Medication Safety

Do Not Crush Medication List

What Medication Cannot Be Crushed?

There are many different ways to split tablets in half. One way is to purchase a tablet splitter from your local pharmacy . These tablet splitters are safe and easy to use. All you need to do is to place the tablet in the proper place and then when the splitter is closed, a steel blade cuts the tablet in halves. Some tablets are scored and have a line dividing the dose in half and may be able to be snapped in half using your fingers. Other alternatives used are splitting by hands (for scored tablets) or with scissors (for unscored tablets), or with a kitchen knife.

However, there are medications that should never be crushed of spitted. The institute for safe medication practice (ISMP) provides a list of oral dosage forms that should not be crushed, commonly referred to as the “Do Not Crush”. This list contains medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustained-release in nature.

The ISMP do not crush list is provided in the table below:

Drug ProductActive Ingredient(s)Dosage Form(s)Reasons/Comments
Abilify MyCite kit(aripiprazole)TabletDrug-device combination
Absorica(ISOtretinoin)CapsuleMucous membrane irritant
Abstral(fentaNYL)TabletNote: Sublingual tablet; do not suck, chew, or swallow whole.
AcipHex(rabeprazole)TabletSlow-release
AcipHex Sprinkle(rabeprazole)CapsuleSlow-release; Note: contents are intended to be sprinkled on food or liquid but should not be chewed or crushed.
Acticlate(doxycycline hyclate)Capsule; TabletFilm-coated; tablet is scored and may be split; Note: 150 mg tablets can be broken into two-thirds or one-third to provide a 100 mg and 50 mg strength, respectively
Actiq(fentaNYL)LozengeSlow-release; Note: this lollipop delivery system requires the patient to slowly allow dissolution. If chewed and swallowed, may result in a lower peak concentration and bioavailability.
Actonel(risedronate)TabletIrritant; Note: chewed, crushed, or sucked tablets may cause oropharyngeal ulceration.
Actoplus Met Xr(combination)TabletSlow-release
Adalat CC(NIFEdipine)TabletSlow-release
Adderall XR(amphetamine salts)CapsuleSlow-release (a)
Adhansia XR(methylephenidate hydrochloride)CapsuleSlow-release (a)
Adzenys XR-ODT(amphetamine)TabletSlow-release; Sublingual form (g)
Aemcolo(rifamycin)TabletSlow-release
Afeditab CR(NIFEdipine)TabletSlow-release
Afinitor(everolimus)TabletMucous membrane irritant
Aggrenox(combination)CapsuleSlow-release
Alecensa(alectinib)CapsuleAntineoplastic
Alophen(bisacodyl)TabletEnteric-coated
Altoprev(lovastatin)TabletSlow-release
Alunbrig(brigantinib)TabletAntineoplastic
Ambien CR(zolpidem)TabletSlow-release
Amitiza(lubiprostone)Capsule
Amnesteem(ISOtretinoin)CapsuleMucous membrane irritant
Ampyra(dalfampridine)TabletSlow-release; Note: formerly fampridine-SR
Amrix(cyclobenzaprine)CapsuleSlow-release (a)
Aplenzin(buPROPion)TabletSlow-release
Aptensio XR(methylphenidate)CapsuleSlow-release (a)
Aptivus(tipranavir)CapsuleNote: oil emulsion within spheres; taste
Arakoda(tafenoqunie succinate)Tablet
Aricept 23 mg(donepezil)TabletNote: crushing the 23 mg tablet may significantly increase the rate of absorption; the 5 mg and 10 mg tablets are not affected
Arthrotec(combination)TabletEnteric-coated
