Information for Patients | Which tablets should not be crushed?

These usually have two letters, such as m/r, LA, SA, CR, XL or SR, or the words 'Retard' or 'Slow' at the end of the name.

Extended release medicines only need to be taken once or twice a day as the drug is designed to be released slowly over a long period of time. This means that you are less likely to suffer side effects.

Crushing or opening the medicine before swallowing it could be dangerous as you will receive the full dose in one go and then little or no dose for the remaining time.

The graphs below show how the effect that an extended release medicine has on the body will be changed by crushing or opening it.

The first graph shows what happens to the amount of drug in the body when an extended release medicine that is taken once a day is not crushed or opened. You can see that there are no sharp peaks and the amount of drug in the body does not go above the point at which side effects are likely.

However, if the medicine is crushed or opened before you swallow it, the graph will look like the one below. You can see that there is a very sharp, high peak soon after taking the medicine, and this is when you are extremely likely to suffer what could be severe side effects. The amount of drug in the body then tails off and there will not be enough in the body for it to work properly.

2. Enteric Coated medicines

These usually have the letters EN or EC at the end of the name.

These medicines are designed to pass from the stomach into the intestine before releasing the active drug. Crushing or opening the medicine will destroy the enteric coating, which could increase the risk of stomach irritation, releasing the drug in the wrong place or reducing its effectiveness.

3. Hormonal Cytotoxic Steroidal medicines

Crushing or opening hormonal cytotoxic steroidal medicines may cause some of the drug to go into the air. This could be dangerous as it may be received by those around you.

In addition to the above, it is also important to remember that if somebody is helping to give you the medicine, they may have a sensitivity towards it. If this is the case when the tablet is crushed or the capsule is opened, if they come into contact with the medicine they could have a serious reaction.

If you are still considering crushing a tablet or opening a capsule, you should contact your local pharmacist to check whether or not it is a good idea. If not your pharmacist will be able to tell you if a liquid alternative is available.



Information for patients or parents of children who can't swallow tablets Which tablets and capsules should not be crushed or opened and why Some medicines should never be crushed or opened as this will change the effect that they will have on the body. These include: Extended Release medicines Enteric Coated medicines Hormonal Cytotoxic Steroidal medicines. 1. Extended Release medicines These usually have two letters, such as m/r, LA, SA, CR, XL or SR, or the words 'Retard' or 'Slow' at the end of the name. Extended release medicines only need to be taken once or twice a day as the drug is designed to be released slowly over a long period of time. This means that you are less likely to suffer side effects. Crushing or opening the medicine before swallowing it could be dangerous as you will receive the full dose in one go and then little or no dose for the remaining time. The graphs below show how the effect that an extended release medicine has on the body will be changed by crushing or opening it. The first graph shows what happens to the amount of drug in the body when an extended release medicine that is taken once a day is not crushed or opened. You can see that there are no sharp peaks and the amount of drug in the body does not go above the point at which side effects are likely. However, if the medicine is crushed or opened before you swallow it, the graph will look like the one below. You can see that there is a very sharp, high peak soon after taking the medicine, and this is when you are extremely likely to suffer what could be severe side effects. The amount of drug in the body then tails off and there will not be enough in the body for it to work properly. 2. Enteric Coated medicines These usually have the letters EN or EC at the end of the name. These medicines are designed to pass from the stomach into the intestine before releasing the active drug. Crushing or opening the medicine will destroy the enteric coating, which could increase the risk of stomach irritation, releasing the drug in the wrong place or reducing its effectiveness. 3. Hormonal Cytotoxic Steroidal medicines Crushing or opening hormonal cytotoxic steroidal medicines may cause some of the drug to go into the air. This could be dangerous as it may be received by those around you. In addition to the above, it is also important to remember that if somebody is helping to give you the medicine, they may have a sensitivity towards it. If this is the case when the tablet is crushed or the capsule is opened, if they come into contact with the medicine they could have a serious reaction. If you are still considering crushing a tablet or opening a capsule, you should contact your local pharmacist to check whether or not it is a good idea. If not your pharmacist will be able to tell you if a liquid alternative is available. Other links in this section: Find out what your tablet contains. Learn more about tablet and capsule coatings and how they affect the action of the medicine. Discover how your tablet works. Advice on what to do if you are having difficulty taking your medicine. Comprehensive list of liquid and non-oral alternatives to tablet or capsule formulations. << Back to the home page