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Pill Splitting: When Is It Safe? When Is It Unsafe?

Pill splitting can help save almost 50% of the cost of some prescription drugs.

Pill Splitting: Which Drugs Can Be Split? continued...

The pills best suited to splitting -- and according to some, the only pills -- are those scored down the middle, making them easier to divide.

Some pills that are commonly split include:

  • Statins, like Crestor, Lipitor, and Pravachol
  • Antidepressants, like Celexa, Paxil, and Zoloft
  • ACE-Inhibitors, like Monopril, Prinivil, Univasc, and Zestril
  • Angiotensin receptor blockers, like Avapro and Cozaar

Having the right equipment helps. Don't try splitting a pill by pushing it against the edge of the counter, or hacking at it with a kitchen knife. Shell out for a proper pill cutter. You might not want to get the absolute cheapest one, either. Researchers found that people tended to do best with pill cutters that have a rubber insert, which holds the pill in place while you cut it. Price: about $5.

For convenience, you might be tempted to split the whole bottle of pills at once. But check with your doctor first. It's possible that exposing the interior of the pills to the air could reduce their effectiveness.

When Pill Splitting Isn't Safe

There are limits to the wonders that you and your pill splitter can achieve. Many medicines, because of their ingredients or design, cannot be split safely.

So what drugs shouldn't be split?

  • Drugs with an enteric coating, designed to protect the stomach. Once split, the interior of the pill could irritate the stomach, leading to potentially serious problems.
  • Drugs that are time-release or long-acting. Cutting the pill destroys the time-release effect, which means you could get too much of the medicine too quickly. "If you split a pill that has a long-acting release, you could conceivably get an overdose," says Sagall.
  • Drugs taken more often than once a day. Drugs that work best with pill splitting are usually taken once a day. They last a while in the body. Why is this important? Even if you're careful when splitting pills, you won't always get it quite right. Sometimes one half will be a bit bigger than the other. But if the drug lasts a long time in the body, these variations won't matter. The amount of medicine in your body at any given time stays pretty level. That's not true with drugs that are taken several times a day, since the body processes them quickly. The amount of the medication in your system will fluctuate more dramatically: too little one day and too much the next.
  • Drugs in capsules.
  • Prepackaged drugs in specific doses, like birth control pills.

Other Pill-Splitting Risks

Splitting the wrong sort of pills isn't the only risk. Another danger lies with the person who's splitting them: what if he or she isn't doing it correctly?

For instance, a person might not split the pill evenly, resulting in two pieces with very different dosages. Or he or she might use a dull blade which crushes the pill as it splits it, leaving too much of the medicine as powder on the bathroom counter, and too little for the body. Or, what if a person taking multiple medications gets confused and starts splitting the wrong pills?

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