Pill Splitting Issues

When Two Halves Don't Equal One Whole

Soaring prescription costs in this country have sent many Americans off to Canada in search of bargains. With Canada now talking about closing up shop for across-the-border sales, some Americans may turn to pill splitting to cut costs. The idea behind this strategy is that the price for some medications is the same in lower and higher dosages. The popular statin, Zocor, for example, costs the same for 20-mg pills as it does for 40-mg ones. If you're taking 20 mg a day, you can halve the 40-mg pills and, at the same time, halve the cost.

However attractive the idea is, though, there are numerous caveats about pill splitting. Not every medication is a candidate... and there are people who may need to skip the practice altogether. I discussed this with Susan C. Winckler, RPh, JD, vice president for policy and communications of the American Pharmaceutical Association, to see when it works - and when it doesn't. As a general guideline, she says, any tablet that is scored (has a line down the middle) is probably okay to split. But there are other types of pills that are not meant to be split, including...

• Controlled (or sustained) release pills. These are designed to release vital ingredients over time. By splitting them, you could end up getting the entire multihour dosage at once. These pills are usually coated. By breaking the coating, the pill dissolves faster. Example: Nifedipine (Procardia XL) for high blood pressure.
• Critical dosage pills. In some medications, even minor variance of dosage makes a difference and splitting could present that risk. Example: Blood thinners such as warfarin (Coumadin).
• Combination product pills. Medications that contain more than one drug may not have both medications evenly distributed throughout the tablet. Example: Diovan HTC (valsartan and hydrochlorothiazide), for hypertension.
• Nonsplittable forms, such as capsules.

Additionally, some pills are coated to disguise an unpleasant taste. Breaking the pills will release that, and it's up to individuals to decide if their taste buds can tolerate that bit of nastiness or not.

How To Do It

The best way to split your pills is with - of course - a pill splitter, a plastic device available at your drugstore. Winckler advises splitting tablets only as you use them rather than splitting them in advance, which invites breakage and crumbling. She suggests keeping even individual halved pills separate by putting them in a clearly marked second bottle.

Assuming that your pills are "safe" to split, pill splitting requires a steady hand and visual acuity. Before you split even one pill, seek the advice of your doctor or pharmacist. They are the experts who can best advise you if and when it will work for you. Saving a little money isn't worth risking your health. Always speak with your pharmacist first to be sure that you are safe with the split.

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This article was provided by Bottom Line's Daily Health News. Bottom Line's vast network of leading mainstream, alternative, and complementary practitioners brings you the information you need to make informed decisions about your health. Sign up now for their FREE electronic newsletter.

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