Arymo ER(morphine)TabletSlow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose.
Asacol HD(mesalamine)TabletSlow-release
Aspirin enteric-coated(aspirin)Caplet; TabletSlow-release; Enteric-coated
Astagraf XL(tacrolimus)CapsuleSlow-release
Atelvia(risedronate)TabletSlow-release; Note: chewed, cut, or crushed tablets may cause oropharyngeal irritation
Augmentin XR(combination)TabletSlow-release (b,h)
Austedo(deutetrabenazine)Tablet
Avodart(dutasteride)CapsuleMucous membrane irritation; Note: drug may cause fetal abnormalities; women who are, or may become, pregnant, should not handle capsules; all women should use caution in handling capsules, especially leaking capsules
Azulfidine EN-Tabs(sulfaSALAzine)TabletSlow-release (b)
Balcoltra(combination)Tablet
Balversa(erdafitinib)TabletAntineoplastic
Bayer EC, Bayer Regular(aspirin)CapletEnteric-coated
Belbuca(buprenorphine)Film, buccalSublingual form (g); Note: chewing or swallowing may result in lower bioavailability.
Belviq XR(lorcaserin hydrochloride)TabletSlow-release
Biaxin-XL(clarithromycin)TabletSlow-release
Biltricide(praziquantel)TabletTaste (h)
Binosto(alendronate)TabletEffervescent tablet (f)
Bisac-Evac(bisacodyl)TabletEnteric-coated (c)
Bisacodyl(combination)TabletEnteric-coated (c)
Bisa-Lax(combination)TabletEnteric-coated (c)
Boniva(ibandronate)TabletNote: chewed, crushed, or sucked tablets may cause oropharyngeal irritation
Bonjesta(combination)TabletSlow-release
Bosulif(bosutinib)TabletAntineoplastic; Note: crushed or broken tablets should not be handled
Briviact(brivaracetam)TabletFilm-coated (b)
Budeprion SR(buPROPion)TabletSlow-release
Bunavail(combination)Buccal filmNote: chewing or swallowing may result in lower peak concentrations and bioavailability
Butrans(buprenorphine)FilmSlow-release; Note: may expose to potentially fatal overdose
Cabometyx(cabozantinib)TabletFilm-coated
Calquence(acalabrutinib)CapsuleAntineoplastic
Caprelsa(vandetanib)TabletIrritant
Carbaglu(carglumic acid)TabletNote: tablets should be dispersed completely in water
Carbatrol(carBAMazepine)CapsuleSlow-release (a)
Cardene SR(niCARdipine)CapsuleSlow-release
Cardizem(dilTIAZem)TabletNote: although not in the package insert, the drug has a coating that is intended to release the drug over approximately 3 hours
Cardizem CD(dilTIAZem)CapsuleSlow-release
Cardizem LA(dilTIAZem)TabletSlow-release
Cardura XL(doxazosin)TabletSlow-release
Cartia XT(dilTIAZem)CapsuleSlow-release
Cassipa(combination)Film, sublingualSublingual form (g)
Cefaclor ER——TabletSlow-release (b)
Ceftin(cefuroxime)TabletTaste (b) (Note: use suspension for children)
CellCept(mycophenolate)Capsule; TabletTeratogenic potential (i)
Cerdelga(eliglustat)CapsulePreferably taken with water
Cholbam(cholic acid)CapsuleNote: capsules may be opened and the contents mixed with food/drink
Cipro XR(ciprofloxacin)TabletSlow-release (b)
Claravis(ISOtretinoin)CapsuleMucous membrane irritant
Colestid(colestipol)TabletSlow-release
Cometriq(cabozantinib)CapsuleAntineoplastic
Concerta(methylphenidate)TabletSlow-release
Contrave(combination)TabletSlow-release
Conzip(traMADol)CapsuleSlow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose.
Copiktra(develisib)CapsuleAntineoplastic
