Is Cutting Your Pills a Safe Way to
Doctor of Pharmacy Candidate, May 2002
The University of Iowa
you've filled a prescription lately, you're probably interested
in ways to cut the high costs of medication. The title line
of an article in the Wall Street Journal (July 27, 2001) suggested
"An Easy Remedy: Cut Your Drug Bills in Half By Cutting Pills
In Half." But this advice only works for certain medicines.
By splitting some medicines, you could be putting your health
Splitting pills can save
money because different strengths of a medicine are sometimes
about the same in price. For example, each 20 mg pill of a medicine
commonly prescribed to lower cholesterol costs about $3.57,
while each 40 mg pill of the same drug costs about $3.61. If
your doctor prescribes 20 mg of this drug daily, you could save
about $640.00 over a year by buying the 40 mg pills and splitting
them in half.
With many medicines, it
is perfectly safe to split pills. Some pills have a grooved
line on them where they break most easily (this is called scoring).
Pills are scored so doctors can prescribe doses that are not
otherwise available or adjust your dose without you having to
get a new prescription. When pills are scored, you know that
they are safe to cut.
Pills that aren't scored
may not be safe to cut. Some of these pills will not work correctly
if they are cut. Others are too difficult to cut or cutting
is risky because an exact dose is so important.
The following are types
of medicines that should not be cut:
Capsules are really just shells that hold in the medicine.
The medicine may be a liquid, a powder, or in tiny pellets.
If the capsule is cut or opened, the medicine inside is almost
impossible to divide equally.
Timed-release medicines may also be called long-acting, controlled-release,
or extended-release medicines. These pills have special coatings
or are made of materials that can control how fast the medicine
is released from the pill. When these pills are split, the
medicine gets out too fast, and you could get too much medicine
These pills are designed to release medicine after it passes
through the stomach. They are covered with a special coating
that won't let the drug out while the pill is still in the
stomach. These pills protect your stomach from the medicine
and protect the medicine from the acid in your stomach. Cutting
these pills lets the medicine out too soon. It may then cause
irritation or be destroyed by the acid in your stomach.
Some medicines come in patches that stick to your skin like
band-aids. Over time, the medicine travels from the patch
through your skin and into your body. Some patches can be
cut into smaller pieces, but always ask your doctor and pharmacist
first. The patch may not stick to your skin like it needs
to if it is cut. The drug may be in a liquid or gel inside
the patch, so cutting it would let the drug out and either
too much drug or not enough drug would get to your body.
Medicines that require
a precise dose
With some medicines, it is very important that you get exactly
the same dose every time you take your medicine. Think of
a pill as a blueberry muffin. The actual drug is scattered
throughout the pill like blueberries in the muffin. Even if
you are able to split the muffin exactly in half, you probably
won't get exactly half of the blueberries in each side. Medicines
that control your heartbeat or help prevent seizures are examples
of medicines that require an exact dose. Cutting these medicines
could result in you taking more or less medicine than you
need. The dose you get could be so high it's dangerous, or
so low that it's not useful.
There are other things to
consider, too. Cutting pills accurately is not an easy task.
It is especially difficult if you have poor vision, arthritis,
or unsteady hands. Pill splitting may not be practical for pills
that are small, odd-shaped or not scored. Your pills may crumble
or break unevenly when you try to cut them. If you are going
to cut your pills, the safest and most reliable way is to use
a pill splitter. These cost about $5.00 and can be bought at
Taking your medicines becomes
more complicated if you decide to split your pills. You can
work with your doctor and pharmacist to develop ways to make
sure you always take the right dose of each medicine. For example,
it might help to put a bright color sticker on your pill bottle
to remind you to split those pills.
© 2001 Consumer Health
Information Corporation. All rights reserved.