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Drugs

pill bottleIt is important that you understand that drugs cannot always be crushed or chewed.
There are several reasons why certain tablets and capsules must be left intact.
Some just taste bad and are coated with something more pleasing. Other drugs are irritating to the stomach and the tablet or contents of a capsule are coated to delay the release of the active ingredient in the drug until it reaches your intestines.
Under the tongue drugs may not work correctly if they are altered by crushing and chewing.
Technology is also a consideration. The drug industry has learned to design tablets and capsules to release medication slowly into the body. This allows for more convenient dosing intervals - taking the drug once or twice a day rather than four or more times a day.

Often, this slower release of the active ingredients in the drug helps to prevent side effects and maintain a good level of the drug in your body.

* Slow release products can often be identified by abbreviations in the name. Examples include (but are not limited to):

-CR (controlled release),
-CD (extended release),
-LA (long acting),
-SR (sustained release),
-XR (extended release),
-TR (timed release),
-EL (extended length) and
-TD (time delay)

Other extended release products do not have any abbreviations in the name for clues. One example is Oxycontin, a powerful narcotic pain reliever.

Crushing or chewing these drugs will often allow too much of the active ingredients to be delivered too fast. This may result in bad health consequences.

To sum up for people who cannot swallow whole tablets or capsules:

- Some medications should not be crushed or chewed.

pills- Read the printouts that come with most drug prescriptions and ask your Physician and Pharmacist specific questions.

- If you discover a problem, consult with your Physician, Pharmacist, Nurse, and Dietitian about possible alternatives such as liquids, immediate release products, or using the contents of some capsules in soft food or feeding tubes, so long as these particles are not crushed or chewed

Additional Information

The following is a web site to provide you with more information on what drugs can NOT be crushed or chewed.

Virtual Hospital

References:

Kaufman, M. (2009). To crush or not to crush. The Hospitalist. Retrieved from
http://www.the-hospitalist.org/details/article/184167/To_Crush_or_Not_to_Crush__.html

Mitchell, J. F. (2000). Oral dosage forms that should not be crushed - 2000 Update. Hospital pharmacy, 35(5), 553-567.

Mitchell, J. (2011). Oral dosage forms that should not be crushed. Retrieved from http://www.ismp.org/tools/donotcrush.pdf

Thomson Medical Economics. (2002). Drugs that should not be crushed. In Drug topics red book (pp. 21-24). Montvale, NJ: Author

Developed in 2003 by Gregory Siegel, JD, RPh at The University of Toledo for the Caring~Web©.

Revised 2010, 2012

Last Updated: 6/17/14