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Pill Splitting? Do it Safely

prescription savings pill-splitting - wellrx

by Hayde Blanco, PharmD Candidate
University of Arizona College of Pharmacy

Pill splitting refers to breaking a pill down to obtain a smaller amount of the whole pill. Your doctor can write a prescription that is usually double the dosage of what you should take in one day. You can then cut the pill in half, making the smaller dose that should actually be taken. For instance, a medication might be prescribed for 40 mg, but then the pill is split so you actually end up taking 20 mg.

Why Split Pills?

Pill splitting can be a huge help in cost savings if the same amount of the larger and smaller doses are sold at a similar price. Some of the most common reasons for pill splitting are:

  • Reduce the costs associated with a medication
  • Take a dosage of a drug that is not already available.

These methods can be useful to help some people save on their prescription medications, but are not suitable for everyone or for every type of pill. There are some risk factors that should be taken into consideration before splitting any pills.

Pill Splitting Concerns

When a pill is split, there may be different amounts in each half of the pill. Since the active ingredient in each pill is not usually evenly distributed throughout the pill, this may lead to one half containing more of the active ingredient than the other, giving it more potency. Some pills may be hard to split due to having an unusual shape, being too hard, or crumbling easily. There are also some medications that should never be split.

Pharmaceutical companies create some pills that are scored, meaning that they have a line down the middle to make it easier to split.

pill splitting sertaline
This pill is generic sertraline 100mg (an antidepressant) with a line down the middle. Generic pricing for 30 tablets of 100mg averages about $11.50. Generic pricing for 30 tablets of 50mg averages about $10.00. By cutting the 100mg dose in half, you would save close to half of the cost.

Some of the risk of pill splitting is related to the individual, instead of being related to the pill. A common issue is forgetting to split a pill, which could lead to taking double the amount of the prescribed dose. The directions might also be unclear if the bottle says to take one daily, but your doctor says to take one-half daily. You should always verify with your doctor if you are not sure about the prescription dosage you should be taking.

​Although there are risks involved with pill spitting, it can be an appropriate cost saving technique for some people. If pills are being split, there are some recommendations that should be followed to reduce the risks.

What are the Risks?

Some of the risk can be related to the individual instead of being related to the pill. A common issue is forgetting to split a pill, which could lead to taking twice or more of the needed dose. The directions might also be unclear if the bottle says to take one daily, but your doctor says to take one-half daily. Always verify with your doctor if you are not sure how much you should be taking.

​Although there are risks involved with pill spitting it can be an appropriate cost saving technique for some people. If pills are being split, there are some recommendations that should be followed to reduce the risks.

Splitting Pills Safely

  1. Always discuss your choices with a pharmacist or doctor before deciding to split a pill.
  2. Have a general understanding of which pills are appropriate to split and which are not.
  3. Use an appropriate pill cutter. Using a pill cutter instead of a knife or other object cuts the pill more evenly and leads to better distribution of the active ingredient.
  4. Cut the pills right before taking them instead of cutting them all at the same time. Since the distribution of the active ingredient is often not the same on both sides, taking both halves on consecutive days allows for a more even intake of the active ingredient. Additionally, a medication might not be as effective at treating your symptoms when it is broken down and exposed to air and moisture over time.
  5. Make sure you are can put this into practice safely or have someone help you if you can’t. If you have any problems with memory, trouble using your hands, or do not think you would be able to split the pills on an ongoing basis this will not be an appropriate technique to use.

These medications are usually appropriate to split, but always check with your pharmacist or doctor if it is okay to split your medication:

  • High blood pressure medications
  • High cholesterol medications (statins, like Lipitor, Crestor, or Zocor)
  • Depression medications.

These pills should not be split:

  • Capsules
  • Enteric-coated medications
  • Extended release or long acting medications
  • Combination pills containing more than one drug
  • Prepackaged pills, like birth control
  • Certain classes of medications, such as chemotherapy drugs
  • Pills with a small therapeutic index (these pills need to be taken at a very precise dose because they can lead to side effects more easily if more than the prescribed dose is taken or they might not be as effective if too little is taken).

Always remember to talk to your healthcare provider to be sure it’s appropriate for you to split a certain pill before using this cost saving technique. When done correctly, pill splitting can be a safe and effective method to reduce prescription medication costs.

 

References:

https://www.linkedin.com/pulse/tablet-splitting-risky-practice-stuart-silverman

http://www.consumerreports.org/drugs/is-it-safe-to-split-pills-in-half/

http://www.consumerreports.org/drugs/get-the-right-pill-splitter-and-save-money-on-your-medication/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827917/


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