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Pill Splitting

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According to Consumer Reports On Health: "The Food and Drug Administration ... called splitting pills a "risky practice" and does not encourage it unless it has specifically approved a drug for that purpose.  Still, our analysis of the research has found that many drugs can be safely split as long as you do it carefully and with the guidance of a medical professional." 

Talk with your doctor or pharmacist before splitting a pill. Not all drugs are safe for splitting. . 

Pill splitting saves money.

  • A tablet twice the content often costs close to the same as a tablet with half the same medication.
    • If you pay a percentage of your drug costs, the percentage you pay will be calculated on a lower medication cost.
    • If you pay a flat dollar co-payment for your prescriptions, your co-payment will be cut in half.
    • If you pay for drugs yourself, your costs will be cut in half.
  • Some tablets are scored. Others require a tablet splitter available at most pharmacies for $5 - $15. Insurance does not usually cover the cost of the splitterbut your savings in one month usually make up for the cost.
  • In order to receive a larger size pill, your health care provider will need to write you a new prescription for the higher strength tablet that can be split.
  • Caution: Ask your doctor or pharmacist whether the pill is safe to split.

It is not safe to split all pills. For instance, it is not safe to split:

  • A time released (sustained-release action) pill.
  • A pill with a coating that can't be broken without compromising the drug's potency -- which could be true even if the pill is scored.
  • Drugs with substantial toxicity or where the correct amount of the drug is absolutely critical. For instance, heart medications where critical dosages should not be changed arbitrarily.

Pill splitting is not recommended for people who may have difficulty organizing or performing the pill splitting task. For instance, pill splitting is not recommended for people who have manual dexterity problems, are frail, are confused or who have poor eyesight.

The fact that most pills do not split precisely in half is generally not a problem

  • A study in 2002 indicated that when pills are split, more than 40% of the resulting split tablets deviated by 10% or more from the target weight, and more than 10% of the split tablets deviated by at least 20%.
  • Some health insurers do not promote the practice because they say it is a patient-safety issue. On the other hand, Kaiser Permanents encourages the practice. It's CEO in 2004, George Halvorson, said that "therapeutically I have not heard of any negative issues."
  • Also, before it became a cost-saving tool in the 1990s, pill splitting was an accepted practice for patients prescribed odd-size doses, such as a tablet and a half a day.

How To Split A Pill

It is best to use a pill splitter rather than using a knife or scissors. Studies have found that pill splitters come closest to dividing medication into equal halves. There are even pill splitters for oddly shaped pills.

You can find pill splitters at drug store for very little money. Some insurance companies even offer splitters free of charge. 

Do not split pills in advance.

It is preferable to split a pill on the day you take the first half.  Take the second half as your next dose. This procedure helps keep the drug from deteriorating due to exposure to heat, moisture or air. It also helps to insure that any deviation in the size of one dose is compensated for in the next dose.

How to test if pill splitting works for you

Begin with a trial dosage of the size the doctor wants because pills don't usually split exactly down the middle so the dosage will be slightly uneven. If you start with the prescribed dosage, you will be sure the medication works for you. Once you know the pill works for you, consider a trial dosage such as a 30-day supply to see if pill splitting is right for you since pill splitting can be a hassle, and it's unlikely the split will be even. With the change in dosage, is the drug still effective? Are there side effects? If pill splitting doesn't work for you, you can return to the previous prescription in regular form.

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Pill Splitting

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