Some people need to split their pills in half for a variety of reasons:
- To make them easier swallow
- To get the correct dose from the pharmacy
- To save money by splitting a higher-dosage into two lower-dose pills
But not all medications can be split safely. The FDA approves some pills for splitting and has guidelines you should follow, most importantly that you should only split pills with the guidance of your doctor.
Why Cutting Pills Cuts Costs
If you're taking a medication that is approved by the FDA to split, it can save you money, even on health insurance copays. Here's how and why.
Medications that are available in different strengths usually cost the same at the pharmacy. So if you have a prescription for medication that comes in 15-milligram tablets, and it's also available in 30 milligrams, you can request your health care provider prescribe the higher dose.
Your copay or out-of-pocket cost will be the same, but you can split the pills so you'll still take 15 milligrams, but you'll get twice as many doses for the same price.
Essentially, splitting the pills stretches your 30-day supply into a 60-day supply. But again, you should only do this for medications that are approved by the FDA to split and with the guidance of your doctor.
Pills You Can Split Safely
It's important to talk to your doctor or pharmacist before you consider cutting your pills. In general, it's OK to split pills if:
- FDA approval. If the FDA has approved a drug for splitting, it will be printed on the package insert.
- Approval from your doctor or pharmacist. Before you split any pills, discuss it with your doctor or pharmacist. The FDA stresses you shouldn't split pills without supervision from a health care provider.
- Scored down the middle. Scored pills are easier to split evenly. But that line down the middle doesn’t always mean it’s safe to split. Check with your doctor or pharmacist, or look for the FDA approval.
Some pills that are commonly split include:
- Statins, like atorvastatin (Lipitor) and rosuvastatin (Crestor)
- Antidepressants, like citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft)
- ACE inhibitors, like fosinopril sodium (Monopril), lisinopril (Prinivil and Zestril), and moexipril hydrochloride (Univasc)
- Angiotensin receptor blockers, like irbesartan (Avapro) and losartan potassium (Cozaar)
Pills Not Suited for Splitting
There are definitely medications you shouldn't split. If your pills have any of these features, don’t cut it in half:
- A hard outer coating: Splitting a coated pill can make it harder to swallow and may change the way your body absorbs the medicine.
- They’re time-release or long-acting: Cutting into this type of pill could give you too much medicine, too quickly. That can put you at risk for an overdose.
- They’re capsules: Because they contain powder or gel, capsules have to be taken whole.
- A small or uneven shape: Some pills are just too difficult to split evenly.
- Prepackaged drugs in specific doses, like birth control pills.
You also shouldn't split pills you take more than once a day. Even if you're careful, you won't always get it exact. Since your body processes them quickly, the amount of medication in your system could go up or down a lot. You may have too little one day and too much the next.
What Could Go Wrong?
Even if your doctor or pharmacist says your pills are safe to split, there can be problems. Think about these before you decide to try pill splitting:
- The possibility of an uneven dose: For some drugs, the dose has to be so accurate even a small difference in two halves of a split pill could put your health at risk.
- Crushed pill issues: Some pills can easily turn to powder. A pile of crumbs will be very difficult to break into two equal doses.
- Miscommunication: Your doctor may write "1/2 pill" and your pharmacist may see "1-2 pills."
- Confusion: If you forget to split pills before taking them, you’ll take twice as much as your doctor intended.
- Physical limitations: If you have any condition that makes it tough to split pills, like your vision is poor or your hands are weak or unsteady, your dosages could be off.
However, a meta analysis that reviewed years of original research, reviews, and expert opinion on splitting pills, didn't find much evidence to support these concerns, except when related to sustained-released pills, which aren't approved by the FDA for splitting.
If You Do Split Pills
- Use a pill splitter. They’re cheap -- between $3 and $10 at most pharmacies or online. If you ask, your health insurer may also send you a pill splitter for free. Keep in mind, some tablets aren't suited for pill splitters because of their shape and size, so talk to your doctor about the best way to split your medicine.
- Keep it clean. Always wash your hands first, and wash the pill splitter thoroughly after each use.
- Ask your pharmacist for advice. Some pills may lose strength when their insides are exposed to heat or humidity.
- Don't split your entire prescription at once. Instead, split one pill at a time.