NOVEMBER 21, 2017
CRUSHING UP MEDICINES
There are times when you may be tempted to break up, crush or chew a tablet or other medicine to make it easier to swallow. It is very important that you find out first if this is ok. This should not be done with certain medicines.
SLOW RELEASE MEDICINES (EG MEDICINES WITH XR, SR AFTER THE NAME)
Some medicines are designed to not be released in to the blood stream all at once but rather for small amounts of the medicine to be released over the course of 12 or 24 hours. Slow release of medicines is very useful in medicines that need to be taken every day in order to get 24 hour use of the medicine.
It is very dangerous to alter this type of medicine by crushing or chewing it (some may be broken) as this means a very high amount of the medicine could be released in to the blood stream all at once rather than small amounts over a longer time. This can result in death due to very high medicine levels.
UNDER THE TONGUE (SUBLINGUAL) TABLETS (EG MEDICINES THAT COME IN A WAFER)
Some medicines are designed to be placed under the tongue so that the medicine can be absorbed in to the blood stream from the mouth. The advantage of this type of medicine is that they work pretty quickly as the medicine does not have to wait to get to the gastrointestinal tract in order to work. If a sublingual medicine is swallowed (following crushing, breaking or chewing) it probably won’t work at all.
ENTERIC COATED MEDICINES (EG MEDICINES WITH EC AFTER THE NAME)
Some medicines have an enteric coating which is designed to dissolve in the small intestine and not in the stomach. These coatings have two uses. They can protect the stomach from medicines that may irritate and they can protect the medicine itself if it can be damaged by the stomach acid.
CHECK BEFORE YOU ALTER YOUR MEDICINE
Always check with a Pharmacist if it is ok to crush, break or chew your medicine. If this is not possible it is likely there will be an alternative to the medicine you need that is available in a liquid or sublingual medicine. Some medicines that come in tablet form can be dispersed in water and the solution then swallowed. Some medicines that come in capsules can be opened up and the medicine inside can be put on/in food or in water.
There are medications that are suitable for crushing. Some of the medicine is always lost when it is crushed and some of it remains on the device used for crushing. After a medicine is crushed it can be place directly in the mouth, placed in water to drink or mixed with yoghurt, jam or apple puree.
Reference Australian Don’t Rush to Crush Handbook 2017