Coreg CR(carvedilol)CapsuleSlow-release (a) (Note: may add contents of capsule to chilled, not warm, applesauce and consume immediately)
Cotempla XR-ODT(methylphenidate)TabletSlow-release; oral disintegrating tablet designed to disintegrate on the tongue.
Creon 5, 10, 20(pancrelipase)CapsuleSlow-release (a)
Cresemba(isavuconazium)Capsule
Crixivan(indinavir)CapsuleTaste; Note: capsule may be opened and mixed with fruit puree (e.g., banana)
Cymbalta(DULoxetine)CapsuleSlow-release
Cytoxan(cyclophosphamide)TabletNote: drug may be crushed but company recommends using injection
Daurismo(glasdegib maleate)TabletAntineoplastic
Delzicol(mesalamine)CapsuleSlow-release (a)
Depakene(valproic acid)CapsuleSlow-release; mucus membrane irritant (b)
Depakote, Depakote ER(divalproex)TabletSlow-release
Detrol LA(tolterodine)CapsuleSlow-release
Dexilant(dexlansoprazole)CapsuleSlow-release (a)
Diacomit(stiripentol)Capsule(b)
Diclegis(combination)TabletSlow-release
Dilatrate-SR(isosorbide dinitrate)CapsuleSlow-release
Ditropan XL(oxybutynin)TabletSlow-release
Doryx, Doryx MPC(doxycycline hyclate)TabletSlow-release
Drisdol(ergocalciferol)CapsuleLiquid filled (d)
Droxia(hydroxyurea)CapsuleNote: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer
Duavee(combination)TabletAntineoplastic
Duexis(combination)Tablet
Dulcolax(bisacodyl)Capsule; TabletEnteric-coated (c); Liquid-filled
Durlaza(aspirin)CapsuleSlow-release
Easprin(aspirin)TabletEnteric-coated
EC-Naprosyn(naproxen)TabletEnteric-coated (b)
Ecotrin Adult Low Strength(aspirin)TabletEnteric-coated
Ecotrin Maximum Strength(aspirin)TabletEnteric-coated
Ecotrin Regular Strength(aspirin)TabletEnteric-coated
Edluar(zolpidem)TabletSublingual form (g)
Effer-K(potassium bicarbonate)TabletEffervescent tablet (f)
Effervescent Potassium——TabletEffervescent tablet (f)
Effexor XR(venlafaxine)CapsuleSlow-release (a)
Elepsia XR(levETIRAcetam)TabletSlow-release (b)
Embeda(combination)CapsuleSlow-release (a); Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
Enablex(darifenacin)TabletSlow-release
Entocort EC(budesonide)CapsuleEnteric-coated (a)
Envarsus XR(tacrolimus)TabletSlow-release
Equetro(carBAMazepine)CapsuleSlow-release (a)
Ergomar(ergotamine)TabletSublingual form (g)
Erivedge(vismodegib)CapsuleNote: package insert indicates potential teratogenic effects; material safety data sheet warns against skin contact; health care workers should take appropriate precautions
Erleada(apalutamide)TabletAntineoplastic
Ery-Tab(erythromycin)TabletEnteric-coated
Eryc(erythromycin)CapsuleEnteric-coated pellets (a)
Erythromycin Base—–TabletEnteric-coated
Erythromycin Stearate——TabletEnteric-coated
Erythromycin ethylsuccinate——TabletTaste (b)
Evekeo ODT(amphetamine sulphate)TabletSublingual form (g)
Evista(raloxifene)TabletTaste; teratogenic potential (i)
Exalgo(HYDROmorphone)TabletSlow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)
Exjade(deferasirox)TabletNote: do not give as whole tablet, tablets are meant to be given as oral suspension; see company insert
Ezallor(rosuvastatin calcium)Capsule(a)
Farydak(panobinostat)CapsuleIrritant
Feldene(piroxicam)CapsuleMucous membrane irritant
Felodipine——TabletSlow-release
Fentora(fentaNYL)TabletNote: buccal tablet; do not swallow whole
Fetzima(levomilnacipran)CapsuleSlow-release
Fibricor(fenofibric acid)Tablet——
