Learn which pills can and cannot be crushed
If you have difficulty swallowing pills and there are no liquid or syrup formulations available, crushing pills may be a reasonable option. However, not every pill can be crushed as doing so can affect the absorption and effectiveness of certain medications. A Crusher Machine
Before crushing a pill, ask your pharmacist or healthcare provider if it is safe to do. If it can be crushed, there is a right way and a wrong way to accomplish this.
This article describes the different ways to crush a pill and lists some of the pills and tablets that should never be crushed.
Many pharmacies place stickers on pill bottles stating they should not be crushed. If you don’t see a warning label, ask your healthcare provider or pharmacist before crushing any pill or tablet.
There are three devices you can use:
Pills crushed in a pill crusher or a mortar and pestle can be dissolved in a small amount of water or mixed into a small amount of soft food. This ensures you are given the complete dose prescribed by your doctor.
By mixing the crushed pill into a large amount of water or food, you risk losing some of the medication on the plate, bowl, or utensil and may end up being underdosed.
Not every pill can be crushed. There are certain pills that are designed to be dispersed in certain parts of the digestive tract or at a specific rate. Crushing certain pills can cause them to be released too early or too quickly, increasing the risk of side effects and/or reducing the absorption and effectiveness of the drug.
There are three types of pills, among others, that should never be crushed:
Enteric-coated drugs are coated to reduce stomach irritation. The coating is gradually dissolved as it passes through the stomach so that the drug begins to be released as it travels to the intestine. Some drugs are also enteric-coated to avoid teeth staining or to prevent stomach acids from destroying the active drug.
For these reasons, enteric-coated pills or tablets should never be crushed, broken, or chewed.
Enteric-coated tablets often have “EN” (enteric) or “EC” (enteric-coated) tagged at the end of their brand names.
You can often tell that a pill is enteric-coated when it has a slight sheen or gloss. If in doubt, ask your pharmacist.
Sustained-release pills are similar to enteric-coated pills in that they are meant to be absorbed slowly. Crushing the pill causes the drug to be released all at once.
By doing so, the concentration of the drug will be high at first and then drop sharply as it is rapidly excreted from the body. This not only reduces the drug’s effectiveness but also increases the risk or severity of side effects.
Sustained-release pills sometimes have the letters “CR” (controlled-release), or “ER,” “XL,” or “XR” (extended-release) in their names.
You should never crush an opioid drug . These drugs, used primarily for pain relief, have a high potential for drug addiction. They are designed to be released at a controlled, steady rate to avoid an unintended “high” and feelings of euphoria that promote addiction.
Crushing an opioid drug may release it too quickly into the bloodstream, increasing the risk of an overdose. However, some opioids now come in abuse-deterrent formulations containing an opioid agonist—a substance that blocks the effects of opioids—that gets mixed with the opioid if the pills are crushed.
Some of the more commonly prescribed opioids include:
Some people may be tempted to crush their pills by placing them in a plastic bag and hitting them with a hammer or mallet. This is problematic for several reasons:
Chewing pills should also be avoided unless the drug is designed to be chewable. Chewed pills can get stuck in your teeth, reducing the dose, or cause a bitter taste. The crushed pill might also irritate the gums, mouth, esophagus, or stomach if it is released quicker than intended.
It is also not a good idea to mix crushed pills. If you need to crush two or more pills, each should be crushed separately and taken separately.
You will need to learn which foods you can and cannot mix with crushed medications. Things like applesauce, fruit juice, pudding, yogurt, or water are generally safe, but other foods are known to interact with certain drugs.
For example, grapefruit juice can interfere with how certain drugs are metabolized (broken down) and lower the concentration of the drug in the bloodstream. These include statin drugs, anticoagulants (blood thinners), and calcium channel blockers.
Other drugs need to be taken without food, meaning that you may have to deal with the bitter taste.
If you or your child have difficulty swallowing pills, ask your healthcare provider if there are other formulations available. This may include chewable tablets, gummies, syrups, suspensions, powders, suppositories, and dissolvable sublingual (under the tongue) films, pellets, and wafers.
Crushing pills may be OK if you or your child have trouble swallowing pills. Still, it’s important to remember that not all medications can be crushed, especially enteric-coated pills, sustained-release pills, and opioid drugs.
If you can crush a pill, use a recommended method like a pill crusher or a mortar and pestle to grind the pill to a fine powder. Ask your healthcare provider or pharmacist how you should take the powdered drug, including which foods or beverages they can be safely mixed with.
If a drug cannot be crushed, ask your healthcare provider if there are other formulations you can take, such as syrups, suspensions, or gummies.
Gracia-Vásquez SL, González-Barranco P, Camacho-Mora IA, González-Santiago O, Vázquez-Rodríguez SA.Medications that should not be crushed.Med Univ. 2017;19(75):50-63.doi:10.1016/j.rmu.2017.03.001
Kambayashi A, Blume H, Dressman J. Understanding the in vivo performance of enteric-coated tablets using an in vitro-in silico-in vivo approach: case example diclofenac. Eur J Pharm Biopharm. 2013;85(3 Pt B):1337-1347. doi:10.1016/j.ejpb.2013.09.009
Fodil M, Nghiem D, Colas M, et al. Assessment of clinical practices for crushing medication in geriatric units. J Nutr Health Aging. 2017;21(8):904-908. doi:10.1007/s12603-017-0886-3
Adler JA, Mallick-Searle T. An overview of abuse-deterrent opioids and recommendations for practical patient care. J Multidiscip Healthc. 2018;11:323-332. doi:10.2147/JMDH.S166915
Thong MYT, Manrique YJ, Steadman KJ. Drug loss while crushing tablets: comparison of 24 tablet crushing devices. PLoS One. 2018;13(3):e0193683. doi:10.1371/journal.pone.0193683
Food and Drug Administration. Grapefruit juice and some drugs don't mix.
By Jaime R. Herndon, MS, MPH Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.
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