Mistakes can occur when people have trouble swallowing a tablet or capsule and they try to chew, crush, break or mix the tablet or capsule in food or drink. The reason is certain medications have a special release mechanism designed to slowly release a certain amount of medication over a given extended time. If the medication is altered or destroyed in any way, the medication can be released too fast and cause a bad effect.
Below is a list of medications that should be swallowed whole.
Download: List of Tablets You Can’t Crush or Chew
John F. Mitchell, PharmD, FASHP1
Last updated: March 2012
| Drug Product | (active ingredient)2 | Dosage Form | Reasons/Comments 3 |
|---|---|---|---|
| Accutane | (ISOtretinoin) | Capsule | Mucous membrane irritant |
| Aciphex | (RABEprazole) | Tablet | Slow-release |
| Actiq | (fentaNYL) | Lozenge | Slow-release Note: this lollipop delivery system requires the patient to slowly allow dissolution |
| Actonel | (risedronate) | Tablet | Irritant Note: chewed, crushed, or sucked tablets may cause oropharyngeal irritation |
| Adalat CC | (NIFEdipine) | Tablet | Slow-release |
| Adderall XR | (amphetamine salts) | Capsule | Slow-release (a) |
| AeroHist Plus | (combination) | Tablet | Slow-release (h) |
| Afeditab CR | (NIFEdipine) | (NIFEdipine) | Slow-release |
| Afinitor | (everolimus) | Tablet | Mucous membrane irritant |
| Aggrenox | (combination) | Capsule | Slow-release |
| Alavert Allergy Sinus 12 Hour |
(combination) | Tablet | Slow-release |
| Allegra-D | (combination) | Tablet | Slow-release |
| Allfen Jr | (guaiFENesin) | Tablet Capsule |
Slow-release Slow-release (a) |
| Alophen | (bisacodyl) | Tablet | Enteric-coated |
| ALPRAZolam ER | (ALPRAZolam) | Tablet | Slow-release |
| Altoprev | (lovastatin) | Tablet | Slow-release |
| Ambien CR | (zolpidem) |
Tablet | Extended-release |
| Amibid DM | (combination) | Tablet | Slow-release |
| Amitiza | (lubiprostone) | Capsule | Slow-release |
| Ampyra | (dalfampridine) |
Tablet |
Slow-release |
| Amrix | (cyclobenzaprine) | Capsule | Slow-release |
| Aplenzin | (buPROPion) | Tablet | Slow-release |
| Apriso | (mesalamine) | Capsule | Slow-release (a) Note: maintain pH at less than or equal to 6.0 |
| Aptivus | (tipranavir) | Capsule | Note: oil emulsion within spheres; taste |
| Aquatab C | (combination) | Tablet | Slow-release (h) |
| Aquatab D | (combination) | Tablet | Slow-release (h) |
| Aricept 23 mg | (donepezil) |
Tablet | Note: Crushing the 23 mg tablet may significantly increase the rate of absorption; the 5 and 10 mg tablets are not affected |
| Arthrotec | (diclofenac) | Tablet | Enteric-coated |
| Asacol | (mesalamine) | Tablet | Slow-release |
| Ascriptin A/D | (combination) | Tablet | Enteric coated |
| Atelvia | (risedronate) |
Tablet |
Extended-release Note: tablet coating is an important part of the delayed release |
| Azulfidine EN | (sulfasalazine) | Tablet | Enteric-coated |
| Augmentin XR | (combination) | Tablet | Slow-release (b,h) |
| AVINza | (morphine) | Capsule | Slow-release (a; not pudding) |
| Avodart | (dutasteride) | Capsule | Note: drug may cause fetal abnormalities; women who are, or may become, pregnant, should not handle capsules; all woman should use caution in handling capsules, especially leaking capsules |
| Bayer EC | (aspirin) | Caplet | Enteric-coated |
