WELL i am not talking about that kinda butterfly in your stomach whenever you meet him that kinda crush , saying that not all your tablets can be cut or crush.
When i was working in Australia , the government funded most of the essential prescription medications with what they call the PBS -pharmaceutical benefit scheme. I am sure it is also the same with most EU countries . But when i move back to work in Malaysia , it is not the same case, medications are not subsidize by the government for the average populations. The public hospital requires 'network' to be able to access to expensive medications , and not to mention the condition of the hospital and waiting time in a public hospital, so most of the middle class citizens will opt for private hospitals, and the medication bill will take up 60% of your expenditure monthly . And the remaining of the money for you to eat at the hawker stalls (no GST ) and mamak ( our local cafes ) which serves food extremely tasty *big smile * and full of oil and sugar *big frown* , and there goes the vicious cycle that you need to increase your does of your medication because there is no way for lifestyle modification if you need to work your butt off to pay bills.
Welcome to our country !!
So what people or patients here do , they will try to save some cost and cut their tablets. AS it always more economical to buy the higher dose pack and cut them into half , that way you pay less and the medication last for 2 months. This was the most frequent question being ask in my training days in the public hospital in Malaysia. The doctors will ring up the out -patient pharmacy to ask if so can so and so (eg.lipitor and norvasc and frusemide ) be cut into half ? and the government is already supplying the generics for these drugs *big sigh* . And then i will have to dug up the information leaflet in the package to read whether if the tablets can be cut .
Here is what i concluded after reading about 100 over leaflets :
1. No Cut or CHEW when you see DR, XR , ER , SR, MR on the pack it should never be cut or half . They stand for Delayed-release, EXTENDed -release , slow -release and modified -release respectively. The tablets are changed to overcome the acid destruction and meant to disintegrate only in the lower stomach or intestines . Once you cut them the protection from acid is gone.
2. You see the word enteric coated, film coated or sugar coated …anything 'coated' means you are meant to swallow it whole. Never Chew.
3. Tablets are scored ?? so what is scored you would ask . Look closer at a white tablet that has a line / dividing section in the middle, like being stamp on the tablet. If the tablet is scored , you can cut them.
4. Written MR on the box but the tablets are scored??? Your mind is going wild thinking isn't it ?? YEHHHHHH. i have seen such tablets, well i checked, the tablets are kind of made in separate / two compartment , when cut or split will still be OK *wink* . This is only applicable to reputable companies productions.
5. Capsules . Can you open them up and mix it with your drinks ? YESHHHH you may , especially for patients feeding on nasogastric tube , capsules are heaven to them . But look closer sometimes the content in the capsules are coating , that way you should not crush the content further into a powder even if they don't dissolve too well with your drink (for example Nexium ) , drink the mixture as a whole without chewing on the granules.
6. Very confuse and still in dilemma ? ASK me or your pharmacist . Drop me a mail on druggqueen@gmail.com or comment on my IG @druggqueen.
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