Splitting Pills and Tablets | Medicalalgorithms.com

Description

One cost saving strategy employed by some health maintenance organizations (HMOs) is to have the patient split pills or tablets into smaller dosage portions. While attractive in some circumstances, this can result in a number of problems that may outweigh the benefits.

Problems:

(1) variation in dosage (either too high or too low)

(2) wastage (lost or crushed product)

(3) difficulty for a disabled patient

Parameter	Splitting is a Good Idea	Splitting is a Bad Idea
drug toxicity	low	high
dose-response efficacy curve	flat	steep
patient eyesight	excellent	poor
patient dexterity	good	poor
patient's ability to comply with instructions	good	poor
implement requirement	no or simple tool	requires special tool (complexity)
product consistency	relatively soft	relatively hard, requiring force to split
product size	relatively large	tiny
product surface stability	flat and stable	round and unstable
ease to determine center (based on product shape)	simple (regular)	difficult (irregular)
response to splitting	intact, equally sized pieces	crumbles or very irregular pieces

where:

• A scored tablet may not split evenly, so that scoring is not a predictor of proper splitting.

• Some pills split better by hand while others split better using a razor.

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Description

Specialty

ICD-10