Mucinex - "do not crush, chew, or break..."

Why can’t you crush or break Mucinex prior to ingesting it? Those are some pretty big pills.

I can see not chewing it, because it tastes gross, but why the others?

Most likely reason is that it’s formulated as a time-release medication.

Time-releases are made in specific layers and coated/mixed with a concoction that breaks down at a fairly consistent rate of speed when exposed to stomach acids. I’m sure you’ve seen an animated version of this if you ever watch daytime tv.

There are two downsides for if you crush it. One: the “time-lapse” effect is lost, because the whole shebang is getting acided at once, so you’re not protected/aided/medicated for the time-period advertised, and also will be screwed because the dosage schedule is based on a whole pill slowly dissolving.
Two, you’re also likely to get a bigger dose than you’re supposed to, because you’re getting the whole deal at one time, which is hell on your kidneys, and possibly really bad for other bits of you regarding dehydration and whatnot.

I’ve personally always wondered (I currently have a head cold, so it’s appropriate) why pills for colds and congestion, when one’s throat is presumably all clogged up, sore, and constricted, are roughly the size of peanuts, while pills for non-throat-related problems are usually teeny little bits smaller than Advil. I don’t get it. Can’t they just make them individually smaller and tell you to take more of them at a time?

You can’t just make a dozen little pills because of marketing. It’s like the Advil/Tylenol commercials where we “know” Advil is better because you only need 2 pills a day instead of 8.

As for the original question, I agree that it’s probably a time-release issue. We found this out specifically with the arthritis formulation for Tylenol, which has an 8-hour release schedule. My mother in law couldn’t swallow well and had been crushing them up to eat with applesauce. When she went to a new nursing home, the staff were horrified, and explained that doing this was like taking 4 regular Tylenol at once, and losing the benefits within 3-4 hours instead of 8.

When a drug company says to take a drug in a certain manner, they really mean it because that is the only manner that has been studied and approved. They really don’t know what will happen if you do something else to the drug before taking it; all that can be done is provide an educated guess. Overdose, exposing something to stomach acid and lowering its effectiveness through chemical means, organ damage… all kinds of things are possible depending on the drug chemistry and its toxicity profile. If a tablet isn’t scored for breaking then you shouldn’t be breaking them because their behaviour when you do that is unknown. (cue 56843 anecdotes about people that break and crush non-scored tablets…)

As to the size; the various ingredients have a volume, and the more ingredients you have the more volume it takes. Add stabilizers, preservative chemicals and potentially activating compounds and you have a larger tablet. IIRC a typical birth control pill weighs about 100mg, so if you have 200mg of ingredient, you’ve got a pill twice that size. Capsules come in standard sizes, though there is a large variety.

Also if it is time-release, then the pill has to be be thicker. The pill is like a slowly melting ice cube. Bigger cube takes longer to get to the center. Similarly, a smaller pill has a harder time making the center resist stomach acid for 8 hours.

It’s not the determining factor, but one reason is because the active ingredient is guaifenesin, which tastes incredibly nasty. It’s why expectorant cough syrups are so heavily flavored. I can’t imagine chewing on one of those things.

Another reason is because many, if not all, Mucinex formulations contain pseudoephedrine, a decongestant (Sudafed). If that stuff is dosed and formulated for extended release, the hit you’ll take from chewing it up all at once could do things to you. Me, I’d be climbing the walls, or maybe have a seizure or something – the stuff works on me like Crank.

But yeah, it’s mostly the time-release thing.

The Wikipedia entry for guaifenesin notes that the makers of Mucinex have a patent on the time-release delivery of guaifenesin, which has otherwise been an approved drug since the 1950s. So yeah, the crush/chew/break warning is all about mucking with its time-release nature.

And yeah, those are big damn pills.

I have to take my mess through a tube. Crushing is the only way. Do I have a choice?

You need to consult with a physician or take a non-time-release version of guaifenesin.

Separately from any medically relevant reason not to chew it, Mucinex tastes like concentrated Satan, so I wouldn’t think chewing would even be an option.

666 mg/tab, take as directed by the deceiver of nations, side effects may include wailing, gnashing of teeth, and being thrown into the lake of fire, which is the Second Death.

I broke the Mucinex D tablet (600 mg) in half without reading directions, and ended up jittery and shaky. So I called poison control and they said it’s nothing to really worry about. Just that the medicine is going to release quicker in my system.

I am also on antibiotics so was concerned if I can still take that with the half tablet in my body. They said it should be fine.

Next time I will read the directions before I assume I know best on how to take medicine.

Always an excellent idea. And if you’re ever not sure, then call your pharmacist. They study a great deal about the technical stuff around how medications work. They will know if something is safe to split or crush, and they will know alternate forms of the same or similar medications you can get if you need them. And yes, this applies to the pharmacist working at the corner drug store as much as a pharmacist working at a big name hospital. Those poor drug store pharmacists don’t get utilized to their full abilities or training nearly enough.

If you have a question about an illness, call the doctor.

If you have a question about medications, call the pharmacist.

Ditto. I had some surgery a while back where my doctor told me not to swallow regular pills for about a month, but to crush them. But I was on all sorts of stuff - diabetes, hypertension, cholesterol - so I needed to ask my pharmacist which were okay and which not.

Painkillers like acetaminophen and codeine were easy to get in liquid form, but all my prescription stuff was impossible. So I asked my pharmacist – a really great lady in Sam’s Club. She worked so hard for me! She knew all the right places and people to ask at the manufacturers who make the stuff and know the answers.

Unfortunately, every single manufacturer said the same thing: We have tested only the regular form of the tablet. We haven’t tested what happens when you crush it, so we can’t recommend it.

I’m sure the development people put plenty of research into whether this medication works best as a tablet, or a liquid, or injection, or inhaled, and at precisely what dose. They ought to know this stuff too. My gues is that the lawyers won’t let them discuss it. AARGGH! :mad:

But off the record, the pharmacist did tell me that IF I wanted to risk taking an unapproved home-crushed version of the medication, these are some possible side-effects to watch for… She really was great.

Mucinex is known to be sold as a EXTENDED slow release tablet… ONLY… Adams them convinced the USA authorities that extended slow release is “best practice” for Guaifenesin … They actually blocked the other companies from selling non-patent “slow release” tablets.

(It doesn’t make a whole lot of sense though. perhaps the authorities were somehow inappropriately influenced to make this move. )

A pharmacist could test a tablet for slow release by mixing up a batch of HCl to stomach acid strength and stirring for a half hour. And test a range of other tablets to compare/control this experiment.

If you can easily dissolve a tablet in lemon juice, then it must be quick release and crushing won’t hurt it.

In addition to points already made (it has a time-release mechanism for part of the tablet, it tastes terrible), the active ingredient, guaifenesin, is more likely to produce stomach pains, nausea, and vomiting with higher dosages than those called for by regular Robitussin syrup labeling (200-400mg guaifenesin per dose every 4 hours). As regular strength Mucinex has 600mg per tablet (dosed 1-2 every 12 hours), you’re looking at 600mg to 1200mg released immediately if crushed/chewed/broken versus the maximum recommended labeling for the immediate release form.

Not necessarily, my extended release morphine pills are good for twelve hours, yet they are very small. They are about the size of a regular Advil. And they are 60mg, so it isn’t a small dosage.