Do Not Crush Drugs
Certain medications have a special release mechanism designed to slowly release a certain amount of medication over a given amount of time. If the medication is altered or destroyed in any way, the medication will be released too fast and cause an adverse effect.
Drug Product | Active Ingredient(s) | Dosage Form(s) | Reasons/Comments |
|---|---|---|---|
Abilify MyCite kit | (aripiprazole) | Tablet | Drug-device combination |
Absorica | (ISOtretinoin) | Capsule | Mucous membrane irritant |
Abstral | (fentaNYL) | Tablet | Note: Sublingual tablet; do not suck, chew, or swallow whole. |
AcipHex | (rabeprazole) | Tablet | Slow-release |
AcipHex Sprinkle | (rabeprazole) | Capsule | Slow-release; Note: contents are intended to be sprinkled on food or liquid but should not be chewed or crushed. |
Acticlate | (doxycycline hyclate) | Capsule; Tablet | Film-coated; tablet is scored and may be split; Note: 150 mg tablets can be broken into two-thirds or one-third to provide a 100 mg and 50 mg strength, respectively |
Actiq | (fentaNYL) | Lozenge | Slow-release; Note: this lollipop delivery system requires the patient to slowly allow dissolution. If chewed and swallowed, may result in a lower peak concentration and bioavailability. |
Actonel | (risedronate) | Tablet | Irritant; Note: chewed, crushed, or sucked tablets may cause oropharyngeal ulceration. |
Actoplus Met Xr | (combination) | Tablet | Slow-release |
Adalat CC | (NIFEdipine) | Tablet | Slow-release |
Adderall XR | (amphetamine salts) | Capsule | Slow-release (a) |
Adhansia XR | (methylephenidate hydrochloride) | Capsule | Slow-release (a) |
Adzenys XR-ODT | (amphetamine) | Tablet | Slow-release; Sublingual form (g) |
Aemcolo | (rifamycin) | Tablet | Slow-release |
Afeditab CR | (NIFEdipine) | Tablet | Slow-release |
Afinitor | (everolimus) | Tablet | Mucous membrane irritant |
Aggrenox | (combination) | Capsule | Slow-release |
Alecensa | (alectinib) | Capsule | Antineoplastic |
Alophen | (bisacodyl) | Tablet | Enteric-coated |
Altoprev | (lovastatin) | Tablet | Slow-release |
Alunbrig | (brigantinib) | Tablet | Antineoplastic |
Ambien CR | (zolpidem) | Tablet | Slow-release |
Amitiza | (lubiprostone) | Capsule | - |
Amnesteem | (ISOtretinoin) | Capsule | Mucous membrane irritant |
Ampyra | (dalfampridine) | Tablet | Slow-release; Note: formerly fampridine-SR |
Amrix | (cyclobenzaprine) | Capsule | Slow-release (a) |
Aplenzin | (buPROPion) | Tablet | Slow-release |
Aptensio XR | (methylphenidate) | Capsule | Slow-release (a) |
Aptivus | (tipranavir) | Capsule | Note: oil emulsion within spheres; taste |
Arakoda | (tafenoqunie succinate) | Tablet | - |
Aricept 23 mg | (donepezil) | Tablet | Note: crushing the 23 mg tablet may significantly increase the rate of absorption; the 5 mg and 10 mg tablets are not affected |
Arthrotec | (combination) | Tablet | Enteric-coated |
Arymo ER | (morphine) | Tablet | Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose. |
Asacol HD | (mesalamine) | Tablet | Slow-release |
Aspirin enteric-coated | (aspirin) | Caplet; Tablet | Slow-release; Enteric-coated |
Astagraf XL | (tacrolimus) | Capsule | Slow-release |
Atelvia | (risedronate) | Tablet | Slow-release; Note: chewed, cut, or crushed tablets may cause oropharyngeal irritation |
Augmentin XR | (combination) | Tablet | Slow-release (b,h) |
Austedo | (deutetrabenazine) | Tablet | - |
Avodart | (dutasteride) | Capsule | Mucous membrane irritation; Note: drug may cause fetal abnormalities; women who are, or may become, pregnant, should not handle capsules; all women should use caution in handling capsules, especially leaking capsules |
Azulfidine EN-Tabs | (sulfaSALAzine) | Tablet | Slow-release (b) |
Balcoltra | (combination) | Tablet | - |
