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Tablet-splitting 'may be dangerous'

  • 2 Comments

Patients suffering from Parkinson’s disease and other conditions are at risk of overdosing on their medication if they split their tablets, researchers have warned.

Researchers from Ghent University in Belgium found that 31% of tablets that were split deviated from the recommended dose by at least 15% and sometimes more than 25%.

They concluded that the practice of splitting tablets could have “serious consequences”, especially where there is a narrow margin between a therapeutic and a toxic dose.

They warned that “the tablet parts obtained are often not equal in size and a substantial amount of tablet can be lost during splitting”.

Drugs prescribed for health problems including congestive heart failure, thrombosis and arthritis were split during the study by hand or using a tablet-splitting device, a knife or scissors.

Writing in the Journal of Advanced Nursing, the authors warned that people should not split tablets themselves but also issued a warning to staff in nursing homes, where tablet-splitting is “daily practice”.

They said: “Our observations in nursing homes have shown that nurses split 15% of the medications they prepare.”

Another study in Germany found around a quarter of drugs were split, with reasons including making tablets easier to swallow, cutting costs and allowing doses to be spread over a time period.

The authors of the latest research have called on pharmaceutical companies to produce a range of options to prevent tablet-splitting, including smaller or bigger dose tablets and liquid alternatives.

  • 2 Comments

Readers' comments (2)

  • I have always been concerned about safety of tablet splitting. It is a common practice as not all tablets are available in the prescribed dose. However, not all tablets have lines across them allowing a cleaner break and some have to be cut and may disintegrate into powder at the level of the break so a few micro- or milligrams of the drug are lost each time they are divided and others are covered by an enteric coating. The other half, and sometimes quarters, are returned to the packets for later use and it is obvious that these are larger or smaller than the first part whcih means that patients are not receiving accurate dosages.

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  • valstewart

    i have often cut down a scored tablet with the provided 'tablet cutter' and found the division obviously completely unequal .
    I have also have seen capsules opened and enteric coated tablets crushed.
    Please pharmacists and especially drug companies listen to our pleas for smaller
    doses or liquid preps.

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