Is it okay to crush Tramadol?
Can you break up tablets?
Some crumble or disintegrate into unevenly large parts. Others shouldn't be divided at all, because that can be dangerous. There are a few things to consider when separating tablets.
Read the instruction leaflet
A study by the University of Heidelberg came to the conclusion that every fourth tablet is broken up. Often times, patients crush their medication because of difficulty swallowing. Some patients only took half a tablet because the drug was not available in the desired strength or it was too expensive. But sharing can affect the way the medicine works.
Basically: You can always crush tablets with a clear conscience if the package insert states that it is harmless. If you cannot find any information on this in the package insert, caution is required. Because with some drugs, shredding can be dangerous. For example, one half of the tablet can contain more active ingredient than the other - either because the two halves are different sizes after dividing or because the active ingredient was not evenly distributed in the tablet during manufacture. As a result, the effect is not equally strong.
Do not rely on the visual impression
Our stomach acid can break down certain ingredients from medicines. Some tablets therefore have an enteric coating that protects their contents from the acid. If you break up this medication, the components will come into direct contact with the stomach acid and will be broken down by the stomach before they can work.
You should also not crush so-called sustained-release capsules. These should distribute the active ingredient throughout the day. They have a special cover for this. If you break up these tablets, the active ingredient will be released more quickly and in an uncontrolled manner. This often leads to an overdose.
The tricky thing: As a layman, you can hardly tell whether a tablet has a special coating that prevents it from being broken up. Even break marks cannot be relied on. Because these visible notches in the tablet surface are not always used for comminution. It is not uncommon for the score lines to be used only to distinguish the tablet from drugs that look similar. Therefore, if in doubt, ask your doctor or pharmacist whether you can split a tablet.
Authors03.12.2012 | Sandra Göbel
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