| Bayer Low Adult | (aspirin) | Tablet | Enteric-coated |
| Bayer Regular | (aspirin) | Caplet | Enteric-coated |
| Bellahist-D LA | (combination) | Tablet | Slow-release |
| Biaxin-XL | (clarithromycin) | Tablet | Slow-release |
| Bidex A | (combination) | Tablet | Slow-release |
| Bidhist-D | (combination) | Tablet | Slow-release |
| Biltricide | (praziquantel) | Tablet | Taste (h) |
| Bisa-Lax | (combination) | Tablet | Enteric-coated (c) |
| Biohist LA | (combination) | Tablet | Slow-release (h) |
| Bisac-Evac | (bisacodyl) | Tablet | Enteric-coated (c) |
| Bisacodyl | (combination) | Tablet | Enteric-coated (c) |
| Boniva | (ibandronate) | Tablet | Note: chewed, crushed, or sucked tablets may cause oropharyngeal irritation |
| Bromfed PD | (combination) | Capsule | Slow-release |
| Budeprion SR | (combination) | Tablet | Slow-release |
| Calan SR | (verapamil) | Tablet | Slow-release (h) |
| Carbatrol | (carBAMazepine) | Capsule | Slow-release (a) |
| Cardene SR | (nicardipine) | Capsule | Slow-release |
| Cardizem | (diltiazem) | Tablet | Note: although not in the PI, the drug has a coating that is intended to release the drug over approximately 3 hours |
| Cardizem CD | (diltiazem) | Capsule | Slow-release |
| Cardizem LA | (diltiazem) | Tablet | Slow-release |
| Cardura XL | (doxazosin) | Tablet | Slow-release |
| Cartia XT | (diltiazem) | Capsule | Slow-release |
| Cefaclor ER | (combination) | Tablet | Slow-release |
| Ceftin | (cefuroxime) | Tablet | Taste (b) Note: use suspension for children |
| Cefuroxime | (combination) | Tablet | Taste (b) Note: use suspension for children |
| CellCept | (mycophenolate) | Capsule, Tablet | Teratogenic potential (i) |
| Charcoal Plus | - | Tablet | Enteric-coated |
| Chlor-Trimeton 12-H | (combination) | Tablet | Slow-release (b) |
| Cipro XR | (ciprofloxacin) | Tablet | Slow-release |
| Claritin-D 12 Hour | (combination) | Tablet | Slow-release |
| Claritin-D 24 Hour | (combination) | Tablet | Slow-release |
| Colace | (docusate) | Capsule | Taste (e) |
| Colestid | (colestipol) | Tablet | Slow-release |
| Concerta | (methylphenidate) | Tablet | Slow-release |
| Commit | (nicotine) | Lozenge | Note: integrity compromised by chewing or crushing |
| Cotazym-S | (pancrelipase) | Capsule | Enteric-coated (a) |
| Covera-HS | (verapamil) | Tablet | Slow-release |
| Creon 5, 10, 20 | (pancrelipase) | Capsule | Slow-release (a) |
| Crixivan | (indinavir) | Capsule | Taste Note: capsule may be opened and mixed with fruit puree (e.g., banana) |
| Cymbalta | (duloxetine) | Capsule | Slow-release (a); Note: may add contents of capsule to apple juice or applesauce but NOT chocolate |
| Cytoxan | (cyclophosphamide) | Tablet | Note: drug may be crushed but company recommends using injection |
| Cytovene | (ganciclovir) | Capsule | Skin irritant |
| Dallergy | (combination) | Tablet | Slow-release (b, h) |
| Dallergy - JR | (combination) | Capsule | Slow-release |
| Deconamine SR | (combination) | Capsule | Slow-release (b) |
| Depakene | (divalproex) | Capsule | Slow-release; mucous membrane irritant (b) |
| Depakote | (divalproex) | Tablet | Slow-release |
| Depakote ER | (divalproex) | Tablet | Slow-release |
| Detrol LA | (tolterodine) | Capsule | Slow-release |
| Dexilant | (dexlansoprazole) | Capsule | Slow-release (a) |
