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Advice and Recommendations from Consumer Reports Best Buy Drugs

Pill splitting can be an easy way to save money. For certain medications, at certain strengths, you may be able to essentially buy two doses of medicine for the price of one. Research shows that a wide variety of drugs can be split safely, as long as it’s done carefully. The following are some tips and best practices you should use if you’re considering splitting your pills.

Ask your doctor or pharmacist whether your medication can be safely split.
The Food and Drug Administration has called pill splitting a “risky practice” and does not encourage it unless the package insert specifically states it has been approved for splitting. However, our medical advisers say pills can be split safely as long as your doctor agrees that it’s appropriate for your health situation, you learn how to do it properly, and you only split pills that can actually be split. As long as you follow those guidelines, many common drugs—including aspirin, cholesterol-lowering drugs, and many high blood pressure and depression drugs—can be split safely

Review reasons why you shouldn’t split your pills. If you have trouble physically splitting pills due to poor eyesight, tremors, arthritis, or dementia, or if your doctor says pill splitting is bad for your condition, you should never attempt it.

Always use a pill splitter to ensure you’ve split the medication into equal halves Pill splitters are widely available from pharmacies for as little as $3. Check with your insurance company, they might provide one for free.

Don’t use a knife or scissors. Doing so can lead to unequal halves—a dangerous outcome. Pills should only be split in half, not into smaller portions, such as thirds or quarters.

Ask your doctor or pharmacist to show you how to split your pills. Research has shown that patients who receive instructions from medical professionals divide their pills more evenly.

The biggest savings come from splitting brand-name drugs that you take regularly for a chronic condition. You might be able to save more money by switching to a generic version of your prescription, if one is available. Talk to your doctor to see if this is an option for you.

Do not split your pills in advance. Some pills may deteriorate when exposed to air and moisture for long periods after being split. So for medications taken on a regular basis, only split your pill on the day you take the first half, and then take the other half whenever you are scheduled to take your next dose.

If your doctor has prescribed half tablets, your pharmacy may split the pills for you. So when you pick up the prescription or a refill, ask if the pills have been split so you don’t inadvertently halve them again. Also be aware that the prescription label may refer to “one tablet” even though your doctor has told you to split the pills. If you’re not sure about the label instructions or your doctor’s instructions, ask for clarification before splitting or taking your medication.

Although there is no official or complete list of medicines that can be split, the following lists can inform your conversation with your doctor. >>

Which pills CAN be split?

These medications can be split but always check with your doctor or pharmacist beforehand: Common use
amlodipine (Norvasc) High blood pressure; heart disease
atorvastatin (Lipitor) High cholesterol
citalopram (Celexa) Depression
doxazosin (Cardura) Enlarged prostate
finasteride (Proscar)
NOTE: Women should NOT handle crushed or broken tablets if pregnant or possibly pregnant. Broken tablets lose some of the protective outer coating, thus allowing absorption of finasteride through the skin. The drug may cause a male fetus to be born with abnormalities of his sex organs
Enlarged prostate
levothyroxine (Synthroid) Under-active thyroid
lisinopril (Zestril) High blood pressure
lovastatin (Mevacor) High cholesterol
paroxetine (Paxil) Depression
quinapril (Accupril) High blood pressure
sertraline (Zoloft) Depression
simvastatin (Zocor) High cholesterol
tadalafil (Cialis) Erectile dysfunction
vardenafil (Levitra) Erectile dysfunction

Which pills CANNOT be split?

It can be dangerous to split some drugs. Generally, the following kinds of pills should not be split:
Chemotherapy drugs
Anti-seizure medicines
Birth control pills
Blood thinners (Coumadin, warfarin)
Capsules of any kind that contain powders or gels
Pills with a hard outside coating
Pills designed to release medication over time in your body (i.e. long-acting, extended-release, etc.)
Pills that are coated to protect your stomach (enteric coating)
Pills that crumble easily, irritate your mouth, taste bitter, or contain strong dyes that could stain your teeth and your mouth.
Combination tablets that contain two or more medicines. Here are some examples:
  • amlodipine/atorvastatin (Caduet)
  • amlodipine/olmesartan (Azor)
  • amoxicillin/clavulanic acid (Augmentin and others)
  • ezetemibe/simvastatin (Vytorin)
  • irbesartan/hydrochlorothiazide (Avalide)
  • oxycodone/acetaminophen (Percocet and others)
  • sitagliptin/metformin (Janumet) >>

How much could you save by splitting your pills?

Drug What is it? Average monthly cost Cost of doubled dose Resulting average monthly cost with split pills

Monthly savings

Generic Lipitor (atorvastatin) A statin prescribed along with lifestyle changes to reduce LDL-cholesterol in the blood and the related risk of heart attack and stroke. 20 mg: $102 40 mg: $100 $50 $52
Escitalopram (Lexapro) An antidepressant prescribed to treat generalized anxiety disorder (excessive worry and tension that disrupts daily life and lasts for 6 months or longer) and depression. 10 mg: $242 20 mg: $254 $127 $115
Irbesartan (Avapro) A medication to control high blood pressure. It is also used to treat kidney disease caused by diabetes in patients with type 2 diabetes and high blood pressure. 150 mg: $147 300 mg: $175 $88 $59
Rosuvastatin (Crestor) A statin prescribed along with lifestyle changes to reduce LDL-cholesterol in the blood and the related risk of heart attack and stroke. 10 mg: $228 20 mg: $234 $117 $111
Valsartan (Diovan) A medication to control high blood pressure. It is also sometimes used to treat heart failure in people who cannot take angiotensin-converting enzyme (ACE) inhibitors. 80 mg: $168 160 mg: $181 $91 $77
Monthly cost reflects national average retail prices for January 2015, rounded to the nearest dollar. Data provided by Symphony Health Solutions, which was not involved in our analysis or recommendations.

Your insurance plan might also provide a list of drugs that can be split. If so, review the list with your doctor or pharmacist before ever splitting your pills.



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