Which pills should NOT be cut in half or split?

I. Which pills should NOT be cut in half or split?

Examples of medications that should usually not be split in half include:

1. Film-coated or enteric-coated tablets, controlled-release (CR), extended-release (ER, XR or XL), sustained-release (SR), or timed-release medications
2. Orally-disintegrating tablets
3. Oddly shaped pills or pills that are too small to split evenly
4. Capsules (note: certain medications in capsules can be opened and sprinkled on food for easier swallowing, but ALWAYS ask your pharmacist if you can do this)
5. CHEMOTHERAPY (cancer) drugs
6. Prepackaged pills
7. Some combination drugs (one pill that contains two or more medicines). Ask your pharmacist if it’s OK to split any combination tablet.
8. Oral contraceptive (birth control) pills
9. Any other medicine where getting the exact dose is critical (drugs with a narrow therapeutic index)

II. Is it safe for anyone to split tablets in half?

It may not be safe for certain people to split tablets on their own, especially those:

1. with memory problems, who may forget to split their tablet and take a double dose of medicine, or may split the wrong tablet
2. with vision problems
3. who have arthritis in their hands
4. who need daily help with their medicines
5. with a movement disorder or tremors
6. with health conditions or impairments
that are children. Adults should split tablets for children.

III. Which medicines can be split in half?

Always check with your pharmacist or doctor, look at the package insert, and / or call the manufacturer to be sure you can split your tablet in half. The following is NOT a complete list of all medicines that can be split.

NOTE: Only certain strengths or formulations of the following medicines are scored and can be split in half. Not all strengths, formulations, generic or brand products, or medicines made by different pharmaceutical companies may be scored and / or can be split in half. ALWAYS ask your healthcare provider.

➖ADHD medications
▪️Adderall (amphetamine and dextroamphetamine)
▪️Ritalin (methylphenidate)

➖Antidepressants
▪️Celexa (citalopram)
▪️Effexor (venlafaxine)
▪️Lexapro (escitalopram)
▪️Luvox (fluvoxamine)
▪️Paxil (paroxetine)
▪️Pexeva (paroxetine)
▪️Zoloft (sertraline)
▪️Trazodone
➖Anti-anxiety medications
▪️Xanax (alprazolam)
▪️Ativan (lorazepam)
▪️Buspar, Buspar Dividose
▪️Valium (diazepam)
➖Anti-Nausea
▪️Promethazine
➖Antibiotics
▪️Penicillin V potassium
➖High Blood pressure
▪️Cozaar
▪️Diovan
▪️Fosinopril
▪️Lopressor HCT
▪️Metoprolol
▪️Propranolol
▪️Zestril (lisinopril)
➖Diuretics (water pills)
▪️Lasix (furosemide)
▪️Hydrochlorothiazide
➖Pain / Fever
▪️Aspirin (but NOT enteric-coated aspirin)
▪️Acetaminophen
➖Parkinson’s disease
▪️Sinemet (carbidopa / levodopa)
➖Thyroid medications
▪️Levothyroxine
➖Muscle Relaxer
▪️Methocarbamol
▪️Zanaflex (tizanidine) tablets
➖Weight loss
▪️Adipex-P (phentermine)

➖Corticosteroids / Anti-Inflammatory
▪️Sexamethasone
▪️Methylprednisolone
▪️Prednisone

IV. Bottom Line:

Many tablets can be split in half, especially if they are scored.

Always check with your doctor or pharmacist first to make sure splitting your pill is a safe and economical choice.

Using a whole tablet for the dose you need is the safest way to be sure you get the most accurate dose.

Splitting your tablets may be helpful if you need to adjust doses (as directed by your doctor) or if it makes it easier to swallow the medication.

Only split one pill at a time, and take both halves, before you split another pill. This will help to prevent deterioration of your medicine.

In some cases, splitting a higher dose tablet in half can save you money, but it depends on the cost of the medicine and the dose you need.

Speak with your doctor and pharmacist about the best way to save money on your prescription medicines. 

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