Is it safe to split my pill in half?
Why split? | How it's done | Is it OK to split pills? | Don't split these pills | What do studies and the FDA say? | Will it save me money? | Bottom Line
To find out if you can safely split your pill in half, ask your pharmacist or check the package insert for your medicine. You can usually find this information in the "How Supplied" or "Patient Information" section. If it's not there, it may mean the FDA has not studied the medicine to determine if it can be safely split.
Check with your pharmacist if you are not sure.
- Pills or tablets that can be cut in half typically have a scored mark down the middle of the pill with a line or indentation.
- Coated pills or tablets that are slowly released in your body, like extended-release (ER) or long-acting (LA) forms should not be cut.
- Capsules should not be split, crushed or opened unless recommended by your healthcare provider.
Splitting a tablet that has a line or indentation but has not been reviewed by the FDA may not contain the same amount of drug or work the same way in the body as the whole tablet. You should discuss with your healthcare professional whether to split this type of tablet.
Check with your doctor or pharmacist first to make sure splitting your pill is a safe and economical choice for you.
Why do people split pills?
People may want to split pills for a variety of reasons, including:
- to save money
- to decrease the tablet size and make it easier to swallow
- to adjust their medication dose, as directed by a healthcare provider
- to get a lower dose that's not available on the market
How do I split tablets safely?
For the most precise splitting, you should buy a pill splitter at the pharmacy or online. Pill splitters are usually inexpensive and cost between $5 and $10. They work best for round pills that are scored, but may not work for oddly shaped pills. Don’t use a knife or razor to cut tablets as this may splinter or crush pills and can be dangerous.
Use caution and read any directions as most pill splitters contain very sharp razors. Have your pharmacist demonstrate the proper technique. Keep tablet splitters away from children and pets.
You should only split one pill at a time and use up both halves before splitting another pill. Do not split all your tabs at once. This can leave the medicine exposed to air, moisture or heat and theoretically could affect its potency.
Pills with special coating (for example, enteric-coated pills) or that are released into the body in a certain way, like extended-release (ER), sustained-release (SR) or long-acting (LA) medicines should typically not be split, cut, crushed or chewed. This can alter how the medicine is release and absorbed into your body, which may cause a dangerous overdose in some cases.
Capsules should not be split, crushed or opened unless approved by your doctor. Some capsules can be opened and sprinkle on food (such as applesauce) to make it easier to swallow. This information will also be found in the package insert.
Not all strengths or generic formulations of the same medicine may be scored, so if you don't see a line, check with your pharmacist or other healthcare provider about splitting.
Pills with no line in the middle
In general, do NOT split tablets that are not scored unless your doctor or pharmacist has given you the okay to do this. Some tablets may be extended-release, enteric-coated or have other characteristics that might affect how the tablet is absorbed or works if you cut it in half.
Even if a tablet is scored, it’s best to ask your healthcare provider before you split it.
Who can split tablets safely?
It may not be safe for certain people to split tablets on their own, especially those:
- with memory problems, who may forget to split their tablet and take a double dose of medicine, or may split the wrong tablet
- with vision problems
- who have arthritis in their hands or wrist
- who need daily help with their medicines
- with a movement disorder or tremors
- with health conditions or impairments
- that are children. Adults should split tablets for children as directed by the doctor.
How do I know if it's OK to split pills in half?
If your pill or tablet is “scored”, this usually means you can split your tablet in half, but check the product information to be sure. A “score” is a line or indentation that is found down the middle of the tablet that allows for easier cutting.
You can see a few examples of a tablet “score” here:
Keep in mind that splitting your pill in half and taking only one-half will change the dose of your medicine. For example, splitting a whole 50 mg tablet in half will typically give you two 25 mg halves. Only take half of your medicine if your healthcare provider has directed you to do this.
Ultimately, the uniformity of the active ingredient in your pills will depend upon the standards of quality assurance set at the particular drug manufacturing facility.
Which pills should NOT be cut in half or split?
Examples of medications that should usually not be split in half include:
- film-coated or enteric-coated tablets, controlled-release (CR), extended-release (ER, XR or XL), sustained-release (SR), long-acting (LA) or other timed-release medications
- orally-disintegrating tablets (that dissolve on or under your tongue).
- oddly shaped pills or pills that are too small to split evenly.