Fleet Laxative(bisacodyl)TabletEnteric-coated (c)
Flomax(tamsulosin)CapsuleSlow-release
FluvoxaMINE ER——CapsuleSlow-release
Focalin XR(dexmethylphenidate)CapsuleSlow-release (a)
Forfivo XL(buPROPion)TabletSlow-release
Fortamet(metFORMIN)TabletSlow-release
Fosamax(alendronate)TabletMucous membrane irritant
Fosamax Plus D(combination)TabletMucous membrane irritant
Galafold(migalastat hydrochloride)Capsule——-
Gleevec(imatinib)TabletMucous membrane irritant; Note: may be dissolved in water or apple juice
Glucophage XR(metFORMIN)TabletSlow-release
Glucotrol XL(glipiZIDE)TabletSlow-release
Glumetza(metFORMIN)TabletSlow-release
Gocovri(amantadine hydrochloride)CapsuleSlow-release (a)
Gralise(gabapentin)TabletSlow-release (b)
Guaifed, Guaifed-PD(combination)CapsuleSlow-release
Guaifenex DM(combination)TabletSlow-release (h)
Guaifenex GP(combination)TabletSlow-release
Guaifenex PSE(combination)TabletSlow-release (h)
GuaifFENesin/Pseudoephedrine——TabletSlow-release
GuaiMAX-D(combination)TabletSlow-release
Halfprin 81(aspirin)TabletEnteric-coated
Hetlioz(tasimelteon)CapsuleNote: not scored; no studies available from company
Horizant(gabapentin)TabletSlow-release (b)
Hydrea(hydroxyurea)CapsuleNote: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer
Hysingla ER(HYDROcodone)TabletSlow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
Ibrance(palbociclib)CapsuleAntineoplastic
Iclusig(PONATinib)TabletAntineoplastic
Idhifa(enasidenib)TabletAntineoplastic
Imbruvica(ibrutinib)CapsuleAntineoplastic; Note: not scored; no studies available from company
Imdur(isosorbide mononitrate)TabletSlow-release (h); Note: 30mg tablet may not be split
Impavido(miltefosine)CapsuleNote: not scored; no studies available from company
Inderal LA(propranolol)CapsuleSlow-release
Inlyta(axitinib)TabletAntineoplastic
InnoPran XL(propranolol)CapsuleSlow-release
Intelence(etravirine)TabletNote: tablet should be swallowed whole and not crushed; tablet may be dispersed in water
Intuniv(guanFACINE)TabletSlow-release
Invega(paliperidone)TabletSlow-release
Invokamet XR(combination)TabletSlow-release
Iressa(gefitinib)TabletNote: tablet may be dissolved in 4-8 ounces of water
Isradipine——TabletSlow-release
Isosorbide SR(isosorbide mononitrate)TabletSlow-release
Jakafi(ruxolitinib)TabletNote: see prescribing information for making a suspension
Jalyn(combination)CapsuleMucous membrane irritant; Note: women who are, or may become, pregnant, should not handle crushed or broken tablets (l)
Janumet, Janumet XR(combination)TabletSlow-release
Jentadueto XR(combination)TabletSlow-release
Jornay PM(methylphenidate hydrochloride)CapsuleSlow-release (a)
Juxtapid(lomitapide)Capsule——
Kadian(morphine)CapsuleSlow-release (a) (Note: do not give via NG tubes; crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)
Kaletra(combination)TabletFilm-coated (b)
Kapspargo Sprinkle(metroprolol succinate)CapsuleSlow-release (a)
Kapvay(cloNIDine)TabletSlow-release
Kazano(combination)TabletNote: not scored; no studies available from company
K-Dur(potassium chloride)TabletSlow-release (b)
Keppra(levETIRAcetam)TabletTaste (b) (Note: some extemporaneous formulas are pharmacy prepared)
Keppra XR(levETIRAcetam)TabletSlow-release (b)
Khedezla(desvenlafaxine)TabletSlow-release
Kisqali(ribociclib succinate)TabletAntineoplastic
