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Tablet Crushing Issues

Many people struggle at times to take their medicine because of swallowing difficulties. As a result, it is common that people may resort to crushing tablets or opening capsules to help make swallowing medication easier.1

What are the consequences of tablet crushing or opening capsules?

The NHS advise that you shouldn't chew, crush and break tablets, or open and empty powder out of capsules, unless your doctor or another healthcare professional has told you to do so. Crushing tablets or opening capsules can cause a major change to how your medicine works, some don’t work properly or can become harmful.2

Elderly patient with tablets in hand Patient talking to GP at desk


Tablets and capsules are very complex and specifically developed to treat the patient’s condition.3 Some are designed to be released over several hours, others have special coatings to protect your stomach or to protect the active ingredient from the stomach acid. Crushed tablets may also taste unpleasant without their special coating.2 It isn’t possible for you to tell if it is safe for you to crush your medicine.3

If a tablet is crushed or a capsule opened, it could mean that the medicine is released into your body all at once when it should be released slowly over many hours. This means you are more likely to receive a very high dose and experience side effects. It could also make your medicine less effective because you do not receive the correct dose.3

When is it ok to crush tablets or open capsules?

Before a prescription is written, it’s important that patients are asked whether they have any difficulty swallowing tablets or capsules. Whenever a swallowing difficulty is identified, the doctor will look to investigate and identify the cause of the issue and treat this appropriately.3

There are many different formats of medication which give options to a patient with difficulties swallowing, your doctor should discuss these with you to find the most appropriate and acceptable one for you. Formats include liquid, dispersible, buccal, sublingual, rectal, transdermal, intranasal or via injection.3 Most commonly available medications are now available in a liquid form. Liquids may be the most appropriate solution for someone suffering from swallowing difficulties.4

Crushing tablets or opening capsules should only be advised as a last resort and only by a doctor or pharmacist. If a healthcare professional does advise the manipulation of your medication, it is important that you are told how to do this safely and appropriately.3

Also, it’s important to remember, your circumstances may change over time. A prescription your doctor has written for you in the past may no longer be the most appropriate way for you to take your medication. It’s important that if you are having problems swallowing your medicines, you inform a healthcare professional such as your doctor, nurse or pharmacist.

Pharmacist reading prescription Elderly patient with nurse


There is a solution

Your pharmacist will be best able to advise you if your medicine is available in a liquid form. If you can swallow liquids safely, a liquid medication will make the medicine easier for you to swallow and will help to ensure that your treatment is working as effectively as it should be.4

For further information about swallowing difficulties and dysphagia visit: www.swallowingdifficulties.com

View References

1. Strachan, I & Greener, M. (2005) Medication-related swallowing difficulties may be more common than we realise. Pharmacy in Practice. Volume 15; issue 9; p411–414. | 2. https://www.nhs.uk/common-health-questions/medicines/can-i-crush-medicines-before-taking-them/ (accessed 6th April 2020) | 3. Wright et al. 2011. Prescribing Medicines for Patients with Dysphagia. A handbook for healthcare professionals. | 4. Medicines Management and Older People- a guide for healthcare professionals. Edited by R Greenwall. August 2016.

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