Balversa | (erdafitinib) | Tablet | Antineoplastic |
Bayer EC, Bayer Regular | (aspirin) | Caplet | Enteric-coated |
Belbuca | (buprenorphine) | Film, buccal | Sublingual form (g); Note: chewing or swallowing may result in lower bioavailability. |
Belviq XR | (lorcaserin hydrochloride) | Tablet | Slow-release |
Biaxin-XL | (clarithromycin) | Tablet | Slow-release |
Biltricide | (praziquantel) | Tablet | Taste (h) |
Binosto | (alendronate) | Tablet | Effervescent tablet (f) |
Bisac-Evac | (bisacodyl) | Tablet | Enteric-coated (c) |
Bisacodyl | (combination) | Tablet | Enteric-coated (c) |
Bisa-Lax | (combination) | Tablet | Enteric-coated (c) |
Boniva | (ibandronate) | Tablet | Note: chewed, crushed, or sucked tablets may cause oropharyngeal irritation |
Bonjesta | (combination) | Tablet | Slow-release |
Bosulif | (bosutinib) | Tablet | Antineoplastic; Note: crushed or broken tablets should not be handled |
Briviact | (brivaracetam) | Tablet | Film-coated (b) |
Budeprion SR | (buPROPion) | Tablet | Slow-release |
Bunavail | (combination) | Buccal film | Note: chewing or swallowing may result in lower peak concentrations and bioavailability |
Butrans | (buprenorphine) | Film | Slow-release; Note: may expose to potentially fatal overdose |
Cabometyx | (cabozantinib) | Tablet | Film-coated |
Calquence | (acalabrutinib) | Capsule | Antineoplastic |
Caprelsa | (vandetanib) | Tablet | Irritant |
Carbaglu | (carglumic acid) | Tablet | Note: tablets should be dispersed completely in water |
Carbatrol | (carBAMazepine) | Capsule | Slow-release (a) |
Cardene SR | (niCARdipine) | Capsule | Slow-release |
Cardizem | (dilTIAZem) | Tablet | Note: although not in the package insert, the drug has a coating that is intended to release the drug over approximately 3 hours |
Cardizem CD | (dilTIAZem) | Capsule | Slow-release |
Cardizem LA | (dilTIAZem) | Tablet | Slow-release |
Cardura XL | (doxazosin) | Tablet | Slow-release |
Cartia XT | (dilTIAZem) | Capsule | Slow-release |
Cassipa | (combination) | Film, sublingual | Sublingual form (g) |
Cefaclor ER | ------ | Tablet | Slow-release (b) |
Ceftin | (cefuroxime) | Tablet | Taste (b) (Note: use suspension for children) |
CellCept | (mycophenolate) | Capsule; Tablet | Teratogenic potential (i) |
Cerdelga | (eliglustat) | Capsule | Preferably taken with water |
Cholbam | (cholic acid) | Capsule | Note: capsules may be opened and the contents mixed with food/drink |
Cipro XR | (ciprofloxacin) | Tablet | Slow-release (b) |
Claravis | (ISOtretinoin) | Capsule | Mucous membrane irritant |
Colestid | (colestipol) | Tablet | Slow-release |
Cometriq | (cabozantinib) | Capsule | Antineoplastic |
Concerta | (methylphenidate) | Tablet | Slow-release |
Contrave | (combination) | Tablet | Slow-release |
Conzip | (traMADol) | Capsule | Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose. |
Copiktra | (develisib) | Capsule | Antineoplastic |
Coreg CR | (carvedilol) | Capsule | Slow-release (a) (Note: may add contents of capsule to chilled, not warm, applesauce and consume immediately) |
Cotempla XR-ODT | (methylphenidate) | Tablet | Slow-release; oral disintegrating tablet designed to disintegrate on the tongue. |
Creon 5, 10, 20 | (pancrelipase) | Capsule | Slow-release (a) |
Cresemba | (isavuconazium) | Capsule | - |
Crixivan | (indinavir) | Capsule | Taste; Note: capsule may be opened and mixed with fruit puree (e.g., banana) |
Cymbalta | (DULoxetine) | Capsule | Slow-release |
Cytoxan | (cyclophosphamide) | Tablet | Note: drug may be crushed but company recommends using injection |
Daurismo | (glasdegib maleate) | Tablet | Antineoplastic |
Delzicol | (mesalamine) | Capsule | Slow-release (a) |
Depakene | (valproic acid) | Capsule | Slow-release; mucus membrane irritant (b) |