| Dilacor XR | (diltiazem) | Capsule | Slow-release |
| Dilatrate-SR | (isosorbide) | Capsule | Slow-release |
| Dilt-CD | (diltiazem) | Capsule | Slow-release |
| Dilt-XR | (diltiazem) | Capsule | Slow-release |
| Diltia XT | (diltiazem) | Capsule | Slow-release |
| Ditropan XL | (oxybutynin) | Tablet | Slow-release |
| Divalproex ER | (combination) | Tablet | Slow-release |
| Doxidan | (bisacodyl) | Tablet | Enteric-coated (c) |
| Drisdol | (ergocalciferol) | Capsule | Liquid filled (d) |
| DriHist SR | (combination) | Tablet | Slow-release (h) |
| Drixoral Cold/Allergy | (combination) | Tablet | Slow-release |
| Drixoral Nondrowsy | (combination) | Tablet | Slow-release |
| Drixoral Allergy Sinus | (combination) | Tablet | Slow-release |
| Droxia | (hydroxyurea) | Capsule | Note: exposure to the powder may cause serious skin toxicities; healthcare workers should wear gloves to administer |
| Drysec | (combination) | Tablet | Slow-release (h) |
| Dulcolax | (bisacodyl) | Tablet Capsule |
Enteric-coated (c) Liquid-filled |
| DuraHist | (combination) | Tablet | Slow-release (h) |
| DuraHist D | (combination) | Tablet | Slow-release (h) |
| DynaCirc CR | (isradipine) | Tablet | Slow-release |
| Duraphen II DM | (combination) | Tablet | Slow-release (h) |
| Duraphen Forte | (combination) | Tablet | Slow-release (h) |
| Duratuss A | (combination) | Tablet | Slow-release (h) |
| Dynex | (combination) | Tablet | Slow-release (h) |
| Easprin | (aspirin) | Tablet | Enteric-coated |
| EC-Naprosyn | (combination) | Tablet | Enteric-coated |
| Ecotrin Adult Low Strength | (aspirin) | Tablet | Enteric-coated |
| Ecotrin Maximum Strength | (aspirin) | Tablet | Enteric-coated |
| Ecotrin Regular Strength | (aspirin) | Tablet | Enteric-coated |
| Ed A-Hist | (combination) | Tablet | Slow-release (b) |
| E.E.S. 400 | (erythromycin) | Tablet | Enteric-coated (b) |
| Effer-K | (potassium bicarbonate) | Tablet | Effervescent tablet (f) |
| Effervescent Potassium | - | Tablet | Effervescent tablet (f) |
| Effexor XR | (venlafaxine) | Capsule | Slow-release |
| Embeda | (morphine sulfate) | Capsule | Slow-release (a); do not give via N/G tube |
| E-Mycin | (erythromycin) | Tablet | Enteric-coated |
| Enablex | (darifenacin) | Tablet | Slow-release |
| Entocort EC | (budesonide) | Capsule | Enteric-coated (a) |
| Equetro | (carBAMazepine) | Capsule | Slow-release (a) |
| Ergomar | (ergotamine) | Tablet | Sublingual form (g) |
| Erivedge | (vismodegib) |
Capsule | Note: PI indicates potential teratogenic; MSDS warns against skin contact; healthcare workers should take appropriate cautions |
| Ery-Tab | (erythromycin) | Tablet | Enteric-coated |
| Erythromycin Stearate | - | Tablet | Enteric-coated |
| Erythromycin Base | - | Tablet | Enteric-coated |
| Erythromycin Delayed-Release | - | Capsule | Enteric-coated Pellets (a) |
| Evista | (raloxifene) | Tablet | Taste; teratogenic potential (i) |
| Exalgo | (HYDROmorphone) |
Tablet |
Slow-release Note: breaking, chewing, crushing, dissolving before swallowing or administering could result in overdose |
| Extendryl JR | (combination) | Capsule | Slow-release |
| Extendryl SR | (combination) | Capsule | Slow-release (b) |
| Feen-a-mint | (bisacodyl) | Tablet | Enteric-coated (c) |
| Feldene | (piroxicam) | Capsule | Mucous membrane irritant |
| Fentora | (fentaNYL) | Tablet | Note: buccal tablet; swallow whole |
