Soaring prescription costs in this
country have sent many Americans off to Canada in
search of bargains. With Canada now talking about
closing up shop for across-the-border sales, some
Americans may turn to pill splitting to cut costs.
The idea behind this strategy is that the price for
some medications is the same in lower and higher dosages.
The popular statin, Zocor, for example, costs the
same for 20-mg pills as it does for 40-mg ones. If
you're taking 20 mg a day, you can halve the 40-mg
pills and, at the same time, halve the cost.
However attractive the idea is,
though, there are numerous caveats about pill splitting.
Not every medication is a candidate... and there are
people who may need to skip the practice altogether.
I discussed this with Susan C. Winckler, RPh, JD,
vice president for policy and communications of the
American Pharmaceutical Association, to see when it
works -- and when it doesn't. As a general guideline,
she says, any tablet that is scored (has a line down
the middle) is probably okay to split. But there are
other types of pills that are not meant to be split,
including...
Controlled (or sustained) release pills.
These are designed to release vital ingredients over time.
By splitting them, you could end up getting the entire multihour
dosage at once. These pills are usually coated. By breaking the
coating, the pill dissolves faster. Example: Nifedipine (Procardia XL)
for high blood pressure.
Critical dosage pills.
In some medications, even minor variance of dosage makes a
difference and splitting could present that risk. Example:
Blood thinners such as warfarin (Coumadin).
Combination product pills.
Medications that contain more than one drug may
not have both medications evenly distributed
throughout the tablet. Example: Diovan HTC
(valsartan and hydrochlorothiazide), for
hypertension.
Nonsplittable forms, such as capsules.
Additionally, some pills are coated to
disguise an unpleasant taste. Breaking the pills will
release that, and it's up to individuals to decide if
their taste buds can tolerate that bit of nastiness
or not.
How To Do It
The best way to split your pills
is with -- of course -- a pill splitter, a plastic
device available at your drugstore. Winckler advises
splitting tablets only as you use them rather than
splitting them in advance, which invites breakage
and crumbling. She suggests keeping even individual
halved pills separate by putting them in a clearly
marked second bottle.
Assuming that your pills are
"safe" to split, pill splitting requires a steady
hand and visual acuity. Before you split even one pill,
seek the advice of your doctor or pharmacist. They are
the experts who can best advise you if and when it will
work for you. Saving a little money isn't worth risking
your health. Always speak with your pharmacist first to
be sure that you are safe with the split.
Sources...
Susan C. Winckler, RPh, JD, vice
president, policy and communications, American
Pharmaceutical Association, Washington, DC.
