# is pill splitting effective? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [August 22, 2013, 12:33pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864 "2013-08-22T12:33:46Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![rbroome](https://avatars.discourse-cdn.com/v4/letter/r/838e76/32.png) [@rbroome](https://boards.straightdope.com/u/rbroome)\ **Post date:** [August 22, 2013, 12:33pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/1 "2013-08-22T12:33:46Z")
I take Fexofenadine (Allegra) almost every day for allergy relief. I buy the 180 mg size and split the pill since I don’t like the side effects of the full dose. 1/2 the pill usually works. However, there are some days when I don’t feel it is enough, in fact it doesn’t seem like it did anything at all. Does anyone know whether drug makers make their pills in a way to defeat splitting? By putting all the active ingredient on one side or on one end of the pill? I think we all understand that the medicine in pills is in the outer layers of the pill-rarely if ever do they make a pill where the active ingredient is distributed through the body of the pill. Exceptions of course for those doses where the volume is a significant portion of the pill. I understand that one can buy Fexofenadine in smaller doses. But 90 mg seems about right, 60 or 30 (the other two pill sizes) mg don’t last the day for me. Anyone know whether pills are made with the active ingredient concentrated in one location on the pill? ---
**Author:** ![Uber\_the\_Goober](https://avatars.discourse-cdn.com/v4/letter/u/58956e/32.png) [@Uber\_the\_Goober](https://boards.straightdope.com/u/Uber_the_Goober)\ **Post date:** [August 22, 2013, 1:28pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/2 "2013-08-22T13:28:33Z")
> [@rbroome](#): > > \ > > I think we all understand that the medicine in pills is in the outer layers of the pill-rarely if ever do they make a pill where the active ingredient is distributed through the body of the pill. Exceptions of course for those doses where the volume is a significant portion of the pill. > > \ :dubious: Come again? News to me. “I think we all understand” == “We all understand” == “Verifiable” ---
**Author:** ![Sister\_Vigilante](https://avatars.discourse-cdn.com/v4/letter/s/9de0a6/32.png) [@Sister\_Vigilante](https://boards.straightdope.com/u/Sister_Vigilante)\ **Post date:** [August 22, 2013, 2:02pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/3 "2013-08-22T14:02:18Z")
All I know is I can puke 30 seconds after I take a pill and it won’t come up (very, very bad gag reflex). At least not in the tablet form I swallowed it in. They dissolve fast. But they don’t put more in one side than the other. That’s why most pills come with a little divider in them. So you can cut them in half. ---
**Author:** ![aNewLeaf](https://avatars.discourse-cdn.com/v4/letter/a/ac91a4/32.png) [@aNewLeaf](https://boards.straightdope.com/u/aNewLeaf)\ **Post date:** [August 22, 2013, 2:16pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/4 "2013-08-22T14:16:51Z")
Pill splitting can be quite effective, but consult with your pharmacist before changing meds. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [August 22, 2013, 2:17pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/5 "2013-08-22T14:17:05Z")
IANA pill expert, but just thinking about the mechanisms… basically you mix up a collection of medicine and filler - hopefully in a uniform mixture - and press it into a solid pill. if necessary, coat it with a “sealer”. Think about the other manufacturing problems - -if you put an “outer layer” like the candy coating on an M&M - if that’s the active ingredient, how do you ensure a uniform layer? For M&M or Reeses, if your machine messes up or your coating material is too viscous, the consuming public gets an small extra dollop of sugar and red dye#2; if the same happens at Placebin Pills, Inc. the public could be overdosing on 2 or 3 times the normal dose. Similarly, dropping a smaller pill on a layer of larger pill, then pouring on the top coat - sounds good, but the centering procedure to ensure proper coating sounds difficult. If you then “press” to compact and form a pill, a mis-centered core piece may make one side of the pill dense and the other crumbly soft. A 2-layer pill, like a twinkie or a jelly donut? You can’t really “inject” a hard pill with another hard pill, and if you inject or drizzle the medication on a sugar pill, now you have drying issues - I don’t imagine a lot of medications like being subject to high heat to speed dyring. The other way would be to “layer”, which seems a bit simpler. Pour Mix A into the mould, flatten, pour mix B, compress into pill. At the end of the day, though, the real question is “why??” Unless you have two separate ingredients that don’t play well together, so you have a 3-layer pill with the bufferin in the middle - why would you make trouble by making the manufacturing process, and the added quality control issues, that much more complex? The only step I could see that matches the OP question is this: Pour the buffer powder into the mould about a third the way. Maybe press it lightly into a bowl shape? Fill a full dose of medicine, then fill the pill mould with the rest of the buffer mix. Compress into a pill. The only reason to do this is if the cost of this 3-step process is cheaper than dealing with the issues around ensuring a pill-buffer mixture is uniform enough to ensure a consistent dose. In any case, an unreliable distribution of medication in the pill would probably cause quality control issues. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [August 22, 2013, 2:17pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/6 "2013-08-22T14:17:30Z")