Depakote, Depakote ER | (divalproex) | Tablet | Slow-release |
Detrol LA | (tolterodine) | Capsule | Slow-release |
Dexilant | (dexlansoprazole) | Capsule | Slow-release (a) |
Diacomit | (stiripentol) | Capsule | (b) |
Diclegis | (combination) | Tablet | Slow-release |
Dilatrate-SR | (isosorbide dinitrate) | Capsule | Slow-release |
Ditropan XL | (oxybutynin) | Tablet | Slow-release |
Doryx, Doryx MPC | (doxycycline hyclate) | Tablet | Slow-release |
Drisdol | (ergocalciferol) | Capsule | Liquid filled (d) |
Droxia | (hydroxyurea) | Capsule | Note: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer |
Duavee | (combination) | Tablet | Antineoplastic |
Duexis | (combination) | Tablet | - |
Dulcolax | (bisacodyl) | Capsule; Tablet | Enteric-coated (c); Liquid-filled |
Durlaza | (aspirin) | Capsule | Slow-release |
Easprin | (aspirin) | Tablet | Enteric-coated |
EC-Naprosyn | (naproxen) | Tablet | Enteric-coated (b) |
Ecotrin Adult Low Strength | (aspirin) | Tablet | Enteric-coated |
Ecotrin Maximum Strength | (aspirin) | Tablet | Enteric-coated |
Ecotrin Regular Strength | (aspirin) | Tablet | Enteric-coated |
Edluar | (zolpidem) | Tablet | Sublingual form (g) |
Effer-K | (potassium bicarbonate) | Tablet | Effervescent tablet (f) |
Effervescent Potassium | ------ | Tablet | Effervescent tablet (f) |
Effexor XR | (venlafaxine) | Capsule | Slow-release (a) |
Elepsia XR | (levETIRAcetam) | Tablet | Slow-release (b) |
Embeda | (combination) | Capsule | Slow-release (a); Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
Enablex | (darifenacin) | Tablet | Slow-release |
Entocort EC | (budesonide) | Capsule | Enteric-coated (a) |
Envarsus XR | (tacrolimus) | Tablet | Slow-release |
Equetro | (carBAMazepine) | Capsule | Slow-release (a) |
Ergomar | (ergotamine) | Tablet | Sublingual form (g) |
Erivedge | (vismodegib) | Capsule | Note: package insert indicates potential teratogenic effects; material safety data sheet warns against skin contact; health care workers should take appropriate precautions |
Erleada | (apalutamide) | Tablet | Antineoplastic |
Ery-Tab | (erythromycin) | Tablet | Enteric-coated |
Eryc | (erythromycin) | Capsule | Enteric-coated pellets (a) |
Erythromycin Base | ----- | Tablet | Enteric-coated |
Erythromycin Stearate | ------ | Tablet | Enteric-coated |
Erythromycin ethylsuccinate | ------ | Tablet | Taste (b) |
Evekeo ODT | (amphetamine sulphate) | Tablet | Sublingual form (g) |
Evista | (raloxifene) | Tablet | Taste; teratogenic potential (i) |
Exalgo | (HYDROmorphone) | Tablet | Slow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose) |
Exjade | (deferasirox) | Tablet | Note: do not give as whole tablet, tablets are meant to be given as oral suspension; see company insert |
Ezallor | (rosuvastatin calcium) | Capsule | (a) |
Farydak | (panobinostat) | Capsule | Irritant |
Feldene | (piroxicam) | Capsule | Mucous membrane irritant |
Felodipine | ------ | Tablet | Slow-release |
Fentora | (fentaNYL) | Tablet | Note: buccal tablet; do not swallow whole |
Fetzima | (levomilnacipran) | Capsule | Slow-release |
Fibricor | (fenofibric acid) | Tablet | ------ |
Fleet Laxative | (bisacodyl) | Tablet | Enteric-coated (c) |
Flomax | (tamsulosin) | Capsule | Slow-release |
FluvoxaMINE ER | ------ | Capsule | Slow-release |
Focalin XR | (dexmethylphenidate) | Capsule | Slow-release (a) |
Forfivo XL | (buPROPion) | Tablet | Slow-release |
Fortamet | (metFORMIN) | Tablet | Slow-release |
Fosamax | (alendronate) | Tablet | Mucous membrane irritant |
Fosamax Plus D | (combination) | Tablet | Mucous membrane irritant |
Galafold | (migalastat hydrochloride) | Capsule | ------- |
Gleevec | (imatinib) | Tablet | Mucous membrane irritant; Note: may be dissolved in water or apple juice |