- 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).
- chemotherapy (cancer) drugs.
- prepackaged pills.
- some combination drugs (one pill that contains two or more medicines). Ask your pharmacist if it’s OK to split any combination tablet.
- oral contraceptive (birth control) pills.
- any other medicine where getting the exact dose is critical (drugs with a narrow therapeutic index).
If a tablet is not scored, ask your pharmacist or doctor if it is safe to cut or split in half.
If you split a tablet in half and it crumbles, splinters, or cuts unevenly, do not split anymore of these pills. Get a prescription from your doctor for the correct strength so you do not need to cut them half.
Extended-release (ER or XR), sustained-release (SR), long-acting (LA) or timed-release medications have a built-in release mechanism to allow the medication to work longer. Examples of these kinds of medicine include Calan SR and Effexor XR. Note that not all pills with different release characteristics may have the abbreviations, such as “XR” or “SR” after the name of the drug.
Some medications may release all at once and lead to a dangerous, high dose in your body if you split, crush or chew it. For example, some opioids medicines used for pain have special release characteristics and splitting them in half and taking them can be dangerous or deadly, as a large dose of medicine may be released all at once.
Check with your healthcare provider and review the product label before you split any combination drug (one pill that contains two or more medicines) in half.
Enteric-coated (EC) pills are coated to help protect your digestive tract. Examples of these kinds of medicines include enteric-coated aspirin or enteric-coated naproxen. Enteric-coated may be abbreviated as "EC" in some drug names.
Some medicines are enteric-coated so they can pass through the acidic pH of the stomach and be absorbed in the intestines. Enteric-coated products should not be dissolved, split chewed or crushed.
Learn more: What are enteric-coated tablets?
Does splitting a pill in half reduce its effectiveness?
According to the FDA, if there is no information about splitting the tablet in the package insert section “How Supplied”, the FDA has not evaluated it to be sure both halves of the tablet are the same weight, contain the same amount of medicine, or work in the same way.
Research studies have found inconsistencies in the amount of active ingredients in tablet halves.
In one study, researchers found that the active ingredient simvastatin (a common cholesterol medicine) was distributed unevenly in tablets manufactured in foreign countries and purchased online but not in the branded product (Zocor) manufactured in the U.S. This could lead to uneven doses when cutting tablets in half.
Another study found that the USP standard specification was exceeded for more than one-third of sampled half tablets for warfarin, metoprolol and lisinopril, and was greater for nonscored vs. scored tablets.
- The USP standard for drugs other than warfarin was 90-110% of half the mean values of the whole tablets, and for warfarin was 95-105%.
- Specifically, standards were met for 19 out of 30 halved warfarin tablets, 27 of 30 for simvastatin, 20 of 30 for metoprolol succinate, 26 of 30 for metoprolol tartrate, 25 of 30 for citalopram and 20 of 30 for lisinopril.
- Weight variation appeared to be due to tablet fragmenting, and the authors conclude that splitting tablets in half precisely may help to eliminate the variation.
However, one review study found that using half of a tablet did not appear to affect the clinical outcomes of patients with high blood pressure, high cholesterol levels, or mental health disorders.
A 2022 systemic review of 138 articles that were published on concerns related to tablet splitting found there is little evidence to support tablet-splitting concerns, with the exception of sustained-release tablets (which should not be split) and for older people who may have trouble splitting tablets due to physical limitations.
Does the FDA say it’s OK to cut pills in half?
The US Food and Drug Administration (FDA) states that pill splitting may be approved under certain circumstances and has published a list of “Best Practices for Tablet Splitting”.
The main points are summarized here:
- FDA-approved tablets that are approved to be split will be noted in the “HOW SUPPLIED” section of the professional label insert and in the patient package insert. The tablet will be scored with a mark indicating where to split it. You can review FDA product labeling here.
- If this information is not in the label, the FDA has not evaluated the tablet to ensure the two halves would be equivalent when split. The manufacturer has not determined if the one-half is the same in weight, drug content or clinical effects. The FDA suggests that patients talk to their healthcare provider about whether to split pills that do not include this information in the package insert.
- Only split pills as you need them and take the split halves before splitting the next tablet. Heat, light, humidity, or moisture content can affect the integrity of the medication; avoid leaving medication in steamy bathrooms or hot cars.
