Why it can be dangerous to split tablets in half
13/9/2023
Translation: Elicia Payne
There’s no generally applicable answer to whether you can split a tablet in half. In some cases it’s not a problem, in other cases it can be dangerous. Read on to find out what you need to pay attention to.
Every once in a while, I take half a painkiller when I feel like half the active ingredient will be enough to relieve my pain. I never really thought about whether that was the smart thing to do and whether I might even be hurting myself.
The fact that it would be practical to halve or quarter a tablet can have different reasons. For example, children or older people often need less of the active ingredient. If the medicine isn’t available in a lower dosage, there’s no alternative except crushing the pills. Some people also find it difficult to swallow particularly large tablets. Then cutting it into two smaller pieces can help. In some cases, however, it may simply be a matter of money, when pills with a higher concentration of active ingredient are sold at a lower price.
Only split tablets if explicitly allowed to do so
In principle, pharmacists and medical staff give the same general advice: you should only split tablets in half if this is explicitly mentioned as a suitable option on the information leaflet. Because there are, in fact, some reasons against crushing the pills on your own. It can even be dangerous. So if there’s nothing in the information leaflet about breaking up the tablet, you should check with your pharmacy whether it’s safe to do so with that particular medicine. After all, in some cases it’s safe to do so even when it’s not stated on the leaflet. Pharmaceutical companies have no obligation to state such information in the leaflet.
Appearances are sometimes deceptive: look out for indentations
«Scoring» i.e. an indentation line shows that the pills are suitable for splitting, but unfortunately not a guarantee. Sometimes the indentation line is a «decorative score» which is merely there to help distinguish tablets.
Two equal sized tablet halves – not so easy
But why shouldn’t I just break a tablet in half?
First of all, it’s difficult (especially without an indentation) to actually break a tablet exactly in half. Depending on the active ingredient, there may not be the desired amount of it in the pill piece you broke off. If the tablet crumbles when it’s split, it’s almost impossible to estimate the amount of active ingredient.
A solution to this problem comes in the form of tablet splitters which can divide pills both with and without an indentation:
This way you’ll get tablet halves of the same size. With medications that are suitable for this, you can be sure to take half the active ingredient with half the tablet.
Half a tablet doesn’t always mean half the amount of active ingredient
Unfortunately, this doesn’t always work, especially with pills that only contain a small amount of active ingredient. It’s possible that it isn’t evenly distributed in the tablet. Even if you do get an exact division, this doesn’t mean it contains the desired amount of drug. If there’s little in total, half a tablet doesn’t necessarily have half the medicine in it. In the worst case, this could lead to an overdose if the ingested portion contained most of the active ingredient.
Pills with protective cover must not be broken
Another reason why tablets shouldn’t simply be split in half is some have a special coating on the surface (sustained-release tablets). Some tablets are designed to deliver the contained drug gradually into the body. To ensure they dissolve gradually and thus release the active ingredient successively, these pills are coated with a protective coating. If you split it before you take it, the sustained-release is gone and the drug enters the body too quickly. This doesn’t just prevent or shorten the effect, but it can also have very serious consequences if there’s an overdose with the active ingredient.
A protective coating may also be designed to protect the medicine from stomach acid. If you divide these tablets, the protective function no longer works and the active ingredient is decomposed in the stomach.
By the way, I took the advice to look at the ibuprofen information leaflet, because I just break them in half at times. I was relieved to find that these tablets can also be taken in halves. So you don’t need to worry about them. However, if in the future, I ever consider swallowing half a pill, I’ll inform myself in advance to be on the safe side.
Header image:cottonbro studio/Shutterstock
Science editor and biologist. I love animals and am fascinated by plants, their abilities and everything you can do with them. That's why my favourite place is always outside - somewhere in nature, preferably in my wild garden.
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