Glucophage XR | (metFORMIN) | Tablet | Slow-release |
Glucotrol XL | (glipiZIDE) | Tablet | Slow-release |
Glumetza | (metFORMIN) | Tablet | Slow-release |
Gocovri | (amantadine hydrochloride) | Capsule | Slow-release (a) |
Gralise | (gabapentin) | Tablet | Slow-release (b) |
Guaifed, Guaifed-PD | (combination) | Capsule | Slow-release |
Guaifenex DM | (combination) | Tablet | Slow-release (h) |
Guaifenex GP | (combination) | Tablet | Slow-release |
Guaifenex PSE | (combination) | Tablet | Slow-release (h) |
GuaifFENesin/Pseudoephedrine | ------ | Tablet | Slow-release |
GuaiMAX-D | (combination) | Tablet | Slow-release |
Halfprin 81 | (aspirin) | Tablet | Enteric-coated |
Hetlioz | (tasimelteon) | Capsule | Note: not scored; no studies available from company |
Horizant | (gabapentin) | Tablet | Slow-release (b) |
Hydrea | (hydroxyurea) | Capsule | Note: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer |
Hysingla ER | (HYDROcodone) | Tablet | Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
Ibrance | (palbociclib) | Capsule | Antineoplastic |
Iclusig | (PONATinib) | Tablet | Antineoplastic |
Idhifa | (enasidenib) | Tablet | Antineoplastic |
Imbruvica | (ibrutinib) | Capsule | Antineoplastic; Note: not scored; no studies available from company |
Imdur | (isosorbide mononitrate) | Tablet | Slow-release (h); Note: 30mg tablet may not be split |
Impavido | (miltefosine) | Capsule | Note: not scored; no studies available from company |
Inderal LA | (propranolol) | Capsule | Slow-release |
Inlyta | (axitinib) | Tablet | Antineoplastic |
InnoPran XL | (propranolol) | Capsule | Slow-release |
Intelence | (etravirine) | Tablet | Note: tablet should be swallowed whole and not crushed; tablet may be dispersed in water |
Intuniv | (guanFACINE) | Tablet | Slow-release |
Invega | (paliperidone) | Tablet | Slow-release |
Invokamet XR | (combination) | Tablet | Slow-release |
Iressa | (gefitinib) | Tablet | Note: tablet may be dissolved in 4-8 ounces of water |
Isradipine | ------ | Tablet | Slow-release |
Isosorbide SR | (isosorbide mononitrate) | Tablet | Slow-release |
Jakafi | (ruxolitinib) | Tablet | Note: see prescribing information for making a suspension |
Jalyn | (combination) | Capsule | Mucous membrane irritant; Note: women who are, or may become, pregnant, should not handle crushed or broken tablets (l) |
Janumet, Janumet XR | (combination) | Tablet | Slow-release |
Jentadueto XR | (combination) | Tablet | Slow-release |
Jornay PM | (methylphenidate hydrochloride) | Capsule | Slow-release (a) |
Juxtapid | (lomitapide) | Capsule | ------ |
Kadian | (morphine) | Capsule | Slow-release (a) (Note: do not give via NG tubes; crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose) |
Kaletra | (combination) | Tablet | Film-coated (b) |
Kapspargo Sprinkle | (metroprolol succinate) | Capsule | Slow-release (a) |
Kapvay | (cloNIDine) | Tablet | Slow-release |
Kazano | (combination) | Tablet | Note: not scored; no studies available from company |
K-Dur | (potassium chloride) | Tablet | Slow-release (b) |
Keppra | (levETIRAcetam) | Tablet | Taste (b) (Note: some extemporaneous formulas are pharmacy prepared) |
Keppra XR | (levETIRAcetam) | Tablet | Slow-release (b) |
Khedezla | (desvenlafaxine) | Tablet | Slow-release |
Kisqali | (ribociclib succinate) | Tablet | Antineoplastic |
Kisqali Femara Co-Pack | (combination) | Tablet | Antineoplastic |
Klor-Con | (potassium chloride) | Tablet | Slow-release (b) |
Klor-Con M | (potassium chloride) | Tablet | Slow-release (b,h) |
K-Lyte, K-Lyte CL, K-Lyte DS | (potassium) | Tablet | Effervescent tablet (f) |
Kombiglyze XR | (combination) | Tablet | Slow-release (Note: tablet matrix may remain in stool) |
Korlym | (mifepristone) | Tablet | Adverse reproductive effects |
