Abstract

PILL SPLITTING A RISKY PRACTICE.

Dr. Saima Yaseen Baig*, Lubna Bashir, Erum Naz, Shazia Naz, Dr. M. Ghiasuddin Siddiqui, Dr. Kauser Yasmeen and Ahmed Kamal

Abstract

The splitting of scored tablets provides a lot of advantages. One advantage is to realize dose flexibility to account for the vast interindividual differences in dose requirements for example in paediatric and geriatric patients, which are often not covered by the existing strengths in the market. Moreover, large-sized tablets can easier be swallowed if broken down before swallowing and tablets costs can often be reduced by splitting brands with higher potency. But not all tablets, mostly unscored tablets, are appropriate for splitting. Splitting of extended release formulations can effect in an overdose by uncontrolled release of the active constituent and degradation of the compound can arise if an enteric coating is damaged by the splitting process. Whether tablets are appropriate for splitting depends on the properties of the active constituent (e.g. light sensitivity), the galenics, the shape of the tablet, and the profile of the scoreline. Furthermore, not all patients are informed, able, or willing to divide tablets and the majority of the elderly population is not able to break tablets. When split tablets are prescribed it is therefore essential to examine the shape of the tablet, to assess the patients capability and willingness to split tablets, to properly inform the patient about the suitable ways of splitting, and if essential to recommend the use of a tablet splitting device. Patients should be cautioned not to split or break a medicine without checking by means of the health care provider or pharmacist.

Keywords: The galenics, the shape of the tablet, and the profile of the scoreline.