ASK THE PHARMACIST | Can I break my medication?

A friend of my son spent a weekend away with us and his mom packed his ADD (attention deficit disorder) medication. She mentioned he struggles to swallow tablets so she breaks the tablet in half to make it easier for him.

This particular tablet is designed using specific technology called an osmotic pump system. A percentage of the drug is contained in the coating, while the remaining percentage is split among layers of differing concentration inside the tablet. The drug is released via a small hole on the side of the tablet. Once the tablet is swallowed, liquid enters it and the drug is pushed through different compartments and membranes in the tablet, resulting in the slow release of the active ingredient.

The point is to avoid having to take multiple doses of medication. You only need to take one tablet daily as the active ingredient is released slowly to work throughout the day.

This technology of releasing the drug over time goes to waste if the tablet is broken. I do not blame the mom, because no-one told her not to break the medication.

It is important not to break, cut, chew, crush or open certain medication. Any tablet or capsule that is long-acting, modified release, extended release or controlled release should be swallowed whole with water. In most instances, the name of the medicine will be followed by the letters LA, MR, XR or CR.

Do not break a film- or sugar-coated tablet. It will not only be difficult to break, but one of the reasons for the coating is to mask the taste: if you break it, it will literally be a bitter pill to swallow.

Certain tablets used for arthritis or cancer are toxic and should not be handled with bare hands by anyone other than the patient and should not be broken.

Sometimes formulations are not available in a strength that a doctor prescribes and a tablet needs to be split in half to get the precise dose.

For patients with swallowing difficulties, medication might be available in a liquid or dissolvable form or a compounding pharmacy might be able to prepare the medication in an easy-to-swallow formulation.

Some patients also split a higher strength tablet in half because it works out cheaper. This is acceptable if it is done correctly.

If a tablet is scored or has a groove down the middle, it is generally safe and easy to split.

Refer to the leaflet to check whether you can break a tablet or break open a capsule to empty out the powder or check with your pharmacist.

When breaking a tablet, use a pill cutter available for sale at pharmacies.

Split tablets to obtain only the exact dose you need to take.

Split tablets might become unstable if kept for a long time with the inside exposed, and are difficult to identify later.

Keep it clean — wash your hands and the pill cutter before and after use and work on a clean, neat surface.

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