- Pill splitters may not be appropriate for oddly shaped tablets. Some tablets may not be suitable to split because of their unique shape and size—even if they appear to be scored.
- If you switch between brand names of the same medication, or between brands and generics, check with your healthcare provider to be sure the new tablets can be safely split.
- Tablet splitting should be done only under the supervision of a healthcare professional.
Can I split my pills a week in advance?
Do not split all of your tablets at once and save them for later use. This may lead to deterioration of the ingredients and can lower the medicine’s effectiveness. Heat, humidity, light or moisture content could possibly affect the effectiveness of your medication.
For scored tablets, you should only split a pill once (unless otherwise directed by your doctor) and use up both halves of the tablet before splitting another pill.
Will splitting pills in half save me money?
This depends. Not all medicines that are twice the strength are twice the price. Because of this, pill splitting may allow you to buy two doses of medicine for the same price as one - the equivalent to getting two months of medications for the price of one.
For some medicines, cutting tablets in half may save you up to 50% off of the cost of your medication.
Splitting tablets in half is a practice that some healthcare providers and even health insurance companies may recommend, but it’s always optional for you.
- For example: say you take 10 milligram (mg) of a cholesterol-lowering drug every day, but the 20 mg tablet costs just about the same. The 20 mg pills are scored and can be safely split in half.
- If you buy the 20 mg tablets, cut them in half, and then take one-half (10 mg) for each dose, you can double your buying power.
However, your doctor will need to prescribe the higher strength of medicine for you to cut in half and your insurance may need to agree, too.
Also, check with your pharmacist to see if this makes sense for you economically. There may be other options that don't run the risk of human error and that may be more affordable.
Can I split a generic tablet?
If you switch between brands or generics, check with your healthcare provider to be sure the new tablets can be safely split if you have done this with the previous pill.
Using generics is a great way to save money. But if your pharmacy fills your prescription with a generic tablet from a different manufacturer, it may not be safe to split, even if you were able to split it before.
Recommendations for pill splitting change frequently, so always ask your pharmacist before assuming it is a safe practice.
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 as directed, before you split another pill. This will help to prevent deterioration of your medicine from heat or moisture.
- 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.
- Tablet splitting should always be done under the direction of your healthcare provider.
See also
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Sources
- Saran AK, Holden NA, Garrison SR. Concerns regarding tablet splitting: a systematic review. BJGP Open. 2022 Sep 28;6(3):BJGPO.2022.0001. doi: 10.3399/BJGPO.2022.0001.
- U.S. Food and Drug Administration (FDA). Tablet Splitting. Updated 8/23/2013. Accessed August 9, 2024. https://www.fda.gov/drugs/buying-using-medicine-safely/tablet-splitting
- Elliott I, Mayxay M, Yeuichaixong S, et al. The practice and clinical implications of tablet splitting in international health. Trop Med Int Health. 2014 Jul;19(7):754-60. doi: 10.1111/tmi.12309
- Hill SW, Varker AS, Karlage K, Myrdal PB. Analysis of drug content and weight uniformity for half-tablets of 6 commonly split medications. J Manag Care Pharm. 2009 Apr;15(3):253-61. DOI: 10.1126/science.1097355
- Veronin MA, Youan BB. Medicine. Magic bullet gone astray: medications and the Internet. Science. 2004 Jul 23;305(5683):481. Accessed Jan 23, 2023. doi: 10.1126/science.
- The Medical Letter. Tablet splitting. August 6, 2012. Accessed August 9, 2024 at medicalletter.org.
- Enderle L. News: FDA Takes on Unsafe Pill Splitting. Pharmacy Times. Sept. 13, 2011. Accessed August 9, 2024 at https://www.pharmacytimes.com/view/fda-takes-on-unsafe-pill-splitting
- Freeman MK, White W, Iranikhah M. Tablet splitting: a review of weight and content uniformity. Part 1. Consult Pharm. 2012 May;27(5):341-52. doi: 10.4140/TCP.n.2012.341.
- Freeman MK, White W, Iranikhah M. Tablet splitting: a review of the clinical and economic outcomes and patient acceptance. Part 2. Consult Pharm. 2012 Jun;27(6):421-30. doi: 10.4140/TCP.n.2012.421.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.