| Feosol | (ferrous sulfate) | Tablet | Enteric-coated (b) |
| Feratab | (ferrous sulfate) | Tablet | Enteric-coated (b) |
| Fergon | (ferrous gluconate) | Tablet | Enteric-coated |
| Fero-Grad 500 mg | (combination) | Tablet | Slow-release |
| Ferro-Sequels | (combination) | Tablet | Slow-release |
| Flagyl ER | (metroNIDAZOLE) | Tablet | Slow-release. |
| Fleet Laxative | (bisacodyl) | Tablet | Enteric-coated (c) |
| Flomax | (tamsulosin) | Capsule | Slow-release |
| Focalin XR | (dexmethylphenidate) | Capsule | Slow-release (a) |
| Fosamax | (alendronate) | Tablet | Mucous membrane irritant |
| Gleevec | (imatinib) | Tablet | Taste (h) Note: may be dissolved in water or apple juice |
| Glucophage XR | (metFORMIN) | Tablet | Slow-release |
| Glucotrol XL | (glipiZIDE) | Tablet | Slow-release |
| Glumetza | (metFORMIN) | Tablet | Slow-release |
| Gralise | (gabapentin) |
Tablet | Slow-release |
| Guaifed | (combination) | Capsule | Slow-release |
| Guaifed-PD | (combination) | Capsule | Slow-release |
| GuaiFENesin Pseudoephedrine | - | Tablet | Slow-release |
| Guaifenex DM | (combination) | Tablet | Slow-release (h) |
| Guaifenex GP | (combination) | Tablet | Slow-release |
| Guaifenex PSE | (combination) | Tablet | Slow-release (h) |
| GuaiMAX-D | (combination) | Tablet | Slow-release |
|
Halfprin 81 |
(aspirin) | Tablet | Enteric-coated |
|
Horizant |
(gabapentin encarbil) |
Tablet | Slow-Release |
| Hista-Vent DA | (combination) | Tablet | Slow-release (h) |
| Hydrea | (hydroxyurea) | Capsule | Note: exposure to the powder may cause serious skin toxicities; healthcare workers should wear gloves to administer. |
| Imdur | (isosorbide) | Tablet | Slow-release (h) |
| Inderal LA | (propranolol) | Capsule | Slow-release |
| Indocin SR | (indomethacin) | Capsule | Slow-release (a,b) |
| Innopran XL | (propranolol) | Capsule | Slow-release |
| Intelence | (etravirine) | Tablet | Note: tablet should be swallowed whole and not crushed; tablet may be dispersed in water |
| Intermezzo | (zolpidem) |
Tablet | Sublingual form (g) |
| Intuniv | (guanFACINE) | Tablet | Slow-release |
| Invega | (paliperidone) | Tablet | Slow-release |
| Isochron | (isosorbide) | Tablet | Slow-release |
| Isoptin SR | (verapamil) | Tablet | Slow-release h |
| Isordil Sublingual | (isosorbide) | Tablet | Sublingual form (g) |
| Isosorbide Dinitrate Sublingual | (isosorbide) | Tablet | Sublingual form (g) |
| Isosorbide SR | (isosorbide) | Tablet | Slow-release |
| Jakafi | (ruxolitinib) |
Tablet | Note: see PI for making a suspension |
| Jalyn | (dutasteride/tamsulosin) | Capsule | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets (l) |
| Janumet XR | (sitagliptin/metFORMIN |
Tablets | Extended-release |
| Jenloga | (cloNIDine) |
Tablet | Slow-release |
| Kadian | (morphine) | Capsule | Slow-release (a) Note: do not give via NG tubes |
| Kaletra | (combination) | Tablet | Film-coated |
| Kapidex | (dexlansoprazole) | Capsule | Slow-release (a) Note: named changed to Dexilant |
| Kapvay | (cloNIDine) |
Tablet | Slow-release |
| Kaon CL-10 | (potassium) | Tablet | Slow-release (b) |
| Keppra | (levetiracetam) | Tablet | Taste Note: some extemporaneous formulas are Pharmacy prepared |
| Ketek | (telithromycin) | Tablet | Slow-release (b) |
| Klor-Con | (potassium) | Tablet | Slow-release (b) |