Kisqali Femara Co-Pack(combination)TabletAntineoplastic
Klor-Con(potassium chloride)TabletSlow-release (b)
Klor-Con M(potassium chloride)TabletSlow-release (b,h)
K-Lyte, K-Lyte CL, K-Lyte DS(potassium)TabletEffervescent tablet (f)
Kombiglyze XR(combination)TabletSlow-release (Note: tablet matrix may remain in stool)
Korlym(mifepristone)TabletAdverse reproductive effects
Krintafel(tafenoquine succinate)Tablet——
K-Tab(potassium chloride)TabletSlow-release (b)
LaMICtal XR(lamoTRIgine)TabletSlow-release
Lenvima(lenvatinib)CapsuleNote: may be dissolved in a small glass of liquid
Lescol XL(fluvastatin)TabletSlow-release
Letairis(ambrisentan)Tablet——
Levbid(hyoscyamine)TabletSlow-release (h)
Levsinex Timecaps(hyoscyamine)CapsuleSlow-release
Lialda(mesalamine)TabletSlow-release
Linzess(linaclotide)Capsule(a)
Lithobid(lithium)TabletSlow-release
Lorbrena(lorlatinib)TabletAntineoplastic
Lovaza(combination)CapsuleNote: contents of capsule may be erosive
Lynparza(olaparib)CapsuleAntineoplastic
Lyrica CR(pregabalin)TabletSlow-release
Mavenclad(cladribine)TabletCytotoxic
Maxifed DM, Maxifed DMX(combination)TabletSlow-release (h)
Maxiphen DM(combination)TabletSlow-release (h)
Medent-DM(combination)TabletSlow-release
Mestinon ER(pyridostigmine)TabletSlow-release (b)
Metadate CD(methylphenidate)CapsuleSlow-release (a)
Metadate ER(methylphenidate)TabletSlow-release
Methylin ER(methylphenidate)TabletSlow-release
Micro K Extencaps(potassium chloride)CapsuleSlow-release (a,b)
Minocin(minocycline)CapsuleMucous membrane irritant
Minolira(minocycline)TabletSlow-release (h)
Miraplex ER(pramipexole)TabletSlow-release
Miraphen PSE(combination)TabletSlow-release
Morphabond(morphine)TabletSlow-release (b); Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
Motrin(ibuprofen)TabletTaste (b,e)
Moxatag(amoxicillin)TabletSlow-release (h)
MS Contin(morphine)TabletSlow-release (b); Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
Mucinex(guaiFENesin)TabletSlow-release
Mucinex DM(combination)TabletSlow-release
Mydayis(combination)CapsuleSlow-release (a)
Myfortic(mycophenolic acid)TabletSlow-release; Enteric-coated
Myorisan(ISOtretinoin)CapsuleMucous membrane irritant
Myrbetriq(mirabegron)TabletSlow-release
Mytesi(crofelemer)TabletSlow-release
Namenda XR(memantine)CapsuleSlow-release (a,b)
Namzaric(combination)CapsuleSlow-release (a)
Naprelan(naproxen)TabletSlow-release
Nerlynx(neratinib maleate)TabletAntineoplastic
Neurontin(gabapentin)Capsule; Tablet(b,h)
NexIUM(esomeprazole)CapsuleSlow-release (a)
Niaspan(niacin)TabletSlow-release
Nifediac CC(NIFEdipine)TabletSlow-release
Nifedical XL(NIFEdipine)TabletSlow-release
Ninlaro(ixazomib)CapsuleAntineoplastic
Nitrostat(nitroglycerin)TabletSublingual form (g)
Norflex ER(orphenadrine)TabletSlow-release
Norpace CR(disopyramide)CapsuleSlow-release form within a special capsule
Northera(droxidopa)CapsuleNote: no studies available from company
Norvir(ritonavir)Capsule; TabletNote: crushing tablets has resulted in decreased bioavailability of drug (b)
Noxafil(posaconazole)TabletSlow-release (b)
Nucynta ER(tapentadole)TabletSlow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
OFEV(nintedanib)CapsuleTaste
Omtryg(omega-3-acid ethyl esters A)CapsuleNote: contents of capsule may be erosive
