month supply of tablets with instructions to “Take ½ tablet daily.” I looked inside the vial and said, “Uh oh, you'll need to get a new vial of medication.”

Why? Because the patient had split all of the tablets in the entire vial in half. He didn't realize that cutting the tablets exposed the medication to air and moisture. Because oxygen degraded the exposed surfaces of the tablets, they were no longer as potent as prescribed.

Tablet-splitting is not always a bad choice

It often can help patients save money on their medications, which is an important benefit. However, you may not realize that splitting medications can be both expensive and harmful if done incorrectly.

Keep in mind the following dos and don'ts if you need to split your tablets:

1. Don't use scissors or kitchen knives to cut tablets—this causes uneven splitting and crumbling, which changes the correct dose.
2. Don't split extended-release or time-release medication.
3. Don't split very small or unevenly shaped tablets.
4. Don't split the entire vial of tablets at one time—air degrades the exposed drug.
5. Do split your tablets only as you need them to maintain potency.
6. Do use a commercially available tablet-cutting device.
7. Do talk to your pharmacist if you have any physical limitations (such as arthritis) that would keep you from splitting tablets accurately or for any other concerns about tablet-splitting.