| Klor-Con M | (potassium) | Table | Slow-release (b, h) |
| Klotrix | (potassium) | Tablet | Slow-release |
| Kombiglyze XR | (combination) |
Tablet |
Extended-release Note: tablet matrix may remain in stool |
| K-Dur | (potassium) | Tablet | Slow-release |
| K-Lyte | (potassium) | Tablet | Effervescent tablet (f) |
| K-Lyte CL | (potassium) | Tablet | Effervescent tablet (f) |
| K-Lyte DS | (potassium) | Tablet | Effervescent tablet (f) |
| K-Tab | (potassium) | Tablet | Slow-release (b) |
| LaMICtal XR | (lamoTRIgine) | Tablet | Slow-release |
| Lescol XL | (fluvastatin) | Tablet | Slow-release |
| Letairis | (ambrisentan) | Tablet | Slow-release |
| Levbid | (hyoscyamine) | Tablet | Slow-release (h) |
| Levsinex Timecaps | (hyoscyamine) | Capsule | Slow-release |
| Lialda | (mesalamine) | Tablet | Slow-release |
| Liquibid-PD | (combination) | Tablet | Slow-release (h) |
| Lithobid | (lithium) | Tablet | Slow-release |
| Lodrane 24 | (brompheniramine) | Capsule | Slow-release |
| Lodrane 24D | (combination) | Capsule | Slow-release |
| LoHist 12 Hour | (brompheniramine) | Tablet | Slow-release |
| Lovaza | (combination) | Capsule | Note: contents of capsule may erode walls of styrofoam or plastic materials |
| Luvox CR | (fluvoxamine) | Capsule | Slow-release |
| Maxifed DM | (combination) | Tablet | Slow-release (h) |
| Maxifed DMX | (combination) | Tablet | Slow-release (h) |
| Maxiphen DM | (combination) | Tablet | Slow-release (h) |
| Medent-DM | (combination) | Tablet | Slow-release |
| Mestinon ER | (pyridostigmine) | Tablet | Slow-release (b) |
| Metadate ER | (methylphenidate) | Tablet | Slow-release |
| Metadate CD | (methylphenidate) | Capsule | Slow-release (a) |
| Methylin ER | (methylphenidate) | Tablet | Slow-release |
| Metoprolol ER | - | Tablet | Slow-release |
| Micro K Extencaps | (potassium chloride) | Capsule | Slow-release (a,b) |
| Miraphen PSE | (combination) | Tablet | Slow-release |
| Modane | (combination) | Tablet | Enteric-coated (c) |
| Moxatag | (amoxicillin) | Tablet | Slow-release |
| Morphine sulfate extended-release |
- | Tablet | Slow-release |
| Motrin | (ibuprofen) | Tablet | Taste (e) |
| MS Contin | (morphine) | Tablet | Slow-release (b) |
| Mucinex | (guaiFENesin) | Tablet | Slow-release |
| Mucinex DM | (combination) | Tablet | Slow-release |
| Myfortic | (mycophenolate) | Tablet | Slow-release |
| Namenda XR | (memantine) | Capsule | Slow-release (a) |
| Naprelan | (naproxen) | Tablet | Slow-release |
| Nasatab LA | (combination) | Tablet | Slow-release (h) |
| NexIUM | (esomeprazole) | Capsule | Slow-release (a) |
| Niaspan | (nicotinic acid) | Tablet | Slow-release |
| Nicotinic Acid | - | Capsule Tablet |
Slow-release (h) |
| Nifediac CC | (NIFEDipine) | Tablet | Slow-release |
| Nifedical XL | (NIFEDipine) | Tablet | Slow-release |
| Nitrostat | (nitroglycerin) | Tablet | Sublingual route (g) |
|
Norpace CR |
(disopyramide) | Capsule | Slow-release form within a special capsule |
|
Norvir |
(ritonavir) |
Tablet | Note: crushing tablets has resulted in decreased bioavailability of drug (b) |
|
Nucynta ER |
(tapentadol) |
Tablet |
Extended-release Note: Toxic dose may occur if tablet is split or crushed |
|
Oleptro |
(traZODone) |
Tablet |
Slow-release |
|
Opana ER |
(oxymorphone) |
Tablet |
Extended-release |