Opana ER(oxyMORphone)TabletSlow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
Opsumit(macitentan)Tablet——
Oravig(miconazole)Tablet, buccalBuccal form
Orenitram(treprostinil)TabletSlow-release
Oseni(combination)Tablet——
Osmolex ER(amantadine hydrochloride)TabletSlow-release (b)
Otezla(apremilast)TabletFilm-coated
Oxaydo(oxyCODONE)TabletNote: not amenable to crushing; may obstruct feeding tubes (b)
Oxtellar XR(OXcarbazepine)TabletSlow-release
OxyCONTIN(oxyCODONE)TabletSlow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose
Pancreaze(pancrelipase)CapsuleSlow-release; Enteric-coated (a)
Paxil (PARoxetine)TabletFilm-coated (b)
Paxil CR(PARoxetine)TabletSlow-release
Pentasa(mesalamine)CapsuleSlow-release (a)
Pertyze(pancrelipase)CapsuleSlow-release (a)
Pexeva(PARoxetine)TabletFilm-coated (b)
Plaquenil(hydroxychloroquine)TabletFilm-coated
Pomalyst(pomalidomide)CapsuleAntineoplastic
Pradaxa(dabigatran)CapsuleNote: breaking, chewing, or emptying contents of the capsule can result in increased exposure
Prevacid(lansoprazole)CapsuleSlow-release (a)
Prevacid SoluTab(lansoprazole)TabletNote: see package insert for administration instructions via an oral syringe of NG tube
Prevpac(combination)Capsule; TabletSlow-release
Prevymis(letermovir)Tablet——
PriLOSEC(omeprazole)CapsuleSlow-release (a,b)
Pristiq(desvenlafaxine)TabletSlow-release
Procardia (NIFEdipine)CapsuleNote: pharmacokinetics may be altered if not taken whole
Procardia XL(NIFEdipine)TabletSlow-release
Procysbi(cysteamine)CapsuleSlow-release (a)
Propecia(finasteride)TabletNote: women who are, or may become, pregnant, should not handle crushed or broken tablets
Proscar(finasteride)TabletNote: women who are, or may become, pregnant, should not handle crushed or broken tablets
Protonix(pantoprazole)TabletSlow-release (b)
PROzac Weekly(FLUoxetine)TabletEnteric-coated
Pylera(combination)CapsuleMucous membrane irritant
Qtern(combination)Tablet——
Qternmet XR(combination)TabletSlow-release
Qudexy XR(topiramate)CapsuleSlow-release (a)
Ranexa(ranolazine)TabletSlow-release
Rapamune(sirolimus)TabletNote: pharmacokinetic parameters may be affected (b)
Rayaldee(calcifediol)CapsuleSlow-release
Rayos(predniSONE)TabletSlow-release; Note: delayed release is dependent on an intact coating (b)
Razadyne ER(galantamine)CapsuleSlow-release
Requip XL(rOPINIRole)TabletSlow-release
Revlimid(lenalidomide)CapsuleNote: Teratogenic potential; health care workers should avoid contact with capsule contents/body fluids
Reyataz(atazanavir)CapsuleNote: an oral powder is available, see prescribing information for administration instructions
Ritalin LA(methylphenidate)CapsuleSlow-release (a)
Roweepra(levETIRAcetam)TabletTaste (b)
Roweepra ER(levETIRAcetam)TabletSlow-release (b)
Rydapt(midostaurin)CapsuleAntineoplastic
Rytary(combination)CapsuleSlow-release (a)
Rythmol SR(propafenone)CapsuleSlow-release
Sensipar(cinacalcet)TabletNote: tablets are not scored and cutting may cause variable dosage accuracy
SEROquel XR(QUEtiapine)TabletSlow-release
Siklos(hydroxyurea)TabletNote: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer
Sinemet CR(levodopa/carbidopa)TabletSlow-release (h)
SINUvent PE(combination)TabletSlow-release (h)
Sirturo(bedaquiline)Tablet——
Sitavig(acyclovir)TabletBuccal form
