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Oral dosage forms that should not be crushed

Oral Dosage Forms That Should Not Be Crushed
John F. Mitchell, PharmD, FASHP1
Last updated: May 1, 2009
Wall charts may be purchased by contacting
Facts and Comparisons (800-223-0554)
http://www.factsandcomparisons.com/hospitalpharm/
Drug Product
Dosage Form
Reasons/Comments 2
Note: this lollipop delivery system requires
Note: chewed, crushed, or sucked tablets
Note: oil emulsion within spheres; taste
Note: drug may cause fetal abnormalities;
Note: Potential for oropharyngeal ulceration
Note: although not described as slow release
in the PI, the drug has a coating that is intended to release the drug over a period of approximately 3 hours Note: use suspension for children
Note: use suspension for children
Note: integrity compromised by chewing or
Note: capsule may be opened and mixed
Slow-release (a); may add to apple juice Note: drug may be crushed but company
Note: exposure to the powder may cause
Note: buccal tablet; swallow whole
Note: may be dissolved in water or apple juice
Note: exposure to the powder may cause
Note: tablet should be swallowed whole and
Note: do give via N/G tubes
Note: some extemporaneous formulas are
Note: contents of capsule may erode walls of
Slow-release form within a special capsule Note: tablet disruption may cause a potentially
fatal overdose of oxymorphone
Note: tablet disruption may cause a potentially
fatal overdose of oxycodone
Note: do not swallow; dissolve in water only
Note: contains enteric-coated granules; mix
Note: women who are, or may become,
Note: women who are, or may become,
Note: radiopharmaceutical
Note: tablets expand in liquid if broken or
Note: do not chew or break tablet; after
Note: Teratogenic potential; healthcare
Note: active ingredients are surrounded by a
women who are, or may become, pregnant, should not handle crushed or broken Note: capsule contents can cause ocular
Note: If capsules are accidentally opened or
taken to avoid inhalation or contact of contents with the skin or mucous membranes (i) Note: swallow whole; temporary local
Note: women who are, or may become,
Note: tablet disruption may cause a potentially
fatal overdose of tramadol
Note: irritant; avoid contact with skin or
Capsule may be opened and the contents taken without crushing or chewing; soft food such as applesauce or pudding may facilitate administration; contents may generally be administered via nasogastric tube using an appropriate fluid provided entire contents are washed down the Liquid dosage forms of the product are available; however, dose, frequency of administration and manufacturers may differ from that of the solid dosage form. Antacids and/or milk may prematurely dissolve the coating of the tablet. Capsule may be opened and the liquid contents removed for administration. The taste of this product in a liquid form would likely be unacceptable to the patient; administration via nasogastric tube should be acceptable. Effervescent tablets must be dissolved in the amount of diluent recommended by the Tablets are made to disintegrate under the tongue. Tablet is scored and may be broken in half without affecting release characteristics. Skin contact may enhance tumor production; avoid direct contact. Disclaimer: This listing is not meant to represent all products, either by generic or trade name. The author encourages
manufacturers, pharmacists, nurses, and other health professionals to notify him of any changes or updates.
1. Correspondence regarding this list may be addressed to: John F. Mitchell, PharmD, FASHP Email: rxmitchell@att.net 2. Two official USP terms are used to designate special-release medication forms: "extended release" and "delayed release". Others such as "sustained release", “controlled release", etc. are commonly used on package labeling. The term "Slow-release" is being used here to signify all such drugs with a special-release mechanism.

Source: http://www.psirx.com/Forms/DoNotCrush2009.pdf

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