| Oracea | (doxycycline) | Capsule | Slow-release |
| Oramorph SR | (morphine) | Tablet | Slow-release (b) |
| Orphenadrine citrate ER | Tablet | Extended-release | |
| OxyCONTIN | (oxyCODONE) | Tablet | Slow-release Note: tablet disruption may cause a potentially fatal overdose of oxyCODONE |
| Oxymorphone ER | Tablet | Extended-release | |
| Pancrease Delayed-Release |
(pancrelipase) | Capsule | Slow-release |
| Pancrease MT | (pancrelipase) | Capsule | Enteric-coated (a) |
| Pancrecarb | (pancrelipase) | Capsule | Enteric-coated (a) |
| Pancrelipase | - | Capsule | Enteric-coated (a) |
| Panocaps | (pancrelipase) | Capsule | Enteric-coated (a) |
| Panocaps MT | (pancrelipase) | Capsule | Enteric-coated (a) |
| Paxil CR | (PARoxetine) | Tablet | Slow-release |
| Pentasa | (mesalamine) | Capsule | Slow-release |
| PhenaVent D | (combination) | Tablet | Slow-release (h) |
| PhenaVent LA | (combination) | Capsule | Slow-release |
| Pre-Hist-D | (combination) | Tablet | Slow-release (h) |
| Plendil | (felodipine) | Tablet | Slow-release |
| Pradaxa | (dabigatran) |
Capsule | Note: bioavailability increases by 75% when the pellets are taken without the capsule shell |
| Prevacid | (lansoprazole) | Capsule | Slow-release |
| Prevacid SoluTab | (lansoprazole) | Tablet | Note: Orally disintegrating do not swallow; dissolve in water only and dispense via dosing syringe or NG tube |
| Prevacid Suspension |
(lansoprazole) | Suspension | Slow-release Note: contains enteric-coated granules; mix with water only; not for NG use |
| PriLOSEC | (omeprazole) | Capsule | Slow-release |
| PriLOSEC OTC | (omeprazole) | Tablet | Slow-release |
| Procardia XL | (NIFEDipine) | Tablet | Slow-release |
| Propecia | (finasteride) | Tablet | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets |
| Proquin XR | (ciprofloxicin) | Tablet | Slow-release |
| Proscar | (finasteride) | Tablet | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets |
| Protonix | (pantoprazole) | Tablet | Slow-release |
| PROzac Weekly | (FLUoxetine) | Tablet | Enteric-coated |
| QDALL | (combination) | Capsule | Slow-release |
| QDALL AR | (combination) | Capsule | Slow-release |
| Ralix | (combination) | Tablet | Slow-release (h) |
| Ranexa | (ranolazine) | Tablet | Slow-release |
| Rapamune | (sirolimus) |
Tablet | Note: pharmacokinetic NanoCrystal technology may be affected (b) |
| Razadyne ER | (galantamine) | Capsule | Slow-release |
| Renagel | (sevelamer) | Tablet | Note: tablets expand in liquid if broken or crushed |
| Renvela | (sevelamer carbonate) |
Tablet | Note: tablets expand in liquid if broken or crushed (b) |
| Requip XL | (ropinirole) | Tablet | Slow-release |
| Rescon | (combination) | Tablet | Slow-release (h) |
| Rescon JR | (combination) | Tablet | Slow-release (h) |
| Rescon MX | (combination) | Tablet | Slow-release (h) |
| Respa-1st | (combination) | Tablet | Slow-release (h) |
| Respa-DM | (combination) | Tablet | Slow-release (h) |
| Respahist | (combination) | Capsule | Slow-release (a) |
| Respaire SR | (combination) | Capsule | Slow-release |
| Revlimid | (lenalidomide) | Capsule | Note: Teratogenic potential; healthcare workers should avoid contact with capsule contents/body fluids |
| Ritalin LA | (methylphenidate) | Capsule | Slow-release (a) |
| Ritalin SR | (methylphenidate) | Tablet | Slow-release |