Solodyn(minocycline)TabletSlow-release
Somnote(chloral hydrate)CapsuleLiquid filled
Sprycel(dasatinib)TabletFilm-coated (Note: active ingredients are surrounded by wax matrix to prevent healthcare exposure; women who are, or may become, pregnant should not handle crushed or broken tablet)
Stalevo(combination)TabletNote: combining multiple tablets or portions of tablets may lead to an overdose of entacapone
Staxyn(verdenafil)TabletSublingual form (g)
Stivarga(regorafenib)TabletAntineoplastic
Strattera(atomoxetine)CapsuleNote: capsule contents can cause ocular irritation
Suboxone(combination)Film, buccalSublingual form (g)
Sular(nisoldipine)TabletSlow-release
Symax Duotab, Symax SR(hyoscyamine)TabletSlow-release
Syndeko (copackaged)(combination)Tablet——
Synjardy XR(combination)TabletSlow-release
Tafinlar(dabrafenib)CapsuleAntineoplastic
Tagrisso(osimertinib)TabletNote: tablet may be dissolved in 2 ounces of water
Talzenna(talazoparib tosylate)CapsuleAntineoplastic
Tasigna(nilotinib)CapsuleNote: disruption of capsule may yield high blood levels causing enhanced toxicity (a)
Taztia XT(dilTIAZem)CapsuleSlow-release (a)
Tecfidera(dimethyl fumarate)CapsuleSlow-release
Tegretol-XR(carBAMazepine)TabletSlow-release
Tekturna(aliskiren hemifumarate)CapsuleEmpty contents into a spoon for administration. Do not swallow the capsule. Do not chew or crush the contents of the capsule. (a)
Temodar(temozolomide)CapsuleMucous membrane irritant; Note: accidentally opened or damaged capsules require rigorous precautions to avoid inhalation or contact with the skin or mucous membranes (i)
Tessalon Perles(benzonatate)CapsuleNote: swallow whole; local anesthesia of the oral mucosa; choking could occur
Theo-24(theophylline)CapsuleSlow-release; Note: contains beads that dissolve throughout the GI tract
Theochron(theophylline)TabletSlow-release
Tiazac(dilTIAZem)CapsuleSlow-release (a)
Tibsovo(ivosidenib)TabletAntineoplastic
Tolsura(itraconazole)Capsule(b)
Topamax(topiramate)Capsule; TabletTaste; Taste (a)
Topamax Sprinkle(topiramate)CapsuleTaste (a)
Toprol XL(metoprolol succinate)TabletSlow-release (h)
Touro CC-LD(combination)TabletSlow-release (h)
Touro LA-LD(combination)TabletSlow-release (h)
Toviaz(fesoterodine)TabletSlow-release
Tracleer(bosentan)TabletNote: women who are, or may become, pregnant, should not handle crushed or broken tablets
Trental(pentoxifylline)TabletSlow-release
Treximet(combination)TabletNote: unique drug matrix enhances rapid drug absorption
Trilipix(fenofibric acid)CapsuleSlow-release
Trokendi XR(topiramate)CapsuleSlow-release
Trulance(plecanatide)TabletNote: see package insert for instructions on crushing administration
Uceris(budesonide)TabletSlow-release; Note: film coating is designed to break down at or above pH of 7.0
Uniphyl(theophylline)TabletSlow-release (h)
Uptravi(selexipag)TabletFilm-coated
Urocit-K(potassium citrate)TabletSlow-release; Wax-coated; prevents upper GI release
Uroxatral(alfuzosin)TabletSlow-release
Valcyte(valGANCiclovir)TabletTeratogenic and irritant potential (b, i)
Vascepa(icosapent ethyl)Capsule——
Venclexta(venetoclax)TabletFilm-coated, Antineoplastic
Verelan, Verelan PM(verapamil)CapsuleSlow-release (a)
Verzenio(abemaciclib)TabletAntineoplastic
VESIcare(solifenacin)TabletTaste
