Crushing or splitting medications: unrecognized hazards

Given the high use and the cost of medications in the current economy, one way older adults may save money on prescription costs is to split some of their medications in half. However, not all oral medications can be split. Splitting inappropriate medications such as extended-release tablets can be harmful and in some instances very dangerous. In addition to splitting medications, older adults who have difficulty swallowing pills may resort to crushing the medication for ease of administration. This option is also problematic and potentially harmful if the medication is not intended to be crushed. Clinicians managing the care of older adults need to discuss medication administration, clarify the dosing schedule, and clearly indicate the route of administration. Patients should be cautioned not to split or crush a medication without checking with the health care provider or pharmacist.