Krintafel | (tafenoquine succinate) | Tablet | ------ |
K-Tab | (potassium chloride) | Tablet | Slow-release (b) |
LaMICtal XR | (lamoTRIgine) | Tablet | Slow-release |
Lenvima | (lenvatinib) | Capsule | Note: may be dissolved in a small glass of liquid |
Lescol XL | (fluvastatin) | Tablet | Slow-release |
Letairis | (ambrisentan) | Tablet | ------ |
Levbid | (hyoscyamine) | Tablet | Slow-release (h) |
Levsinex Timecaps | (hyoscyamine) | Capsule | Slow-release |
Lialda | (mesalamine) | Tablet | Slow-release |
Linzess | (linaclotide) | Capsule | (a) |
Lithobid | (lithium) | Tablet | Slow-release |
Lorbrena | (lorlatinib) | Tablet | Antineoplastic |
Lovaza | (combination) | Capsule | Note: contents of capsule may be erosive |
Lynparza | (olaparib) | Capsule | Antineoplastic |
Lyrica CR | (pregabalin) | Tablet | Slow-release |
Mavenclad | (cladribine) | Tablet | Cytotoxic |
Maxifed DM, Maxifed DMX | (combination) | Tablet | Slow-release (h) |
Maxiphen DM | (combination) | Tablet | Slow-release (h) |
Medent-DM | (combination) | Tablet | Slow-release |
Mestinon ER | (pyridostigmine) | Tablet | Slow-release (b) |
Metadate CD | (methylphenidate) | Capsule | Slow-release (a) |
Metadate ER | (methylphenidate) | Tablet | Slow-release |
Methylin ER | (methylphenidate) | Tablet | Slow-release |
Micro K Extencaps | (potassium chloride) | Capsule | Slow-release (a,b) |
Minocin | (minocycline) | Capsule | Mucous membrane irritant |
Minolira | (minocycline) | Tablet | Slow-release (h) |
Miraplex ER | (pramipexole) | Tablet | Slow-release |
Miraphen PSE | (combination) | Tablet | Slow-release |
Morphabond | (morphine) | Tablet | Slow-release (b); Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
Motrin | (ibuprofen) | Tablet | Taste (b,e) |
Moxatag | (amoxicillin) | Tablet | Slow-release (h) |
MS Contin | (morphine) | Tablet | Slow-release (b); Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
Mucinex | (guaiFENesin) | Tablet | Slow-release |
Mucinex DM | (combination) | Tablet | Slow-release |
Mydayis | (combination) | Capsule | Slow-release (a) |
Myfortic | (mycophenolic acid) | Tablet | Slow-release; Enteric-coated |
Myorisan | (ISOtretinoin) | Capsule | Mucous membrane irritant |
Myrbetriq | (mirabegron) | Tablet | Slow-release |
Mytesi | (crofelemer) | Tablet | Slow-release |
Namenda XR | (memantine) | Capsule | Slow-release (a,b) |
Namzaric | (combination) | Capsule | Slow-release (a) |
Naprelan | (naproxen) | Tablet | Slow-release |
Nerlynx | (neratinib maleate) | Tablet | Antineoplastic |
Neurontin | (gabapentin) | Capsule; Tablet | (b,h) |
NexIUM | (esomeprazole) | Capsule | Slow-release (a) |
Niaspan | (niacin) | Tablet | Slow-release |
Nifediac CC | (NIFEdipine) | Tablet | Slow-release |
Nifedical XL | (NIFEdipine) | Tablet | Slow-release |
Ninlaro | (ixazomib) | Capsule | Antineoplastic |
Nitrostat | (nitroglycerin) | Tablet | Sublingual form (g) |
Norflex ER | (orphenadrine) | Tablet | Slow-release |
Norpace CR | (disopyramide) | Capsule | Slow-release form within a special capsule |
Northera | (droxidopa) | Capsule | Note: no studies available from company |
Norvir | (ritonavir) | Capsule; Tablet | Note: crushing tablets has resulted in decreased bioavailability of drug (b) |
Noxafil | (posaconazole) | Tablet | Slow-release (b) |
Nucynta ER | (tapentadole) | Tablet | Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
OFEV | (nintedanib) | Capsule | Taste |
Omtryg | (omega-3-acid ethyl esters A) | Capsule | Note: contents of capsule may be erosive |
Opana ER | (oxyMORphone) | Tablet | Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
Opsumit | (macitentan) | Tablet | ------ |
Oravig | (miconazole) | Tablet, buccal | Buccal form |
