Photo Credit: by dumbeast, Flickr.com
Due to a quirk in the pricing strategy for most prescription medications, particularly in the United States, one medication may have the similar pricings for a range of different dosages. Also, a pill with lowest dosage does not mean the lowest price for this medication. A pill with a dosage twice as strong as prescribed may not be twice the price.
According to a recent report from the American Council of Economic Advisors to the White House, the United States funds nearly ½ of the entire world’s medical research and development. This is because American drug prices are the highest in the world, pulling in more profits for the drug companies than anywhere else. What happens is, a fifth of the revenue brought in is redirected back into research and development of new medications. But it also means, high drug prices for the American people as we take on this burden.
With healthcare costs digging deep into most consumer pockets, sometimes people have to get creative in order to make ends meet while staying on top of their medications. The practice of splitting pills (cutting them in half) is one many doctors and even some health plans support. However, despite this, 8% of consumers still admit to splitting pills without approval—and this is practice can land someone in the ER, if not careful.
Pill splitting, when done right and under the direct guidance of a doctor or pharmacist can definitely save you some money. However, it’s best to know there are risks, as well as rewards, when considering it as a viable option.
WHO & WHAT SHOULD SPLIT?
Patients trying to save money aren’t the only ones considering pill splitting. In fact, pill splitting may be the only viable option for patients who need a lower dosage as prescribed however there might be only one dosage option for that medication. E.g., patients who are prescribed to Abilify 2.5 mg but the lowest dosage of Abilify starts from 5 mg. The similar problem for Domperidone - only 10mg exists in the market but sometimes the patient is prescribed to 5 mg. So, they’ll split the tablet in half to take half dosages. Others may split a tablet if the next jump in dosage is too high—effectively creating a dose and a half. The doctor may sometimes prescribe “half of the pill” on the RX note.
Generally speaking, most blood pressure medications, erectile dysfunction medications, cholesterol medications, and depression tablets are good candidates for splitting. Consumer Reports has a pretty great quick-glance list of pills that can be split and ones that should not be.
NOTE: It’s important to note that just because a tablet is scored, does not mean it’s meant to be split. Don’t assume anything. Not all scored tablets are meant to be broken, as many of them may be scored simply for aesthetic sake.
DO:
If pill splitting has been recommended, or if you’re considering it as a way to bring your medication costs down, there are a few things you’ll want to do before you cut that first pill in half (or quarters).
Look for approval on package insert. If you’re wondering if the medication you’re currently taking can be split, open up the package insert and have a look around. Those approved for splitting will have the details inside the packet. You can take this information with you when you visit your doctor or pharmacist next.
Consider your physical limitations. If your medical condition, or a disability has made your hands unsteady or weak, or if your vision is impaired, it can be difficult, if not dangerous, to split the tablets on your own.
Always ask your doctor or pharmacist first. Your doctor will be able to tell you if the medication you’re taking is a good candidate for pill splitting. Not all medications should be split, even if they look like they can be. While you’re chatting, it’s important to note not every patient is a good fit for pill splitting either. If you’re prone to forgetfulness or have any disability that would stop you from accurately splitting the pill, your doctor may not advise it.
During your talk, if your doctor believes you and your medication are a good candidate, here’s what you should have them do:
• Prescribe higher dosage (usually double) so when it’s split, it equals the therapeutic dosage you’re prescribed.
• Get their advice on a pill splitter meant for this kind of work. This may be better asked of your pharmacist, but here’s a site with some great recommendations.
Use a pill splitter. Commercially available pill splitters will allow you to more accurately cut your pills to the correct dosage, minimizing or reducing completely any crumbling of the tablets.
Do NOT:
There are some definite no-go’s when it comes to pill splitting. In order to safely cut your pills and be sure you’re getting the correct dosage for your biochemistry, you’ll want to pay attention to these.
Do not split tablets without a doctor or pharmacist’s advice
. There is a narrow window between a therapeutic dosage and one that could hurt you.
These types of pills should NEVER be split:
• Extended-release (ER) or sustained-release (SR) and prolonged-release tablets can’t be split. Medications which dissolve at specific intervals in the digestive system cannot be split while maintaining their efficacy.
• Combination drugs should not be split. There is no guarantee when you a split a combination medication that you will get the perfect split of active ingredients.
• Coated tablets should not be split. These medications are coated to make it easier to swallow, protect your stomach, or for various other reasons. Cutting them in half would leave one side open to the active ingredients, nullifying the protective coating.
• Capsules should not be split. Inside, the medication is a powder and typically cannot be split equally for maximum efficacy and safety.
Don’t use scissors or kitchen knives
. This can cause crumbling and can change the dosage you end up ingesting. Always use a commercially available pill splitter.
Don’t split entire vials of tablets at one time
. Most doctors and pharmacists will want you to cut your pill just before use. The air can cause degradation to some active ingredients, causing you to get the wrong dose.
When it comes to pill splitting, the biggest concern is safety. Incorrectly splitting your pills can cause an overdose (or under-dose) of medication – both of which can be dangerous in the right circumstances. Cutting tablets without the approval and guidance of a medical provider or pharmacist can land you in the ER—or worse. It’s always best to first start with an open dialogue with your doctor or pharmacist, when you’re considering this step. They’ll be able to guide you on whether or not pill splitting makes sense in your circumstances. If you’re a good candidate, as well as your medication, be sure use the right tools by investing in a quality pill splitter. Treat pill splitting with a certain amount of caution, but know when done right and with approval, you can save yourself a lot of money over the years.
References:
http://fortune.com/2018/08/09/trump-drugs-prices-pharmaceutical-research/
https://www.consumerreports.org/drugs/is-it-safe-to-split-pills-in-half/
https://www.ncbi.nlm.nih.gov/pubmed/20069474
###
Your email address will not be published. Required fields are marked with *.