Split Hairs, Not Pills-Splitting Pills Is Inaccurate and Potentially Dangerous

All physicians have had discussions with patients about splitting their medications.  Pills are usually split to decrease the cost of medications by 50%, or because of adverse effects, or because the patient has difficulty swallowing the pill.  A study published in the January issue of the Journal of Advanced Nursing (JAN) reports that nearly a third of pills that are split deviated from recommended dosages by 15%. Split tablets are often of unequal sizes and a substantial amount of the medication can be lost during the splitting process.  This variation is of particular clinical importance for heart medications, anti-coagulants, anti-depressants, and antibiotics.  Patients will split medications with scissors, table knives, or with a device specially designed for splitting pills and tablets.  The most accurate method of splitting tablets was found to be with the use of the splitting device which is available in nearly every pharmacy.  (

So what should we recommend to our patients?  If patients are going to split medications, they should first tell their doctor so this can be recorded in the chart. Second, they should a splitting device as this is the most accurate.  Finally, if it is is a problem with ingesting the medication, then suggest a liquid formulation.

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