Icelandic Medicines Agency
Can tablets be split or crushed?
The pharmaceutical form and excipients can be crucial to ensuring that a medicine works as intended.
This is why some medicines must not be split or crushed before they are taken.
It can be tempting to split a tablet into smaller pieces that are easier to swallow, or to crush it and mix it with something that masks the taste. This can be unsafe because it may prevent the medicine from working as intended. The package leaflet states whether the tablet can be split or crushed, or whether it must be swallowed whole.
A capsule or tablet contains two types of ingredients:
The medicine itself: the active substance.
Other ingredients added for various reasons. These are called excipients.
For the active substance to work as intended, it must reach the correct place in the body safely. Some active substances act locally in the stomach or intestines, but most must be absorbed into the bloodstream before they can affect other organ systems.
Excipients enclose the medicine, hold it together and ensure that the active substance travels through the body as intended so that it is absorbed correctly.
Some active substances break down when they come into contact with acid. Medicines containing these active substances are often coated to ensure that they reach the correct destination and have their full effect.
If a tablet or capsule has a coating that protects it from stomach acid, it is important not to split the tablet or open the capsule, to prevent stomach acid from entering and destroying the medicine.
In other medicines, small pellets inside the tablet or capsule provide this protection. These medicines can be split or opened without losing the protective effect. It is generally not acceptable to chew or crush these pellets. They should be swallowed whole, either as a powder or, in some cases, mixed into a drink.
Prolonged-release tablets
Prolonged-release tablets and capsules work over an extended period. This means that the active substance is released gradually into the body over several hours. This prolonged-release effect is useful for many medicines, particularly when the best effect is achieved through a steady supply of the active substance. These medicines do not need to be taken as often.
Some medicines must be swallowed whole to maintain this effect. Crushing or splitting prolonged-release tablets can destroy the medicine’s prolonged-release properties.
How can you tell whether a medicine can be split or crushed?
The package leaflet, under “How to take…”, provides instructions on using the medicine, including whether it should be swallowed whole or can be split or crushed. If in doubt, ask a pharmacist or pharmacy technician at a pharmacy.
This article is one of a series of educational articles published by the Icelandic Medicines Agency.
Last reviewed: 16th February 2024