The do’s and don’ts of splitting pills or chewable tablets

To split or not to split? That is the question. Here are some things to consider first.

Maybe you want to save money on your prescriptions. Maybe your current medication is too difficult to swallow whole. Or maybe your medication isn’t available in your prescribed dosage. Whatever your reason may be, before you start splitting pills, it’s important to consider the risks associated with doing so — as well as which ones can be split safely and which ones can’t.

How do I know if my pills are safe to split?

One way to tell if a pill is likely safe to split is to look for a score line down the middle. You can also check the patient package insert that comes with your medication to see if it’s FDA-approved to split.

However, just because a medication can be split doesn’t mean that it should be. Always check with your doctor or pharmacist before splitting any of your pills.

When is it not safe to split pills?

If your medication is very small, has an uneven shape, or is filled with gel or powder, it will generally be too difficult to split evenly and safely. You also run the risk of the medication crumbling.

Most sustained, controlled, or time-released medications aren’t meant for splitting because they are designed to release medication throughout a specific period of time. By cutting a time-released medication, you run the risk of having too much or too little in your body at once. If you’re taking a medication with a narrow therapeutic index or window, even a small difference in dose or blood concentration can lead to life-threatening outcomes.

It’s also not recommended to split tablets with a hard outer coating. This coating is usually there to help make the medication easier to swallow. If you split the medication, it becomes harder to swallow and may also change the way the medication is absorbed. Most capsules are meant to be swallowed whole, not chewed or crushed. In some cases, the contents of the capsule may be opened and sprinkled on food — but always check with your pharmacist.

Can splitting pills actually save me money?

Splitting pills is not necessarily the best way to save money on medications and you do run the risk of human error. Talk to your pharmacist before you do. They may be able to suggest less expensive medication options to help lower the cost.

How can I split pills safely?

The best way to split pills is to use a tablet splitter or pill cutter. These specialized cutters have a v-shaped pill holder and a retractable blade. You’ll want to place the pill inside the v-shaped holder with the score line directly in the middle. Then quickly press downward on the blade to cut the pill. If you do this too slowly, the pill is more likely to crumble.

Can I split the entire supply of pills at one time?

It’s generally recommended to split one tablet at a time and to wait until you’ve taken both halves before splitting the next tablet. Cutting pills exposes your medication to air, heat, and moisture, potentially making it less potent.

Talk to your pharmacist

When in doubt, always talk to your pharmacist before you split your medications. In cases where medications cannot be split, your pharmacist may be able to recommend a different medication that is the proper strength, a lower-cost medication, or a pill that is smaller in size and easier to swallow.

If your health benefits include Express Scripts^® Pharmacy, our specially trained pharmacists are available 24/7 to discuss all of your medications and answer any questions or concerns, including whether or not it’s a good idea to split your pills or chewable tablets.