Saving money is far from the only reason that encourages us to divide medicines into parts. When can this be done, and when is it absolutely impossible?
Our expert – Associate Professor of the Department of Pharmacology named after A. P. Nelyubina Sechenov University, Candidate of Pharmaceutical Sciences Olga Stepanova.
Only a third of drug instructions contain instructions from the manufacturer about the possibility of dividing them. Often, patients consider the presence of a notch (risks) to be a signal for dividing the tablet. It’s really just a design element.
half for you and half for me
The need to share the medicine arises for various reasons.
- The prescribed dose is lower than the one in the pharmacy. And it happens that the drug in the right dosage is simply not produced.
- The size of the tablet does not allow swallowing it whole. Such difficulties are more often experienced by children and the elderly, as well as adults with individual characteristics. Problems arise up to vomiting, fear of choking, or pain in the esophagus after swallowing.
The need to stop taking the medicine gradually. These can be sleeping pills, tranquilizers, antidepressants and other drugs that have a withdrawal syndrome.
Saving money. The drug in a large dosage can be divided into 2-3 doses. Financially it is, of course, more profitable. True, this can not be done with all medicines.
Many active substances in preparations are damaged by sunlight or high humidity. The opened cell of the blister cannot provide the necessary protection either. It often happens that the patient uses the drug episodically and the next dose may come in a few days, and sometimes even weeks – the therapeutic activity of the “awaiting” part of the pill will drop sharply.
Do not share!
There are drugs that absolutely cannot be divided.
Intended for absorption in the stomach or intestines (as a rule, such drugs have a protective shell). The coating, which is resistant to the action of gastric juice or enzymes, dissolves only after the tablet has left the stomach. If the drug is broken, the coating will be damaged, and its contents will be in the stomach cavity. In this case, either the effect of the drug is neutralized, since the active substance will be damaged by the acid of the gastric juice, or the stomach itself will suffer from the active substance (which can lead to nausea, vomiting, pain). There are also drugs, the absorption of which depends on the pH environment in which they find themselves. Acids are better absorbed in the acidic environment of the stomach, while alkalis are better absorbed in the intestines, where the pH is alkaline. Once “not at ease”, the active substance will be much weaker.
prolonged action. These drugs take time to be absorbed into the blood. Such funds are usually taken only once a day. To do this, they initially contain a triple dose of a biologically active substance. Breaking such a tablet into 3 parts, the patient will get a sharp and instant effect.
Most suppositories (rectal, vaginal, etc.). They are not recommended to be divided, with the exception of those few drugs, the division of which is clearly stated in the instructions. When cutting a candle into roughly equal halves, it is impossible to evenly divide the amount of the active substance contained in them. In addition, when dividing, the streamlined shape will be disturbed, and when a candle is inserted, a tender area can be injured.
Capsules, dragees, lozenges for resorption. It is impossible to break the protective shell of the capsule under which the medicinal substance is located. Each lozenge for sucking contains a dose of biologically active substance, calculated for a single use. Its decrease can lead both to a decrease in the therapeutic effect, and to addiction (insensitivity) of microbes to the drug, which will make recovery more difficult.
TTS – transdermal therapeutic systems (pain relief patches or hormonal preparations in the form of dermal forms). They cannot be cut into several pieces.