| R-Tanna | (combination) | Tablet | Slow-release |
| Rythmol SR | (propafenone) | Capsule | Slow-release |
| Ryzolt | (traMADol) | Tablet | Slow-release Note: crushing may cause overdose |
| Sensipar | (cinacalcet) |
Tablet) | Note: tablets are not scored and cutting may cause variable dosage accuracy |
| SEROquel XR | (QUEtiapine) | Tablet | Slow-release |
| Sinemet CR | (levo/carbidopa) | Tablet | Slow-release (h) |
| Sinuvent PE | (combination) | Tablet | Slow-release (h) |
| Slo-Niacin | (nicotinic acid) | Tablet | Slow-release (h) |
| Solodyn | (minocycline) | Tablet | Slow-release |
| Somnote | (chloral hydrate) | Capsule | Liquid filled |
| Sprycel | (dasatinib) | Tablet | Film-coated Note: active ingredients are surrounded by a wax matrix to prevent healthcare exposure; women who are, or may become, pregnant, should not handle crushed or broken tablets |
| Strattera | (atomoxetine) | Capsule | Note: capsule contents can cause ocular irritation |
| Sudafed 12 hour | (combination) | Capsule | Slow-release (b) |
| Sudafed 24 hour | (combination) | Capsule | Slow-release (b) |
| Sular | (nisoldipine) | Tablet | Slow-release |
| Symax Duotab | (hyoscyamine) | Tablet | Slow-release |
| Symax SR | (hyoscyamine) | Tablet | Slow-release |
| Tasigna | (nilotinib) | Capsule | Note: disruption of capsule may yield high blood levels causing enhanced toxicity |
| Taztia XT | (diltiazem) | Capsule | Slow-release (a) Slow-release (a) |
| Tegretol-XR | (carBAMazepine) | Tablet | Slow-release |
| Temodar | (temozolomide) | Capsule | Slow-release Note: accidentally opened or damaged capsules require rigorous precautions to avoid inhalation or contact with the skin or mucous membranes (i) |
| Tessalon Perles | (benzonatate) | Capsule | Note: swallow whole; local anesthesia of the oral mucosa; choking could occur |
| Theo-24 | (theophylline) | Capsule | Slow-release; Note: contains beads that dissolve throughout the GI tract |
| Theochron | (theophylline) | Tablet | Slow-release |
| Tiazac | (diltiazem) | Capsule | Slow-release (a) |
| Topamax | (topiramate) | Tablet Capsule |
Taste Taste (a) |
| Toprol XL | (metoprolol) | Tablet | Slow-release (h) |
| Touro CC-LD | (combination) | Tablet | Slow-release (h) |
| Touro LA-LD | (combination) | Tablet | Slow-release (h) |
| Toviaz | (fesoterodine) | Tablet | Slow-release |
| Tracleer | (bosentan) | Tablet | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets |
| Trental | (pentoxifylline) | Tablet | Slow-release |
| Treximet | (combination) | Tablet | Note: unique drug matrix enhances rapid drug absorption |
| Tylenol Arthritis | (acetaminophen) | Tablet | Slow-release |
| Ultram ER | (traMADol) | Tablet | Slow-release Note: tablet disruption may cause a potentially fatal overdose of drug |
| Ultrase | (pancrelipase) | Capsule | Enteric-coated |
| Uniphyl | (theophylline) | Tablet | Slow-release |
| Urocit-K | (potassium citrate) | Tablet | Wax-coated; prevents upper GI release |
| Uroxatral | (alfuzosin) | Tablet | Slow-release |
| Valcyte | (valGANCiclovir) | Tablet | Teratogenic and irritant potential (i, b) |
| Verapamil SR | - | Tablet | Slow-release (h) |
| Verelan | (verapamil) | Capsule | Slow-release (a) |
| Verelan PM | (verapamil) | Capsule | Slow-release (a) |
| VesiCare | (solifenacin) | Tablet | Enteric coated |
