New Research
Pill splitting could lead to improper dosing
Archived article from Sep 20, 2004
By Joseph Blumberg
Patients who split their pills may be getting anywhere from one-half to one-and-a-half times the amount of medicine they believe they are taking, a new Rutgers study suggests.
A team of researchers, led by Thomas Cook, assistant professor at Rutgers’ Ernest Mario School of Pharmacy, studied back and neck pain sufferers who had divided Flexeril (cyclobenzaprine HCl 10-milligram), a frequently prescribed muscle relaxant, using a tablet splitter or kitchen knife into two 5-milligram portions. After analyzing the tablets, they found that splitting them tended to deliver inconsistent doses of the medication.
“Ideally, an evenly split 10-milligram tablet should have 100 percent of the half tablet weight and 5-milligrams of the medication,” Cook said. “In this study, the variance in estimated drug content due to uneven tablet splitting ranged from 50 to 150 percent of the ideal targets, meaning a patient would have no guarantee of receiving a full half-dose consistently throughout the course of therapy.”
The team initiated the study following anecdotal reports of patients who, given a prescription for 5-milligram tablets, were being advised to split generic 10-milligram tablets instead of taking the 5-milligram tablet as prescribed by their physician.
Since generic cyclobenzaprine HCl 10-milligram tablets are not designed for splitting (the tablets are not scored), there is an increased likelihood that they will split unevenly, crumble or shatter.
“In this instance, the practice of pill splitting may put patients at risk of receiving too little or too much medication, either depriving them of the intended therapeutic benefit of the medication or exposing them to unintended side effects, such as dizziness or tiredness,” Cook said.
The study was sponsored by Flexeril manufacturer McNeil Consumer & Specialty Pharmaceuticals.
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