You shouldn’t chew, crush or break tablets or pills, or open and empty powder out of capsules, unless your physician or another qualified healthcare professional has told you to do so.
Experts warn that some tablets, pills and capsules don’t work properly or may be harmful if they’re crushed or opened.
They also gave reasons why tablets may need to be swallowed.
According to experts at the United Kingdom’s National Health Service, tablets, pills and capsules are designed to release medicine slowly into your body over time and crushing them could cause an overdose.
They also said stomach acid could stop the drugs from working if they are stripped of their special coating.
“Crushed drugs could be harmful to the lining of your stomach without their special coating; while they may also taste unpleasant without their special coating,” NHS warned; adding, “you could get side effects from inhaling powder from crushed medicines.”
Indeed, experts say, if you’ve been advised by your healthcare professional to crush your medicine, they will also tell you how to do this and how to take the medicine.
Speaking to our correspondent, clinical pharmacist, Dr. Charles Nwako warns patients to refrain from crushing enteric-coated and encapsulated medications before taking them.
He said patients risk developing adverse drug effects from the practice.
An enteric coating is a polymer barrier applied to oral medication that prevents its dissolution or disintegration in the gastric environment.
It helps by either protecting drugs from the acidity of the stomach, or the stomach from the detrimental effects of the drug.
Drugs encapsulation, on the other hand, is a pharmaceutical strategy designed to cope with the limitations of conventional dosage forms such as unsuitable bioavailability, stability, taste, and odour.
Nwako said crushing medication before use is a common practice among patients who dread swallowing pills.
“Not all drugs are crushable or scored. Only drugs that are scored are crushable. It is wrong for patients to try to break or crush their drugs without first getting approval from their pharmacist. The pharmacist knows best in terms of drug properties.
“Some drugs have a narrow margin of safety and unequal division could lead to toxicities. Coated drugs should not be crushed,” he said.
A drug manufacturer may score pills with a groove to both indicate that a pill may be split and to aid the practice of splitting pills. When manufacturers do create grooves in pills, the groove must be consistent for consumers to be able to use them effectively.
According to Nwako, the essence of coating drugs is to mask the bitter taste and reduce acidic degradation in the stomach.
“Enteric-coated drugs like low-dose Aspirin should not be crushed to avoid degradation by the acid in the stomach.
“Film or sugar-coated tablets should not be crushed like quinine and fersolate or ferrous sulphate.
“Crushing them will expose their bitter taste, increase the acidic degradation of their active ingredients.
“Patients should refrain from opening their encapsulated drugs, except instructed otherwise by their pharmacist. Doing so could lead to early degradation,” he warned.
Continuing, Nwako emphasized that some drugs are ‘modified release medications’ and labelled as sustained, slow, extended or controlled release drugs.
“Crushing or breaking such medications will definitely alter their release profiles. No other person, except the pharmacist, knows so much about the nature of drugs,” he said.
Experts advise that if you, your child or someone you’re caring for has problems swallowing tablets, pills or capsules, tell your doctor or the healthcare professional who is prescribing the medicine.
“There may be an alternative medicine available, such as a liquid medicine or a tablet that can be dissolved in water,” they said.
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