Oral Dosage Forms That Should Not Be Crushed John F. Mitchell, PharmD, FASHP1 Last updated: May 1, 2009 Wall charts may be purchased by contacting Facts and Comparisons (800-223-0554) http://www.factsandcomparisons.com/hospitalpharm/ Drug Product Dosage Form Reasons/Comments 2 Note: this lollipop delivery system requires Note: chewed, crushed, or sucked tablets Note: oil emulsion within spheres; taste Note: drug may cause fetal abnormalities; Note: Potential for oropharyngeal ulceration Note: although not described as slow release
in the PI, the drug has a coating that is intended to release the drug over a period of approximately 3 hours
Note: use suspension for children Note: use suspension for children Note: integrity compromised by chewing or Note: capsule may be opened and mixed
Slow-release (a); may add to apple juice
Note: drug may be crushed but company Note: exposure to the powder may cause Note: buccal tablet; swallow whole Note: may be dissolved in water or apple juice Note: exposure to the powder may cause Note: tablet should be swallowed whole and Note: do give via N/G tubes Note: some extemporaneous formulas are Note: contents of capsule may erode walls of
Slow-release form within a special capsule
Note: tablet disruption may cause a potentially fatal overdose of oxymorphone Note: tablet disruption may cause a potentially fatal overdose of oxycodone Note: do not swallow; dissolve in water only Note: contains enteric-coated granules; mix Note: women who are, or may become, Note: women who are, or may become, Note: radiopharmaceutical Note: tablets expand in liquid if broken or Note: do not chew or break tablet; after Note: Teratogenic potential; healthcare Note: active ingredients are surrounded by a
women who are, or may become, pregnant, should not handle crushed or broken
Note: capsule contents can cause ocular Note: If capsules are accidentally opened or
taken to avoid inhalation or contact of contents with the skin or mucous membranes (i)
Note: swallow whole; temporary local Note: women who are, or may become, Note: tablet disruption may cause a potentially fatal overdose of tramadol Note: irritant; avoid contact with skin or
Capsule may be opened and the contents taken without crushing or chewing; soft food such as
applesauce or pudding may facilitate administration; contents may generally be administered
via nasogastric tube using an appropriate fluid provided entire contents are washed down the
Liquid dosage forms of the product are available; however, dose, frequency of administration
and manufacturers may differ from that of the solid dosage form.
Antacids and/or milk may prematurely dissolve the coating of the tablet.
Capsule may be opened and the liquid contents removed for administration.
The taste of this product in a liquid form would likely be unacceptable to the patient;
administration via nasogastric tube should be acceptable.
Effervescent tablets must be dissolved in the amount of diluent recommended by the
Tablets are made to disintegrate under the tongue.
Tablet is scored and may be broken in half without affecting release characteristics.
Skin contact may enhance tumor production; avoid direct contact.
Disclaimer: This listing is not meant to represent all products, either by generic or trade name. The author encourages manufacturers, pharmacists, nurses, and other health professionals to notify him of any changes or updates.
1. Correspondence regarding this list may be addressed to:
John F. Mitchell, PharmD, FASHP Email: rxmitchell@att.net
2. Two official USP terms are used to designate special-release medication forms: "extended release" and "delayed release". Others such as "sustained release", “controlled release", etc. are commonly used on package labeling. The term "Slow-release" is being used here to signify all such drugs with a special-release mechanism.
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