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.
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).
Some descriptions found on the label could be a clue that the medicine should not be cut, crushed, or chewed. Words and phrases such as extended-release; time release; slow release; sustained release; 8, 12, or 24 hours of relief; lozenges; effervescent; safety coated; enteric coated; comfort coated; controlled dose; long acting; sustained action; and time delayed are some examples. See the slide show below for specific examples.
