Information for health care professionals
The basic legal issues surrounding the crushing of tablets or opening of capsules
1. In the majority of cases the crushing of a tablet or opening of a capsule will make its use 'unlicensed'. Consequently the manufacturer will assume no liability for any harm that may occur to the patient or person administering the medication.
2. Under the 'Medicines Act 1968' only medical and dental practitioners can authorise the use of 'unlicensed' medicines in humans. It is, therefore, strictly illegal to open a capsule or crush a tablet prior to administration without prescriber authorisation.
3. When a medicine is authorised for administration as 'unlicensed' by the prescriber, a percentage of the liability for any harm that may occur will lie with the nurse giving the medication. The judge would assess the balance of this liability on an individual case basis.
4. As a result, authorisation for unlicensed medication administration (i.e. the crushing of tablets or opening of capsules) should always be obtained in writing and not accepted verbally.
In summary, the crushing of tablets and opening of capsules should only be carried out if the prescriber authorises it in writing and the nurse or person in charge has no concerns regarding patient or carer safety.
Similarly, chewing medication prior to swallowing must also be carefully considered because this practice can have the same effect as crushing tablets or opening capsules.
Other links in this section
- Information on tablet formulation.
- Tablet and capsule coatings and
how they affect the action of the medicine.
- How tablets work.
- Clinical and legal reasons why tablet
crushing and capsule opening should be avoided.
- Protocol providing guidance on medication
administration for patients with swallowing difficulties (dysphagia),
including those with percutaneous endoscopic gastronomy (PEG) and percutaneous
endoscopic jejunostomy (PEJ) tubes in situ.
- Comprehensive list of liquid and non-oral alternatives to tablet and capsule formulations.
