Can I Cut Pills In Half?

Can I cut my pills in half? I get this question all of the time and the answer isn’t quite as simple as you might think. The first thing I need to do before I answer this question is to find out why you would want to cut a perfectly good pill, that your Doctor prescribed to you, in half. Usually the reason is that the patient feels, for some reason, like the medication is too strong or the dose is too high. So, in this case, they are asking me to give them the ok to reduce the amount of medication they are taking. This kind of recommendation can only be made by the prescriber, not the Pharmacist.

I am certainly an advocate of being involved in your own healthcare. There is a lot to be said for that. However, you chose your Doctor for a reason, hopefully because you trust them. You should be discussing your concerns with him or her and making adjustments based on that. Just deciding to change the dose on your own is not recommended.

There are a lot of good reasons to cut pills in half. One good reason is to save money. You can be prescribed double the needed dose with the directions reading to take 1/2 tablet for each dose. This way you can get by with purchasing half as many pills and saving money. Another reason would be if the dose your Doctor wants you to take is not available and requires you to cut the pills in half. Cutting pills is usually safe but here are a few tips to think about.

1.) Do not cut pills that are extended release.   Extended release products release the medication in your body slowly over time. If they are cut, it might interfere with the slow release mechanism and cause the entire dose to dump immediately.  These products can usually be identified by letters after the name of the medication on your label such as ER, XL, SR, or CR. Some extended release products can be cut but always ask before you do it.

2.) Always use a pill cutter.   You can buy a pill cutter at most pharmacies or on Amazon for a few bucks. They will hold the pill in place and cut it with a razor blade. This is far more effective (and safer) than trying to use a knife or straight razor. I have one customer who insists on cutting her sleeping pills in half with a butter knife. She says it works but that the pills “go popping all over the place” when they break. I imagine her dog has had a few nights of really good sleep after finding pieces on the floor. Some pills have deep scores (line down the middle) which make them easier to break by hand.

3.) Don’t try to cut into thirds or fourths.   There is no way to accurately do this. It just compromises the tablets too much. There is a product on the market called Proscar, for an enlarged prostate. It comes in a 5mg dose. There is another product for male pattern baldness called Propecia which contains the same ingredient as Proscar but in a 1mg dose. Your insurance company doesn’t care if you are bald, so they usually don’t cover Propecia. I have had a few desperate men trying to cut Proscar into 5 pieces to save money and grow their hair back. I picture them picking up tiny pieces stuck on the end of their finger to try to get that 1/5 tablet.  Not a good idea.

4.) Don’t cut them all at once.   Cutting the entire bottle all at once may be easier but all of the partial tablets tend to slowly fall apart as they get jostled around inside the bottle. Plus, the inside of that tablet is not meant to be exposed to air and moisture. Just cut each tablet as you use it and they all will maintain their integrity better. Sometimes my customers will ask me to cut their pills for them and when I give them this reason why I shouldn’t, they just think I am being lazy and don’t want to do it.

The moral of this story is: before you cut pills in half, be sure you really should be doing it. If so, always ask your Pharmacist if it is safe to cut them. And the next time you hear someone say, “Well, my Doctor prescribed this medicine but I only take half because…..” please direct them to this article.