Is Cutting Your Pills a Safe Way to Save Money?

Leticia Dieleman
Doctor of Pharmacy Candidate, May 2002
The University of Iowa

If you've filled a prescription lately, you're probably interested in ways to cut the high costs of medication. The title line of an article in the Wall Street Journal (July 27, 2001) suggested "An Easy Remedy: Cut Your Drug Bills in Half By Cutting Pills In Half." But this advice only works for certain medicines. By splitting some medicines, you could be putting your health at risk.

Splitting pills can save money because different strengths of a medicine are sometimes about the same in price. For example, each 20 mg pill of a medicine commonly prescribed to lower cholesterol costs about $3.57, while each 40 mg pill of the same drug costs about $3.61. If your doctor prescribes 20 mg of this drug daily, you could save about $640.00 over a year by buying the 40 mg pills and splitting them in half.

With many medicines, it is perfectly safe to split pills. Some pills have a grooved line on them where they break most easily (this is called scoring). Pills are scored so doctors can prescribe doses that are not otherwise available or adjust your dose without you having to get a new prescription. When pills are scored, you know that they are safe to cut.

Pills that aren't scored may not be safe to cut. Some of these pills will not work correctly if they are cut. Others are too difficult to cut or cutting is risky because an exact dose is so important.

The following are types of medicines that should not be cut:

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Capsules
Capsules are really just shells that hold in the medicine. The medicine may be a liquid, a powder, or in tiny pellets. If the capsule is cut or opened, the medicine inside is almost impossible to divide equally.
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Timed-release medicines
Timed-release medicines may also be called long-acting, controlled-release, or extended-release medicines. These pills have special coatings or are made of materials that can control how fast the medicine is released from the pill. When these pills are split, the medicine gets out too fast, and you could get too much medicine at once.
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Enteric-coated medicines
These pills are designed to release medicine after it passes through the stomach. They are covered with a special coating that won't let the drug out while the pill is still in the stomach. These pills protect your stomach from the medicine and protect the medicine from the acid in your stomach. Cutting these pills lets the medicine out too soon. It may then cause irritation or be destroyed by the acid in your stomach.
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Transdermal Patches
Some medicines come in patches that stick to your skin like band-aids. Over time, the medicine travels from the patch through your skin and into your body. Some patches can be cut into smaller pieces, but always ask your doctor and pharmacist first. The patch may not stick to your skin like it needs to if it is cut. The drug may be in a liquid or gel inside the patch, so cutting it would let the drug out and either too much drug or not enough drug would get to your body.
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Medicines that require a precise dose
With some medicines, it is very important that you get exactly the same dose every time you take your medicine. Think of a pill as a blueberry muffin. The actual drug is scattered throughout the pill like blueberries in the muffin. Even if you are able to split the muffin exactly in half, you probably won't get exactly half of the blueberries in each side. Medicines that control your heartbeat or help prevent seizures are examples of medicines that require an exact dose. Cutting these medicines could result in you taking more or less medicine than you need. The dose you get could be so high it's dangerous, or so low that it's not useful.

If you are thinking about splitting your pills to save money, it's a good idea to ask your doctor and pharmacist these questions first:

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Can my medicine safely be cut in half?
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Does my medicine come in a strength that is two times the dose I take?
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How much money will I save by buying the larger pills and splitting them in half?

There are other things to consider, too. Cutting pills accurately is not an easy task. It is especially difficult if you have poor vision, arthritis, or unsteady hands. Pill splitting may not be practical for pills that are small, odd-shaped or not scored. Your pills may crumble or break unevenly when you try to cut them. If you are going to cut your pills, the safest and most reliable way is to use a pill splitter. These cost about $5.00 and can be bought at your pharmacy.

Taking your medicines becomes more complicated if you decide to split your pills. You can work with your doctor and pharmacist to develop ways to make sure you always take the right dose of each medicine. For example, it might help to put a bright color sticker on your pill bottle to remind you to split those pills.

SOURCE:- Consumer Health Information Corporation.