Tablet Splitting: How to ensure correct dosing and prevent medication errors

Tablet Splitting, or breaking tablets in half, is a common occurrence in Hong Kong and elsewhere. Although using a whole tablet is the safest and most accurate means to ensure patients receive the appropriate dose, there are instances which warrant tablet splitting.

Reasons for splitting tablets

  • Increased flexibility in dosing such as when dose required by the patient is not available as whole tablets.
  • Cost. Price of halving a higher strength tablet is less than the cost of a whole tablet of the same dose.
  • Facilitate swallowing of larger sized tablets.


Disadvantages of tablet splitting

The United States Food and Drug Administration (FDA) discusses certain reasons why tablet splitting could be risky:

  • Confusion of correct dose. Patients may have purchased whole tablet doses intending to split them but forgot, resulting in accidental overdose. Conversely, patients may split tablets of the correct dose resulting in under dosing.
  • Unequal distribution of dose. Several studies have shown that the active ingredient in each halved tablet may be different even if the tablet is scored.
  • Tablets may be difficult to split. Tablets which are oblong or unusually shaped may make them difficult to split evenly. Additionally, small tablets may crumble more easily when split.
  • Not all medications are safe to split. Certain medications such as capsules, time-released drugs, or those with special coating should be taken whole.
  • Certain patients such as the elderly, patients who are visually impaired, patients with arthritis, Parkinson’s, or those with difficult hand coordination may have difficulty splitting tablets.


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