Here's why you shouldn't rush to crush your meds
WHETHER it's prescribed or over-the-counter medications you are taking, don't assume that cutting, crushing or chewing is okay; there's some very good reasons why not.
The Society of Hospital Pharmacists of Australia publications pharmacist Keli Symons advises it can be hazardous to the person taking the medicine and it can be hazardous to the person crushing it.
Here's why -
- When a medication is being crushed or ground, particles can be released into the air. Any people in the vicinity could inhale the particles or absorb it through their fingers.
- There is the potential of contamination of the medication from other surfaces.
- It can also land on surfaces and utensils nearby, contaminating them.
- You don't get the full dose. There is an inherent loss of a dose, potentially up to 20 per cent, with any type of crushing device. The solution here is to rinse the crushing device at least twice with 20 mils of water, to catch any powder left in a crushing device, and then drink that water.
- Some tablets are formulated with a special coating. For example, it passes through the stomach acid and then is absorbed further down the GI track in the intestine. "If you crushed it, you remove that coating and exposing that medicine to the stomach where it might not work, or it might be harmful to the stomach," Ms Symons said.
- A once-a-day tablet may be designed to be swallowed whole and released over the whole day. If it is crushed, you would end up with the whole and higher dose, just once, which might cause an adverse reaction.
"There are some drugs you can crush, but it's always going to be the last resort," Ms Symons "And that applies to chewing which is essentially crushing."
So, before you cut, crush or chew, tell -
- Your GP before a prescription is written if you can't swallow tablets or capsules.
- Your pharmacist. Every prescribed medication has a Consumer Medication Information sheet inside the package which lists how it can be taken, but if you want to cut, crush or chew that medication, talk to your pharmacist who can suggest an alternative and has access online or in print to the Don't Rush to Crush guidelines from the SHPA.
Your other options may be -
- Oral liquid.
- Tablets which are dispersible or dissolvable either in water or on your tongue.
- Disintegrating tablet.
- Transdermal patches.
- Injection, but this is often a last resort option.
"It might not be the same drug, but it could be from the same class or group of drugs that your doctor might consider changing the person over to," Ms Symons added.
If you have a dry mouth
Often looking for another way to consume a medication is because you have a dry mouth. Ms Symons advises you can get relief for that from therapies, which you GP can advise you on, or by using a mouth lubricant, which is like a gel and you can buy from a pharmacy. "You can put a tablet in the gel and that makes it slippery and easier to swallow," she said.