Jennifer Gold

Jennifer Gold

Tuesday, 28 January 2014 22:12

Common pain relievers and when to take them

headacheJudy still needs to write this

Some over-the-counter (OTC) medicines can be cut, crushed, chewed, opened, or dissolved prior to taking them. But other specific dosage forms of medicines must be swallowed whole and are not safe to cut, crush, chew, or dissolve. These medicines are designed to release an even amount of medicine over a specific period of time in the body. Or, they may have a specially designed coating to prevent stomach irritation. Some lozenges or effervescent tablets are intended to be dissolved in a specific amount of liquid or to be dissolved slowly in the mouth. Medicine that is not meant to be cut, crushed, chewed, or altered may cause harm if it is not taken exactly as instructed on the label. Doing so can affect the way the medicine works and how quickly the medicine is released and absorbed.

drug facts dont crushFigure 1. The directions on the Drug Facts label for this medicine specify to swallow the tablets whole—do not chew or crush the tablets.

Crushing, chewing, or dissolving these tablets also increases the risk of adverse reactions. Injury can range from minor to severe, depending on the type of medicine ingested. Severe injuries are often related to rapid release and absorption of the medicine.

Always read the Drug Facts label to determine how the medicine should be taken. If a specific medicine should not be cut, crushed, chewed, or otherwise altered, a special warning will be provided in the Directions section of the Drug Facts label (Figure 1).


 What's in a name? Other clues on the label

As a good rule of thumb, the following slideshow shows examples of descriptions found on the label of a medicine package that mean the medicine should not be cut, crushed, or chewed.


    Extended-Release tablets or capsules

  •    Time Release tablets or capsules

       melatonin time release

  • Slow Release tablets or capsules

    Slow Release tablets or capsules
  • Sustained Release tablets and capsules

  • Tablets and capsules that indicate 8, 12, or 24 hours of relief

  • Tablets that are labeled as Lozenges, which are intended to be dissolved slowly in the mouth

  • Tablets that are labeled as Effervescent, which are designed to be dissolved in a specific amount of fluid before ingestion

  • Tablets that are labeled as Safety Coated

  • Tablets or capsules that are labeled as Enteric Coated

    enteric coated
  • Tablets that are labeled as Comfort Coated

    comfort coated
  • Other key terms that might signal the medicine can't be split, crushed, or chewed:


    Controlled Dose

    Long Acting

    Sustained Action

    Time Delayed

A rare but fatal error can occur when the cancer medicine vincristine is given the wrong way. Vincristine is given intravenously (into the vein) to treat various types of cancer. It is often given in combination with another cancer medicine called methotrexate. Methotrexate can be given into the spinal canal (intrathecally). This helps prevent the cancer from spreading to the brain. If vincristine is mistakenly given into the spinal canal instead of the methotrexate, death is almost certain.

topten spot-smIs your medicine cabinet a source for a teen’s legal “high?” Because a doctor’s prescription is not needed, many mistakenly believe that over-the-counter (OTC) medicines are safer than prescription medicines and illegal street drugs. They are in fact safe and effective when taken as directed, but even OTC medicines—including herbals—can cause serious and potentially fatal side effects when abused.

Camphorated phenol is an antiseptic liquid containing camphor and phenol. These two ingredients, used in combination, are often used to treat pain and itching associated with conditions such as minor burns, cold sores, insect bites, itching skin and mild sunburn. Camphorated phenol is a liquid that must only be applied directly to the skin. Ingesting camphorated phenol can cause toxicity, especially in children.

As the number of people diagnosed with diabetes continues to grow, illegally sold products promising to prevent, treat, and even cure diabetes are flooding the marketplace.

FDA is making it easier for patients, their families, and advocates to get involved in medical product approval and safety through the FDA Patient Network website at

The last two inhalers in the United States that contain ozone-damaging chloroflurocarbons (CFCs) will both be taken off the market by the end of this year. People with asthma and chronic obstructive pulmonary disease (COPD) who use these inhalers should talk to their health care providers about a prescription for an alternative.

A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. The FDA frequently reviews and analyzes reports of medication errors on marketed human drugs including prescription drugs, generic drugs, and over-the-counter drugs that come through MedWatch, which is the FDA's adverse event reporting program. FDA also conducts pre-marketing reviews of all proprietary drug names, labeling and packaging to minimize the potential for confusion. Furthermore, FDA educates the public about medication error prevention through public health advisories, medica¬tion guides and outreach partner ships with other organizations.

Grapefruit juice can delay, increase or enhance the reaction of some drugs. Check your prescription labels for warnings of potentially dangerous grapefruit interactions.