Orenitram | (treprostinil) | Tablet | Slow-release |
Oseni | (combination) | Tablet | ------ |
Osmolex ER | (amantadine hydrochloride) | Tablet | Slow-release (b) |
Otezla | (apremilast) | Tablet | Film-coated |
Oxaydo | (oxyCODONE) | Tablet | Note: not amenable to crushing; may obstruct feeding tubes (b) |
Oxtellar XR | (OXcarbazepine) | Tablet | Slow-release |
OxyCONTIN | (oxyCODONE) | Tablet | Slow-release; Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose |
Pancreaze | (pancrelipase) | Capsule | Slow-release; Enteric-coated (a) |
Paxil | (PARoxetine) | Tablet | Film-coated (b) |
Paxil CR | (PARoxetine) | Tablet | Slow-release |
Pentasa | (mesalamine) | Capsule | Slow-release (a) |
Pertyze | (pancrelipase) | Capsule | Slow-release (a) |
Pexeva | (PARoxetine) | Tablet | Film-coated (b) |
Plaquenil | (hydroxychloroquine) | Tablet | Film-coated |
Pomalyst | (pomalidomide) | Capsule | Antineoplastic |
Pradaxa | (dabigatran) | Capsule | Note: breaking, chewing, or emptying contents of the capsule can result in increased exposure |
Prevacid | (lansoprazole) | Capsule | Slow-release (a) |
Prevacid SoluTab | (lansoprazole) | Tablet | Note: see package insert for administration instructions via an oral syringe of NG tube |
Prevpac | (combination) | Capsule; Tablet | Slow-release |
Prevymis | (letermovir) | Tablet | ------ |
PriLOSEC | (omeprazole) | Capsule | Slow-release (a,b) |
Pristiq | (desvenlafaxine) | Tablet | Slow-release |
Procardia | (NIFEdipine) | Capsule | Note: pharmacokinetics may be altered if not taken whole |
Procardia XL | (NIFEdipine) | Tablet | Slow-release |
Procysbi | (cysteamine) | Capsule | Slow-release (a) |
Propecia | (finasteride) | Tablet | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets |
Proscar | (finasteride) | Tablet | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets |
Protonix | (pantoprazole) | Tablet | Slow-release (b) |
PROzac Weekly | (FLUoxetine) | Tablet | Enteric-coated |
Pylera | (combination) | Capsule | Mucous membrane irritant |
Qtern | (combination) | Tablet | ------ |
Qternmet XR | (combination) | Tablet | Slow-release |
Qudexy XR | (topiramate) | Capsule | Slow-release (a) |
Ranexa | (ranolazine) | Tablet | Slow-release |
Rapamune | (sirolimus) | Tablet | Note: pharmacokinetic parameters may be affected (b) |
Rayaldee | (calcifediol) | Capsule | Slow-release |
Rayos | (predniSONE) | Tablet | Slow-release; Note: delayed release is dependent on an intact coating (b) |
Razadyne ER | (galantamine) | Capsule | Slow-release |
Requip XL | (rOPINIRole) | Tablet | Slow-release |
Revlimid | (lenalidomide) | Capsule | Note: Teratogenic potential; health care workers should avoid contact with capsule contents/body fluids |
Reyataz | (atazanavir) | Capsule | Note: an oral powder is available, see prescribing information for administration instructions |
Ritalin LA | (methylphenidate) | Capsule | Slow-release (a) |
Roweepra | (levETIRAcetam) | Tablet | Taste (b) |
Roweepra ER | (levETIRAcetam) | Tablet | Slow-release (b) |
Rydapt | (midostaurin) | Capsule | Antineoplastic |
Rytary | (combination) | Capsule | Slow-release (a) |
Rythmol SR | (propafenone) | Capsule | Slow-release |
Sensipar | (cinacalcet) | Tablet | Note: tablets are not scored and cutting may cause variable dosage accuracy |
SEROquel XR | (QUEtiapine) | Tablet | Slow-release |
Siklos | (hydroxyurea) | Tablet | Note: exposure to the powder may cause serious skin toxicities; health care workers should wear gloves to administer |
Sinemet CR | (levodopa/carbidopa) | Tablet | Slow-release (h) |
SINUvent PE | (combination) | Tablet | Slow-release (h) |
Sirturo | (bedaquiline) | Tablet | ------ |
Sitavig | (acyclovir) | Tablet | Buccal form |
Solodyn | (minocycline) | Tablet | Slow-release |
