March 6, 2022

Is It Safe To Split Pills?

Cutting pills is a normal — and potentially dangerous — practice

Splitting pills

It’s not ideal to split a pill. But can it be done? Absolutely, in some cases — but it’s a process that can come with definite risks, primarily related to getting a correct dosage.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

But the reality is that the slicing and dicing of medications happens … and it happens a lot. One study estimated that almost 25% of pills are split. The reasons why vary from the economic (saving cash) to the physical (difficulty swallowing a whole tablet).

So, if you’re going to do it, follow this advice: Ask before you make a cut and take safety steps to do it properly, advises pharmacist Alison Miller, PharmD.

“Splitting a pill can be dangerous,” says Dr. Miller. “That’s where the discussion needs to start.”

What pills can be cut in half?

Tablets with a score line typically mean they can be split. This mark, or notch, offers assistance to make a clean cut — usually to make two even halves. “A score is the No. 1 thing to look for,” notes Dr. Miller.

Guidance can also be found within the gobs of text on medication labels or patient package inserts. The “How Supplied” section notes whether a pill has been approved for splitting by the U.S. Food and Drug Administration (FDA).

But don’t just assume it’s safe to split any pill with a score mark.

“It’s always best to talk with your pharmacist or doctor first,” cautions Dr. Miller. “A score line might indicate a pill can be split, but it doesn’t mean that you should.”

Advertisement

Pills to never split

If there’s no score line on a pill, consider it a STRONG message that it’s not meant to be split. Medications that fall in this category include:

  • Extended-release pills. Cutting a pill engineered to slowly release medication undermines that intended delay. “Splitting this sort of pill can lead to the entire dosage being dumped at once — and that can be very unsafe,” cautions Dr. Miller.
  • Liquid- or bead-filled capsules. Aside from being messy, there’s just no good way to ensure a proper dosage after cutting into a liquid- or bead-filled capsule.
  • Asymmetrical pills. Imagine trying to make a precise and measured cut on a uniquely shaped tablet. (Spoiler alert: Your odds aren’t good.)
  • Tiny tablets. Avoid any pill cut that demands high surgical precision.

How to cut pills in half

The right equipment is essential for splitting a pill. For more accurate splitting, look for a specialized pill cutter at a pharmacy or online market.

The most common design features a V-shaped pill holder and a retractable blade that presses down on the tablet. Make sure to do the downward cutting motion quickly. A slow press can make the pill crumble.

These nifty pill cutting devices — which often can be purchased for just a few bucks — are a much better option than, ahem, other more creative methods.

“I’ve had people tell me they’ve bitten pills in half or used their fingernails,” says Dr. Miller. “I’ve heard from people about using butter knives, too, which usually sends pill pieces flying all over the kitchen.”

Other splitting tips include:

  • Cut only one pill at a time.Splitting multiple pills at once can make it difficult to identify the medication later. Also, the FDA reports that split pills that sit around are more likely to be affected ­— and made less effective — by heat, humidity and moisture.
  • Focus on cleanliness.Wear gloves or make sure to wash your hands before and after splitting a pill to help avoid any reaction. Make sure to clean the pill cutter, too.
  • Don’t assume it’s OK to split a pill.Always check to make sure a pill can be split, even if it’s a medication or prescription you have previously used and cut. Manufacturing changes happen. Don’t be caught off guard by them.

Risks of splitting pills

How difficult can it be to evenly split a pill in half? Well, it’s tougher than you might think. One study found that almost 1 in 8 split pills were off by more than 20%. That’s not exactly top precision.

Advertisement

Dosage errors can be dangerous in either direction, notes Dr. Miller. Taking too much of a medication can lead to a potential overdose. Getting too little, meanwhile, can limit the intended benefits.

“Whenever you split a pill, you probably aren’t getting the exact dosage your prescription calls for,” says Dr. Miller. “That can have consequences.”

So, why split pills at all?

While splitting pills may not be encouraged, there are definite and understandable reasons why it’s done. The most common explanations include:

  • Maximizing prescriptions.Say you need a 10 milligram (mg) dosage and 20 mg pills are available. Splitting tablets can stretch 30 pills into a 60-day supply, saving you cost on the refill.
  • A nonstandard dosage. Splitting pills may be necessary if pills aren’t made in your prescribed amount.
  • Difficulty swallowing whole pills.A national survey once revealed that more than 40% of adults experience problems swallowing pills. To borrow a phrase from “Mary Poppins,” splitting pills can serve as the “spoonful of sugar that helps the medicine go down.”

“There are times when you might need to split a pill,” says Dr. Miller. “But it’s always best to talk to your doctor or pharmacist first. There may be ways to get the proper dosage into one pill that works, which is preferred.”

Related Articles

Variety of medication pills and tablets and liquids
February 22, 2024
Is It OK To Take Expired Medicine?

Some types of expired meds may not be harmful, but they probably aren’t worth the risk

group of people with non-alcoholic beverages
October 30, 2023
Nonalcoholic Drinks Are on the Rise — But Are They Good for You?

Options for sober social drinking are abundant, but be mindful about additives and triggers

nasal spray
May 15, 2023
This Is Why Your Nasal Spray Stopped Working (and What To Do About It)

‘Rebound congestion’ happens when your body starts to rely on decongestant nasal spray

Person handing a pharmacist a prescription.
March 29, 2023
Is Ozempic the Answer for Your Weight Loss?

This diabetes med can treat obesity, but it’s not for people who just want to drop a few pounds

Mom and son meditate and realx on beach
March 24, 2022
Meditation for Kids: The Basics and the Benefits

Learn how a little quiet time can make a big difference

A person wearing glasses sitting at a table reading medication bottles
March 18, 2021
Should You Avoid Certain Medications or Treatments Before Getting Vaccinated for COVID-19?

If you’re not sure, talk to your healthcare provider — first

Mom giving medication to child
March 10, 2021
What Cold and Flu Products Are Best For My Child?

Learn what meds to give at which ages, and which ones to avoid

woman eating grapefruit in bed
January 14, 2020
How What You’re Eating Could Be Affecting Your Medications

Understanding food-drug interactions

Trending Topics

close up of keto gummies
Do Keto Gummies Work for Weight Loss? Are They Safe?

Research is inconclusive whether or not these supplements are helpful

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

Older person postioned sideways showing dowager hump.
Dowager’s Hump: What It Is and How To Get Rid of It

The hump at the base of your neck may be caused by osteoporosis or poor posture

Ad