Note that _some_ pills come with a scored line down the middle. These are intended so you can break them in half if you want. Other pills don’t have that. They are intended to _not_ be broken in half. One common reason why some pills are intended to _not_ be broken is because they are “sustained release” pills. (The wording may vary: sustained release; extended release; various other wording. Sometimes it is abbreviated to SR or XR or various other ways.) These are pills that release their toxic potion into your system gradually over a prolonged period of time. There are several different mechanisms that are used to cause pills to work this way. The most common, I suppose, is that the pill is made of some material carefully formulated to dissolve in your gut at a specific speed, and the medicine mixed with it thus gets released likewise. It’s possible, I suppose, that some pills could have the medicine carefully layered to create this effect too. One pill I took consisted to a shell with a teeny tiny hole in it, and the medicine inside. The medicine was supposed to leak out of the hole at a particular rate over several hours. One clue that a pill works this way is in the instructions: These pills always come with instructions saying something like “Do not chew or crush.” If you do that, or break it open, it would release too much of the medicine too fast, presumably with undesirable results. ---
**Author:** ![Xema](https://avatars.discourse-cdn.com/v4/letter/x/9de053/32.png) [@Xema](https://boards.straightdope.com/u/Xema)\ **Post date:** [August 22, 2013, 2:40pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/7 "2013-08-22T14:40:05Z")
> [@rbroome](#): > > rarely if ever do they make a pill where the active ingredient is distributed through the body of the pill. I’d be interested in a cite here - sounds wildly improbable. ---
**Author:** ![aNewLeaf](https://avatars.discourse-cdn.com/v4/letter/a/ac91a4/32.png) [@aNewLeaf](https://boards.straightdope.com/u/aNewLeaf)\ **Post date:** [August 22, 2013, 2:50pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/8 "2013-08-22T14:50:59Z")
For values of improbable = utter nonsense in many cases. Some pills have a binder, some are mostly just drug. Weigh a 500mg acetaminophen tablet some time. ---
**Author:** ![Exapno\_Mapcase](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/exapno_mapcase/32/1051_2.png) [@Exapno\_Mapcase](https://boards.straightdope.com/u/Exapno_Mapcase)\ **Post date:** [August 22, 2013, 3:02pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/9 "2013-08-22T15:02:41Z")
> [@Xema](#): > > I’d be interested in a cite here - sounds wildly improbable. I’d go farther. I think it would be actively illegal. The FDA would go bonkers. Medications must be evenly distributed. ---
**Author:** ![njtt](https://avatars.discourse-cdn.com/v4/letter/n/ecd19e/32.png) [@njtt](https://boards.straightdope.com/u/njtt)\ **Post date:** [August 22, 2013, 3:55pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/10 "2013-08-22T15:55:29Z")
> [@rbroome](#): > > I think we all understand that the medicine in pills is in the outer layers of the pill-rarely if ever do they make a pill where the active ingredient is distributed through the body of the pill. On the contrary, some pills are coated with something inactive (often if the actual drug tastes particularly nasty), with the active ingredient inside. Apart from cases like that, and timed-release pills, I would expect the active ingredient to be evenly distributed throughout. As for splitting, unless it is a timed-release type (in which case there is likely to be some eye-catching instruction about not crushing or chewing) splitting should be fine. ---
**Author:** ![lazybratsche](https://avatars.discourse-cdn.com/v4/letter/l/ba8739/32.png) [@lazybratsche](https://boards.straightdope.com/u/lazybratsche)\ **Post date:** [August 22, 2013, 4:03pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/11 "2013-08-22T16:03:06Z")
Why are you invoking some complicated explanation about pill design and manufacture? You say that 90 mg usually works, and 180 mg is too much. Isn’t it simpler to say that 90 mg is occasionally an inadequate dose? Personally, zyrtec is usually fine for controlling my seasonally allergies. But some times I need to take something stronger like benadryl instead, and on particularly nasty days even the maximum dose of benadryl isn’t enough to tame my sinuses. ---
**Author:** ![Daylate](https://avatars.discourse-cdn.com/v4/letter/d/9dc877/32.png) [@Daylate](https://boards.straightdope.com/u/Daylate)\ **Post date:** [August 22, 2013, 4:14pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/12 "2013-08-22T16:14:06Z")
I’ve been taking a daily dose of 10mg of Lipitor for years, for cholesterol control. Buy 20mg pills, and split them. The Lipitor instructions say in effect “FOR GOD’S SAKE, DON’T DO THIS!”, but it’s worked for me for years, and saved a whole bunch of money. The pills are in a pronounced oval shape, but with a little care, they split OK. ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [August 22, 2013, 4:15pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/13 "2013-08-22T16:15:22Z")
My doctor has told me to ask before splitting any thyroid medication. Some brands are okay to be split, some are time-release and shouldn’t be split. Same thing with Ambien – the generic substitutes can be split, but not the time-release version. ---