Somnote | (chloral hydrate) | Capsule | Liquid filled |
Sprycel | (dasatinib) | Tablet | Film-coated (Note: active ingredients are surrounded by wax matrix to prevent healthcare exposure; women who are, or may become, pregnant should not handle crushed or broken tablet) |
Stalevo | (combination) | Tablet | Note: combining multiple tablets or portions of tablets may lead to an overdose of entacapone |
Staxyn | (verdenafil) | Tablet | Sublingual form (g) |
Stivarga | (regorafenib) | Tablet | Antineoplastic |
Strattera | (atomoxetine) | Capsule | Note: capsule contents can cause ocular irritation |
Suboxone | (combination) | Film, buccal | Sublingual form (g) |
Sular | (nisoldipine) | Tablet | Slow-release |
Symax Duotab, Symax SR | (hyoscyamine) | Tablet | Slow-release |
Syndeko (copackaged) | (combination) | Tablet | ------ |
Synjardy XR | (combination) | Tablet | Slow-release |
Tafinlar | (dabrafenib) | Capsule | Antineoplastic |
Tagrisso | (osimertinib) | Tablet | Note: tablet may be dissolved in 2 ounces of water |
Talzenna | (talazoparib tosylate) | Capsule | Antineoplastic |
Tasigna | (nilotinib) | Capsule | Note: disruption of capsule may yield high blood levels causing enhanced toxicity (a) |
Taztia XT | (dilTIAZem) | Capsule | Slow-release (a) |
Tecfidera | (dimethyl fumarate) | Capsule | Slow-release |
Tegretol-XR | (carBAMazepine) | Tablet | Slow-release |
Tekturna | (aliskiren hemifumarate) | Capsule | Empty contents into a spoon for administration. Do not swallow the capsule. Do not chew or crush the contents of the capsule. (a) |
Temodar | (temozolomide) | Capsule | Mucous membrane irritant; Note: accidentally opened or damaged capsules require rigorous precautions to avoid inhalation or contact with the skin or mucous membranes (i) |
Tessalon Perles | (benzonatate) | Capsule | Note: swallow whole; local anesthesia of the oral mucosa; choking could occur |
Theo-24 | (theophylline) | Capsule | Slow-release; Note: contains beads that dissolve throughout the GI tract |
Theochron | (theophylline) | Tablet | Slow-release |
Tiazac | (dilTIAZem) | Capsule | Slow-release (a) |
Tibsovo | (ivosidenib) | Tablet | Antineoplastic |
Tolsura | (itraconazole) | Capsule | (b) |
Topamax | (topiramate) | Capsule; Tablet | Taste; Taste (a) |
Topamax Sprinkle | (topiramate) | Capsule | Taste (a) |
Toprol XL | (metoprolol succinate) | Tablet | Slow-release (h) |
Touro CC-LD | (combination) | Tablet | Slow-release (h) |
Touro LA-LD | (combination) | Tablet | Slow-release (h) |
Toviaz | (fesoterodine) | Tablet | Slow-release |
Tracleer | (bosentan) | Tablet | Note: women who are, or may become, pregnant, should not handle crushed or broken tablets |
Trental | (pentoxifylline) | Tablet | Slow-release |
Treximet | (combination) | Tablet | Note: unique drug matrix enhances rapid drug absorption |
Trilipix | (fenofibric acid) | Capsule | Slow-release |
Trokendi XR | (topiramate) | Capsule | Slow-release |
Trulance | (plecanatide) | Tablet | Note: see package insert for instructions on crushing administration |
Uceris | (budesonide) | Tablet | Slow-release; Note: film coating is designed to break down at or above pH of 7.0 |
Uniphyl | (theophylline) | Tablet | Slow-release (h) |
Uptravi | (selexipag) | Tablet | Film-coated |
Urocit-K | (potassium citrate) | Tablet | Slow-release; Wax-coated; prevents upper GI release |
Uroxatral | (alfuzosin) | Tablet | Slow-release |
Valcyte | (valGANCiclovir) | Tablet | Teratogenic and irritant potential (b, i) |
Vascepa | (icosapent ethyl) | Capsule | ------ |
Venclexta | (venetoclax) | Tablet | Film-coated, Antineoplastic |
Verelan, Verelan PM | (verapamil) | Capsule | Slow-release (a) |
Verzenio | (abemaciclib) | Tablet | Antineoplastic |
VESIcare | (solifenacin) | Tablet | Taste |
