Tablet Splitting---Is it for you?

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Tablet Splitting---Is it for you?

Postby dlcnurse » Sat Jan 03, 2009 5:31 am

Tablet splitting has become a widespread thing over the last few years to help maintain medication costs. Many insurance companies are now offering a "Tablet Splitting Program" which according to them with save you 50% of the cost. Some of them that are offering this type of program are Aetna, Medical Mutual, United Healthcare, and Paramount. There are probably many more in different states so be sure and ask your own insurance company if they have such a program.

Many medications come in different strengths to be able to titrate a specific medication to a person's specific need. With all of these different dosages of 10,20, 40, 60 mg etc... if is possible to be able to cut costs by tablet splitting. This is really a difficult task when it comes to the elderly and children as sometimes a very small dosage of a medication is all that is needed.
Some insurance companies are not taking this in to consideration and are requiring people to obtain a larger dose and have to split the tablets. More medication errors and harm has come to the elderly and children because a wrong dose has been taken. Addressing this with the physician can prevent these errors- the physician has to notify the insurance company in regards to the lower dosage and the danger to the patient. Many insurance companies will pay for the lower dose if this is done. Don't put yourself or a loved one in danger if they are unable to take large doses of medications and your insurance company refuses to pay for it simply to save themselves money.

Their are some pitfalls to tablet splitting as well. Things that need to be taken into consideration are :
1) Does the person fully understand the dosage prescribed to them, and have the cognitive ability to follow directions on the bottle.
2) Is the person capable of splitting their pills--for those with osteoarthritis, Reumatoid Arthritis,parkingsons or essential tremors--do they have the dexterity to be able to split the tablets easily.
3) Is the person able to visually see the tablets they are splitting.

These are not taken into consideration by insurance companies. But it is something that needs met. If you cannot fully understanding the doctor's directions on taking the medication, are not able to split them without difficulty, then pill splitting may not be an option for you.

3) The medications to be split have to be chosed carefully. Many types of medications cannot be split such as enteric coated aspirin. Medications that are of really small shapes, sizes are difficult to cut them without fragmenting the pill.
4)Medications that have "LA, CR, SA,ER" IN THE TITLE OF THE MEDICATION CANNOT BE SPLIT IN HALF. THESE MEDICATIONS RE DESIGNED TO RELEASE THE MEDICINE INSIDE THEM OVER A PERIOD OF TIME.
5)STABILITY OF THE MEDICATION HAS TO BE TAKEN INTO CONSIDERATION. iF YOU HAVE A PILL THAT IS NOT SCORED AND YOU ARE BREAKING THEM ANYWAY, YOU MAY BE UNDERDOSING OR OVERDOSING YOUR BODY. THESE PILLS TEND TO BE SOFT AND ONCE BROKEN, CRUMBLE AND FRAGMENT THEMSELF SO YOU ARE NOT GETTING THE MEDICATION THAT YOU SHOULD BE.

Here are things that you can do to ensure that you are getting what you need when cutting pills in half.
1) Get a new script for the higher dose that you need to take
2) Make sure when you pick up the script that it is the dosage your doctor ordered for you, and ask the pharmacist if the pills are already split so that you don't split them.
3)Make sure the directions on the bottle are accurate. Some scripts are written as 1-2 instead of 1/2. (This can result in overdose of medications!)
4)Don't assume that the pharacist has already split them because it was order that way. YOU NEED TO ASK!

Here are some rules to live by when considering splitting tablets/pills

1) Ask yourself these questions:
Is the medication for the heart, (such as Digoxin), is it for your thyroid?

These pills should not be crushed/split. Tablets that are scored can be split but these tablets tend to be soft and fragment if all of the tablets are cut in half.
2) Is the medication have a ending such as LA, CA, ER, CR or SA. These tablets cannot be broken or cut. These are long acting medications that will release the medication slowly over the course of the day.

3) Is the tablet scored. If yes, these can be split, if no, it is also possible to split them but they tend to have uneven cuts.

Is your medication a combination medicaion such as Lotrin, any of these medications can not be split. Read the label. If it is a combination medication it will have a slash in the name of the medications indicating that it is a combination pill. Splitting them will cause the medication to become unstable. THESE ARE COMBINATION MEDICATIONS AND HAVE MORE THAN ONE INGREDIENT IN THEM. SPLITTING THEM CAN BE DANGEROUS WITH THESE TYPE OF MEDICINES.

4) Does the tablet begin to break into pieces when minimally handled?
If yes, splitting these will cause overdosing or underdosing of your medication. It is best not to split them. It is possible but you will need to use caution in doing so.

5) Is the tablet coated?
Coated tablets are designed to protect the GI tract--they are not intended to be split. Some tablets contain a film coat because the tablet is soft-if you try to split these and they crumble, they should not be split if this happens

When you are splitting tablets be sure and use a pill cutter. These can be obtained at any big chain store such as walmart, kmart, krogers, etc... and and all pharmacies. If your insurance plan has a program be sure and ask your pharmacist for a pill cutter- insurance companies that have a program will pay for these for 0 cost to you.
DO NOT use scissors or a kitchen knife. These will cause uneven distribution of the medications as they do not cut evenly when used.

DO NOT SPLIT MORE THAN ONE DAY AT A TIME! MEDICATION TENDS TO BECOME MORE FRAGMENTED OVER TIME AND YOU WILL NOT BE GETTING THE CORRECT DOSE OF YOUR MEDICATION AS THE POTETENCY WILL BE WEAKER OVER TIME WHEN AIR AND MOISTURE BECOME IN CONTACT WITH THE MEDICATIONS.

Splitting your medications can be done safely and everyone should use caution when doing so... and be sure and wash your hands before handling any medication so that germs are not carried. Make sure that your pill cutter is clean as well. Dust tends to collect on the blade as you use it so be sure and clean it each time you use it for a different medication.

Using simple rules can avoid some of the pitfalls of tablet splitting and make it more safe for everyone involved.
dlcnurse
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