If you have trouble swallowing pills and don’t have an alternative like syrup, crushing the pill may be a reasonable option. However, not every pill can be crushed because it can affect the absorption of the drug and reduce the expected effect.
Before crushing a pill, talk to your prescribing doctor about whether this is safe to do. If a pill can be crushed, there is a right way and a wrong way. Here’s a primer that can help.
What drugs can crush?
Not all pills can be crushed. Sometimes doing so can decrease the effectiveness of the medicine or increase the risk of side effects and overdose.
The medicines below must not be crushed.
Entericcoated drug Never crush, break or chew. The medicine is coated to reduce stomach irritation. The special coating gradually dissolves as it passes through the stomach so that the drug begins to be released as it enters the intestines.
Some medications are also coated in the intestine to prevent tooth staining or to prevent stomach acid from destroying the medication. If not swallowed whole, these medications may be less effective and more likely to cause side effects.
Enteric coated tablets usually have the tag “-EN” (enteric-coated) or “-EC” (enteric coated) at the end of the brand name.
Some examples of enteric coated drugs include:
You can usually tell that a pill is coated in the intestine when it has a slight sheen. If in doubt, call your pharmacist.
sustained release drug
Sustained-release drugs are similar to enteric-coated tablets in that they are absorbed slowly rather than all at once. Crushing the pill causes the drug to be released at the same time. These products typically have brand names ending in “-CR” (controlled release), “-DA” (delayed action), and “-ER” or “-XR” (extended release) ), among others.
Medications like these can include things like:
This reduces the effectiveness of the drug because the drug concentration will be high at first and then decrease rapidly so that it is not left in the body. Initial high levels may also increase the risk (or severity) of side effects.
You should never crush drugs, also known as opioids. These drugs are highly addictive and are designed to release at a steady, controlled rate.
The rapid release of opioids in the bloodstream can enhance the effects of the drug, including pain relief and feelings of euphoria. This can increase the risk of drug overdose. It can also increase the risk of addiction as the body gets used to the rapid burst of the drug and is increasingly demanding more and more to achieve the same effects.
Some commonly prescribed opiates include:
Not all tablets can be crushed. These include enteric coated or extended-release tablets. Especially never crush opiate drugs as it increases the risk of addiction and overdose.
How to crush pills
Many pharmacies put a sticker on the package saying they are not crushed. If you don’t see a warning label, ask your doctor or pharmacist before crushing any pills.
There are three safe and effective ways to do this if a pill can be crushed.
The device works by grinding a pill into a fine powder to mix with food or drink.
Most pill crushers are hand-held devices that you twist to achieve a fine grind. Others look like a stapler or garlic grinder that you hold to crush the pill.
Mortar and pestle
This tried-and-true device is always a good choice, but it may not be easy if you have arthritis. Purchase mortars and pestles with smooth surfaces to prevent powered medicine from getting lost in the grooves. Use the device to crush tablets only to avoid contamination.
You can’t crush certain pills, but they can be broken down. In this case, you can buy an inexpensive pill divider to cut the pills in half or even quarters.
Drop the tablet into the lidded container and close the lid. The separator helps you avoid cutting your fingers with a knife if the pill is small or round.
What not to do
Some people like to crush pills by putting them in a plastic bag and hitting them with a hammer or mallet. But this is a problem for a number of reasons:
- It can make holes in the bag, causing you to lose your medication and reduce your dose.
- Powdered medicine may collect in the corners of the bag, making it difficult to remove.
- Some medications can get stuck in the plastic.
- It can leave small debris stuck in your throat, causing choking.
It is also not a good idea to mix the crushed tablets. If you need to crush two or more pills, each pill should be crushed separately and taken separately.
In addition to crushing your current medication, you need to find out what foods you may or may not mix the drug with. You can safely mix many medications with things like apple sauce, fruit juice, pudding, or water, but not just with food.
Certain foods can decrease the effectiveness of crushed pills. For example, grapefruit juice can significantly affect how a drug is absorbed and metabolized (broken down or activated) in the body, changing its concentration in the blood.
Even if you can mix the tablet with food, your healthcare provider may recommend that you take it only with a small amount of soft food. While sprinkling it over yogurt or porridge can help remove the bitterness, you can lose a lot of medicine if you don’t finish the bowl and scrape the bottom thoroughly.
You may also have to take some medications without food and deal with the bitter taste some medications leave behind.
If you or your child have trouble swallowing, ask your doctor or pharmacist if you can take other formulations. This may include chewable tablets, gum, syrup, suspension, powder, suppositories, and dissolvable sublingual (sublingual) tablets.
Crushing a pill is only half the problem. You also need to know what foods or drinks are allowed to mix drugs and, in some cases, how much food you can mix with it.
Crushing the medicine may be okay if you or your child have trouble swallowing the medicine. However, it’s important to remember that not all medicines are crushable, especially enteric-coated or extended-release tablets and opiates.
If you can crush the pill, use a recommended method such as a pill mill or mortar and pestle to grind the pill into a fine powder. Ask your doctor or pharmacist how you should take your powdered medicines, including what foods or drinks are acceptable to take them.
If the medicine you take cannot be crushed, ask your doctor if you can use other formulations such as syrup or suspension.
A very good word
If you have trouble swallowing pills, talk to your doctor to determine if there may be a medical cause for the condition. DysphagiaThe medical term for difficulty swallowing, which can be caused by any number of reasons, including acid reflux, untreated sores, or certain neurological conditions.
Swallowing problems can sometimes be easily treated and can help you improve your ability to swallow pills and your overall quality of life.
frequently asked Questions
What happens if you chew a pill?
Like crushing pills, chewing certain medications can cause problems.
Most importantly, some drugs release the active ingredient at a steady rate. Chewing them can change the absorption and effects of the drug. It can also irritate the mouth, throat, or stomach.
Can you crush acetaminophen?
There are several Tylenol (acetaminophen) formulations that you can crush, but extended-release formulations should not be broken down.
Extended-release Tylenol contains 650 milligrams (mg) of acetaminophen. Extended-release Tylenol must be swallowed whole to avoid side effects such as nausea and upset stomach.
Can I dissolve the medicine in water to drink?
You can safely dissolve some medications in water or another substance such as apple sauce. However, you need to check with your doctor and pharmacist to make sure that your medicine will not cause side effects or complications if it is taken as a dissolving agent.
If you’re okay, remember to take all the medicine. It is easy for some to be left behind or thrown away, which can lead to missed doses.
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