Drugs That Can Be Broken Into Two Half Or Not

There are situations that put one in the position of breaking a tablet into two equal half. For example, a father that comes back from work and find one of his children with high temperature. In order to bring it down, he dash out to the first aid box. Discovering the only paracetamol in the house is 500mg tablet which is too high for the child will resolve to cutting the pill into two equal half if that is the right strength. But because of the urgency of the situation, the father may not have the time to confirm if what he did was proper or not. Let us see when and on what ground drugs in tablet or caplet can be cut into two.
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Drug Formulation

Different drugs come in different formulation and strength. Some even come in multiple formulation like paracetamol tablet and injection. However this is not the case of drugs like insulin that have only injection.
In all the formulation, only tablet and caplet get cut in two. Capsules can be open up and half using eye gauge or in advance settings weighed. It is very rare a patient may want to half a capsule because of high strength. The other half will be waste if the other side will be consumed in the evening as it will be contaminated. Besides, capsules are shells have functions which will be defeated when it is remove. So this is not advisable.

Drugs Never To Cut

Modified Tablets

There are some drugs that are designed to be taken orally but do not dissolve instantly. The drug is release over a long period of time in the stomach. Some can work like this for 12 hours while in other cases, days. Breaking or cutting it can alter the mechanism employed in its design to delay or slowly release the drug over time. In that case, the drug is released instantly when the half is swallowed. That half can be toxic to the body if all the constituent is release instantly.
These drugs are usually labeled for both the pharmacist and patient to see. They are clearly written in places very visible. Some of the inscriptions are;
CR or Chrono or CRT which means control released tablet
MR or Retard which means modified release tablet
SA or SR or Dur or Dural which means sustained action or sustained release tablet
XL means extended release tablet
LA means long action or activity tablet
There are others depending on which country but these are the commonly encountered signs use for drugs in Nigeria.

Coated Tablet

Other sets of drugs that are designed to to bypass the stomach before releasing their content in other target area are term enteric coated tablets. Cuting or breaking the coat will alter this coat and lead to release of the drug in the stomach. The end result may be stomach irritation if the drug was coated to prevent the drug from irritating the stomach. On the other hand, damage, reduce potency of the drug due to acid degradation by stomach acid when the drug was coated to prevent the stomach acid from destroying it or even release the drug at the wrong site.
The symbols use for them are;
EC/EN which means enteric coated.

Special Design

The last set of drugs that should not be tampered with are effervescent or sublingual drugs. Example is methotrexate which release the active ingredient into the air immediately the physical shape of the drug is altered by cutting. The release dose may be inhaled either by the administering nurse or the patient through the nose. Since this is not the intended route of administration, the drug may then be ineffective.
They are usually identified with the word effervescent or sublingual tablet.

Drugs That Can Be Cut

Break line

There are still drugs that can be crush or cut into half. Majority of drugs that fall into the category of drugs that can be cut or broken usually come with a break line. It run along one side or both side parallel to each other. This enable the drug to be accurately half equally without lose of ingredient.
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These drugs can be cut into two equal half with the use of hand. But there is usually a little error with this method. The use of a blunt knife may end up crushing the drug if not done properly. The best way to give an accurate cut is with the use of pill cutter. They are inexpensive and available in most community pharmacy. You can also get them at Jumia and Konga here.
Buy now from Jumia:
Buy now from Konga: pill splitter

Pill splitter

Open it, insert the drug inside the cutter with the line along the knife in the cutter. Press down on the cutter for a perfect cut. This can also be use to cut into two pieces tablets without the break line.

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