| Videx EC | (didanosine) | Capsule | Slow-release |
| Vimovo | (naproxen/esomeprazole) | Tablet | Slow-release |
| Viramune XR | (nevirapine) |
Tablet | Extended-release (b) |
| Voltaren XR | (diclofenac) | Tablet | Slow-release |
| VoSpire ER | (albuterol) | Tablet | Slow-release |
| Votrient | (pazopanib) | Tablet | Note: crushing significantly increases the AUC and Tmax |
| Wellbutrin SR, XL | (buPROPion) | Tablet | Slow-release |
| Xanax XR | (ALPRAZolam) | Tablet | Slow-release |
| Zegerid OTC | (omeprazole/sodium bicarbonate |
Capsule | Slow-release |
| Zenpep | (pancrelipase) | Capsules | Slow-release (a) |
| Zolinza | (vorinostat) | Capsule | Note: irritant; avoid contact with skin or mucous membranes; avoid contact with crushed or broken tablets |
| ZORprin | (aspirin) | Tablet | Slow-release |
| Zortress | (everolimus) | Tablet | Note: crushed powder may cause dangerous effects to mucous membranes |
| Zyban | (buPROPion) | Tablet | Slow-release |
| Zyflo CR | (zileuton) | Tablet | Slow-release |
| (a) | Capsule may be opened and the contents taken without crushing or chewing; soft food such as applesauce or pudding may facilitate administration; contents may generally be administered via nasogastric tube using an appropriate fluid provided entire contents and washed down the tube. | ||
| (b) | Liquid dosage forms of the product are available; however, dose, frequency of administration and manufacturers may differ from that of the solid dosage form. | ||
| (c) | Antacids and/or milk may prematurely dissolve the coating of the tablet. | ||
| (d) | Capsule may be opened and the liquid contents removed for administration. | ||
| (e) | The taste of this product in a liquid form would likely be unacceptable to the patient; administration via nasogastric tube should be acceptable. | ||
| (f) | Effervescent tablets must be dissolved in the amount of diluent recommended by the manufacturer. | ||
| (g) | Tablets are made to disintegrate under the tongue. | ||
| (h) | Tablet is scored and may be broken in half without affecting release characteristics. | ||
| (i) | Skin contact may enhance tumor production; avoid direct contact. | ||
Disclaimer: This listing is not meant to represent all products, either by generic or trade name. The author encourages manufacturers, pharmacists, nurses, and other health professionals to notify him of any changes or updates. 1.
- Correspondence regarding this list may be addressed to:
John F. Mitchell, Pharm.D., FASHP
Email: This email address is being protected from spambots. You need JavaScript enabled to view it. - The generic name is provided merely as a reference point and is only listed for single ingredient medications; it should not be assumed that drugs with the same generic are equivalent to the specific brand name listed relative to crushing or chewing. If questions arise, please check with your pharmacist.
- Two official USP terms are used to designate special-release medication forms: "extended release" and "delayed release". Others such as "sustained release", "controlled release", etc. are commonly used on package labeling. The term "Slow-release" is being used here to signify all such drugs with a special-release mechanism.
© Copyright 2012. No part of this list may be reproduced in any format without the expressed permission of the author.