**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\ **Post date:** [August 22, 2013, 4:48pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/14 "2013-08-22T16:48:53Z")
Medical advice is best suited to IMHO. Colibri General Questions Moderator ---
**Author:** ![california\_jobcase](https://avatars.discourse-cdn.com/v4/letter/c/9d8465/32.png) [@california\_jobcase](https://boards.straightdope.com/u/california_jobcase)\ **Post date:** [August 22, 2013, 5:01pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/15 "2013-08-22T17:01:59Z")
I have to split three pills a day to get the correct doses, and have for three years. Neither have a line on them for splitting. They aren’t timed release ones. ---
**Author:** ![rbroome](https://avatars.discourse-cdn.com/v4/letter/r/838e76/32.png) [@rbroome](https://boards.straightdope.com/u/rbroome)\ **Post date:** [August 23, 2013, 12:44pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/16 "2013-08-23T12:44:53Z")
> [@Uber\_the\_Goober](#): > > :dubious: > > Come again? News to me. > > “I think we all understand” == “We all understand” == “Verifiable” I have to admit, it is such “common knowledge” to me that I didn’t even question it. I have been told by nurses and doctors that this is how pills are made for so long, I figured everyone knew. Perhaps I am wrong. I will research it. I do know both my wife and I have had, over the years and with different medicines, had pills that made it all the way through and when we inquired, we were told not to worry, the medicine is on the outside. It was my assumption that drug companies make, or buy, pill cores, coat them with the active ingredient, and apply sealer/timed release coatings etc. It seems unreasonable to count on every pill dissolving completely in the stomach when that isn’t a necessary assumption. But I may be wrong. I will try to find out. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [August 23, 2013, 1:27pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/17 "2013-08-23T13:27:14Z")
> [@Senegoid](#): > > Note that _some_ pills come with a scored line down the middle. These are intended so you can break them in half if you want. Other pills don’t have that. They are intended to _not_ be broken in half. And some (many) don’t have a score mark, but can be safely split with a pill cutter anyhow. Check with a pharmacist, before you split non-scored pills, but yes, many of them can be safely split. And make sure you know exactly what you’re asking: a 10mg zolpidem can be split (according to the pharmacist I asked last week), a 10mg zolpidem MR (modified release) cannot…but neither one has a score mark. > [@rbroome](#): > > I have been told by nurses and doctors that this is how pills are made for so long, I figured everyone knew. Perhaps I am wrong. I will research it. I’ve never heard it (registered nurse) but pharmacists know much much more about this than either doctors or nurses. I’d ask a pharmacist. I wonder if _your particular meds_ are time release, extended release or modified release. If so, then it’s not entirely inaccurate for your meds, and I could see a busy nurse or doctor explaining it that way, but it’s still very imprecise and not technically correct. For example, the modified release zolpidem does have an inner core of slower acting zolpidem, wrapped in a faster release zolpidem. The inside isn’t inert, it’s more medicine, but it’s slightly different medicine, and we don’t want it to be exposed to your digestive process until the outside has dissolved in the time designed. ---
**Author:** ![Nametag](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nametag/32/406_2.png) [@Nametag](https://boards.straightdope.com/u/Nametag)\ **Post date:** [August 25, 2013, 4:48am UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/18 "2013-08-25T04:48:30Z")
> [@Daylate](#): > > I’ve been taking a daily dose of 10mg of Lipitor for years, for cholesterol control. Buy 20mg pills, and split them. The Lipitor instructions say in effect “FOR GOD’S SAKE, DON’T DO THIS!”, but it’s worked for me for years, and saved a whole bunch of money. The pills are in a pronounced oval shape, but with a little care, they split OK. They say nothing of the kind. The sentence “Don’t break LIPITOR tablets before taking” appears once in the patient information, and I’m sure there is no therapeutic reason for doing so. ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [August 26, 2013, 9:09pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/19 "2013-08-26T21:09:33Z")
Ask your druggist. It depends on the pill. One of my pills I take one pill 3 days a week and one and a half four days a week. They are scored for easy splitting. Another pill is a timed release pill that comes with a warning: Do not split. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [August 26, 2013, 11:31pm UTC](https://boards.straightdope.com/t/is-pill-splitting-effective/666864/20 "2013-08-26T23:31:33Z")
> [@rbroome](#): > > Does anyone know whether drug makers make their pills in a way to defeat splitting? By putting all the active ingredient on one side or on one end of the pill? Yep. It’s the right side that’s the placebo. Whatever you do, **don’t** take the right side after you’ve split the pill. Throw it out and re-split the left half and take _that_ half and then you’ll get the half-dose you’re looking for. ETA: Obviously don’t take my advice. [Next page](https://boards.straightdope.com/t/is-pill-splitting-effective/666864.md?page=2)