Videx EC(didanosine)CapsuleSlow-release; Enteric-coated
Viekira XR(combination)TabletSlow-release
Vimovo(combination)TabletSlow-release
Viokace(pancrelipase)TabletMucous membrane irritant
Viramune XR(nevirapine)TabletSlow-release (b)
Vitrakvi(larotrectinib)CapsuleAntineoplastic (b)
Voltaren XR(diclofenac)TabletSlow-release
VoSpire ER(albuterol)TabletSlow-release
Votrient(PAZOPanib)TabletNote: crushing significantly increases the AUC and Tmax
Vyndamax(tafamidis)Capsule——
Vyndagel(tafamidis meglumine)Capsule——
Wellbutrin(buPROPion)Tablet——
Wellbutrin SR, Wellbutrin XL(buPROPion)TabletSlow-release
Xalkori(crizotinib)CapsuleAntineoplastic
Xanax XR(ALPRAZolam)TabletSlow-release (b)
Xartemis XR(combination)TabletSlow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose)
Xeljanz XR(tofacitinib)TabletSlow-release
Ximino(minocycline)CapsuleSlow-release
Xigduo XR(combination)TabletSlow-release
Xospata(gilteritinib fumarate)TabletAntineoplastic
Xtampza ER(oxyCODONE)CapsuleSlow-release (a, b)
Xtandi(enzalutamide)CapsuleAntineoplastic
Yonsa(abiraterone acetate)TabletAntineoplastic
Yosprala(combination)TabletSlow-release
Zegerid(combination)CapsuleSlow-release (b)
Zejula(niraparib tosylate)CapsuleAntineoplastic
Zelboraf(vemurafenib)TabletAntineoplastic
Zenatane(ISOtretinoin)CapsuleMucous membrane irritant
Zenpep(pancrelipase)CapsuleSlow-release (a)
Zohydro ER(HYDROcodone)CapsuleSlow-release; Note: crushing, chewing, or dissolving capsules can cause rapid release and absorption of a potentially fatal dose
Zolinza(vorinostat)CapsuleNote: irritant; avoid contact with skin or mucous membranes; avoid contact with crushed or broken tablets
Zortress(everolimus)TabletNote: crushed powder may cause mucous membrane irritation
Zubsolv(combination)TabletSublingual form (g)
Zuplenz(ondansetron)Film, oralSublingual form (g)
Zyban(buPROPion)TabletSlow-release
Zydelig(idelalisib)TabletAntineoplastic; Note: not scored; film-coated
Zytiga(abiraterone)TabletAntineoplastic
Zyflo CR(zileuton)TabletSlow-release

a: Capsule may be opened and the contents taken without chewing or crushing; soft food such as applesauce  or pudding may facilitate administration; contents may generally be administered via NG tube using an appropriate fluid provided entire contents are washed down the tube.

b: Liquid dosage forms of the product are available; however, dose, frequency of administration, and manufacturers may differ from that of the solid dosage form.

c: Antacids and/or milk may prematurely dissolve the coating of the tablet.

d: Capsule may be opened and the liquid contents removed for administration.

e: The taste of this product in a liquid form would likely be unacceptable to the patient; administration via NG tube should be acceptable.

f: Effervescent tablets must be dissolved in the amount of diluent recommended by the manufacturer.

g: Tablets are made to disintegrate under the tongue.

h: Tablet is scored and may be broken in half without affecting release characteristics.

i: Skin contact may enhance tumor production; avoid direct contact.

For More Information Visit : What Are The 5 R’s For Medication Safety?

<

Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
Back to top button

Adblock Detected

Please consider supporting us by disabling your ad blocker