Information For Patients On The Dangers Of Tablet Crushing
Learn more about clinical consequences for crushing tablets or opening capsules.
“Don’t rush to crush”
For patients who have difficulty swallowing, a common solution is to crush tablets or open capsules. Before crushing a tablet or opening a capsule, it is better to consider and research the impact crushing a tablet may have on the drug’s effects. It is sometimes preferable to use a different dosage form, or a different active ingredient.
The clinical consequences for the patient of crushing tablets or opening capsules can mean that the drug is less effective or more likely to cause side effects. When crushing disrupts a drug’s sustained-release properties, the active ingredient is no longer released and absorbed gradually, resulting in overdose. When a gastro-resistant layer is destroyed by crushing, underdosing is likely.
The person who crushes the tablets or opens the capsules is exposed to drug particles, which may cause side effects including allergies. In practice, there are many drugs that should never be crushed or opened.
Why you shouldn’t crush
Whether your medication is prescribed by a doctor or bought over the counter (OTC), it always comes with guidance on how you should take it to make sure it’s safe and that it works.
Medication is manufactured in a variety of formats, such as tablets, capsules, liquids or patches. These formulations have different purposes, such as slow-release or easy-swallow formulations and are rigorously tested for their safety and efficacy.
1. Some have a special protective coating
- Enteric coatings (may have EN or EC at the end of the drug name). These stop the drug breaking down in the stomach, to protect either the stomach or the drug, or to enable it to be released further along the digestive process.
- Modified or prolonged release (may have XL, LA, SR or MR at the end of the drug name). These drugs – also known as extended release, slow release or controlled release – are steadily released, which means they don’t have to be taken so frequently.
It isn’t always possible to tell if a tablet or capsule has a special modification or coating just by looking at it. If you’re unsure, check the patient information leaflet or ask your pharmacist.
2. You could be risking an overdose
3. It might make the medication unstable
4. It could put other people in danger
What to do instead of crushing
Speak to your pharmacist to see if another version of your meds are available, such as a liquid, a dissolvable or chewable tablet or even a patch (if it’s prescribed, you may need to ask your GP to amend the prescription).
ROS000051-002 DOP September 2023
- Crushing tablets or opening capsules: many uncertainties, some established dangers. Available at: https://pubmed.ncbi.nlm.nih.gov/25325120/. (Last accessed 14th September 2023)
- This is why you shouldn’t crush pills. Available at: https://www.which.co.uk/news/article/this-is-why-you-shouldnt-crush-pills-ahsgL3T5VgJN (Last accessed 14th September 2023)