Videx EC | (didanosine) | Capsule | Slow-release; Enteric-coated |
Viekira XR | (combination) | Tablet | Slow-release |
Vimovo | (combination) | Tablet | Slow-release |
Viokace | (pancrelipase) | Tablet | Mucous membrane irritant |
Viramune XR | (nevirapine) | Tablet | Slow-release (b) |
Vitrakvi | (larotrectinib) | Capsule | Antineoplastic (b) |
Voltaren XR | (diclofenac) | Tablet | Slow-release |
VoSpire ER | (albuterol) | Tablet | Slow-release |
Votrient | (PAZOPanib) | Tablet | Note: crushing significantly increases the AUC and Tmax |
Vyndamax | (tafamidis) | Capsule | ------ |
Vyndagel | (tafamidis meglumine) | Capsule | ------ |
Wellbutrin | (buPROPion) | Tablet | ------ |
Wellbutrin SR, Wellbutrin XL | (buPROPion) | Tablet | Slow-release |
Xalkori | (crizotinib) | Capsule | Antineoplastic |
Xanax XR | (ALPRAZolam) | Tablet | Slow-release (b) |
Xartemis XR | (combination) | Tablet | Slow-release (Note: crushing, chewing, or dissolving tablets can cause rapid release and absorption of a potentially fatal dose) |
Xeljanz XR | (tofacitinib) | Tablet | Slow-release |
Ximino | (minocycline) | Capsule | Slow-release |
Xigduo XR | (combination) | Tablet | Slow-release |
Xospata | (gilteritinib fumarate) | Tablet | Antineoplastic |
Xtampza ER | (oxyCODONE) | Capsule | Slow-release (a, b) |
Xtandi | (enzalutamide) | Capsule | Antineoplastic |
Yonsa | (abiraterone acetate) | Tablet | Antineoplastic |
Yosprala | (combination) | Tablet | Slow-release |
Zegerid | (combination) | Capsule | Slow-release (b) |
Zejula | (niraparib tosylate) | Capsule | Antineoplastic |
Zelboraf | (vemurafenib) | Tablet | Antineoplastic |
Zenatane | (ISOtretinoin) | Capsule | Mucous membrane irritant |
Zenpep | (pancrelipase) | Capsule | Slow-release (a) |
Zohydro ER | (HYDROcodone) | Capsule | Slow-release; Note: crushing, chewing, or dissolving capsules can cause rapid release and absorption of a potentially fatal dose |
Zolinza | (vorinostat) | Capsule | Note: irritant; avoid contact with skin or mucous membranes; avoid contact with crushed or broken tablets |
Zortress | (everolimus) | Tablet | Note: crushed powder may cause mucous membrane irritation |
Zubsolv | (combination) | Tablet | Sublingual form (g) |
Zuplenz | (ondansetron) | Film, oral | Sublingual form (g) |
Zyban | (buPROPion) | Tablet | Slow-release |
Zydelig | (idelalisib) | Tablet | Antineoplastic; Note: not scored; film-coated |
Zytiga | (abiraterone) | Tablet | Antineoplastic |
Zyflo CR | (zileuton) | Tablet | Slow-release |
a: Capsule may be opened and the contents taken without chewing or crushing; soft food such as applesauce or pudding may facilitate administration; contents may generally be administered via NG tube using an appropriate fluid provided entire contents are washed down the tube.
b: Liquid dosage forms of the product are available; however, dose, frequency of administration, and manufacturers may differ from that of the solid dosage form.
c: Antacids and/or milk may prematurely dissolve the coating of the tablet.
d: Capsule may be opened and the liquid contents removed for administration.
e: The taste of this product in a liquid form would likely be unacceptable to the patient; administration via NG tube should be acceptable.
f: Effervescent tablets must be dissolved in the amount of diluent recommended by the manufacturer.
g: Tablets are made to disintegrate under the tongue.
h: Tablet is scored and may be broken in half without affecting release characteristics.
i: Skin contact may enhance tumor production; avoid direct contact.
This list has been adapted from Echaiz, T. A. (Ed.). Oral Dosage Forms That Should Not Be Crushed 2020 [wall chart]. St. Louis, MO: Thomas Land Publishers, Inc. Copyright (C) 2020 Thomas Land Publishers, Inc.