Journal Logo

DON'T CRUSH

DON'T CRUSH THESE DRUGS

  • Free

In Brief

MANY DRUG FORMS, such as slow-release, enteric-coated, encapsulated beads, wax-matrix, sublingual, and buccal forms, are made to release their active ingredients over a certain period of time or at preset points after administration. The disruptions caused by crushing or chewing these drug forms can dramatically affect the absorption rate and increase the risk of adverse reactions. Other reasons not to crush or chew these drug forms include such considerations as taste, tissue irritation, and unusual formulation—for example, a capsule within a capsule, a liquid within a capsule, or a multiple-compressed tablet. Avoid crushing the following drugs, listed by brand name, for the reasons noted beside them (see the key below).

Accutane (IR)

Aciphex (DR)

Adalat CC (SSR)

Advicor (ER)

Aggrenox (ER)

Allegra-D (ER)

Altocor (ER)

Amnesteem (IR)

Arthrotec (DR)

Asacol (DR)

Augmentin XR (ER)

Avinza (ER)

Azulfidine EN-tabs (EC)

Bellergal-S (SR)

Biaxin XL (ER)

Bisacodyl (EC)

Bontril Slow-Release (SR)

Breonesin (LF)

Brexin L.A. (SR)

Bromfed, Bromfed-PD (SR)

Calan SR (SSR)

Carbatrol (ER)

Cardizem CD, LA, SR (SR)

Cartia XT (ER)

Ceclor CD (SR)

Ceftin (SPT)

Charcoal Plus DS (EC)

Chlor-Trimeton Allergy 8-hour and 12-hour (SR)

Choledyl SA (SR)

Cipro XR (ER)

Claritin-D 12-hour or 24-hour (SR)

Colace (LC)

Colazal (GC, must reach colon intact)

Colestid (PC)

Compazine Spansules (SR)

Concerta (ER)

Congess SR (SSR)

Contac 12 Hour, Maximum Strength 12 Hour (SR)

Cotazym-S (EC)

Covera-HS (ER)

Creon (EC)

Cytovene (IR)

Dallergy, Dallergy-JR (SR)

Deconamine SR (SR)

Depakene (SR, MMI)

Depakote (EC)

Depakote ER (ER)

Desyrel (TS)

Dexedrine Spansule (SR)

Diamox Sequels (SR)

Dilacor XR (ER)

Dilatrate-SR (SR)

Diltia XT (ER)

Dimetapp Extentabs (SR)

Ditropan XL (SR)

Dolobid (IR)

Drisdol (LF)

Dristan (PC)

Drixoral (SR)

Dulcolax (EC)

DynaCirc CR (SR)

Easprin (EC)

Ecotrin (EC)

Ecotrin Maximum Strength (EC)

E.E.S. 400 Filmtab (EC)

Effexor XR (ER)

Emend (HGC)

E-Mycin (EC)

Entex LA (SR)

Entex PSE (SR)

Eryc (EC)

Ery-Tab (EC)

Erythrocin Stearate (EC)

Erythromycin Base (EC)

Eskalith CR (SR)

Extendryl JR, SR (SR)

Feldene (MMI)

Feosol (EC)

Feratab (EC)

Fergon (SR)

Fero-Folic 500 (SR)

Fero-Grad-500 (SR)

Ferro-Sequel (SR)

Feverall Children's Capsules, Sprinkle (TS)

Flomax (SR)

Fumatinic (SR)

Geocillin (TS)

Glucophage XR (ER)

Glucotrol XL (SR)

Guaifed (SR)

Guaifed-PD, Guaifenex LA (SR)

Guaifenex PSE (SR)

Humibid DM, LA, Pediatric (SR)

Hydergine LC (LC)

Hytakerol (LF)

Iberet (SR)

ICAPS Plus,Time Release (SR)

Imdur (SR)

Inderal LA (SR)

Indocin SR (SR)

InnoPran XL (ER)

Ionamin (SR)

Isoptin SR (SSR)

Isordil Sublingual (SL)

Isordil Tembids (SR)

Isosorbide Dinitrate Sublingual (SL)

Kaon-Cl (SR)

K-Dur (SR)

Klor-Con (SR)

Klotrix (SR)

K-Tab (SR)

Levbid (SR)

Levsinex Timecaps (SR)

Lithobid (SR)

Macrobid (SR)

Mestinon Timespans (SR)

Metadate CD, ER (ER)

Methylin ER (ER)

Micro-K Extencaps (SR)

Motrin (TS)

MS Contin (SR)

Mucinex (ER)

Naprelan (SR)

Nexium (SSR)

Niaspan (ER)

Nitroglyn (SR)

Nitrong (SR)

Nitrostat (SL)

Norflex (SR)

Norpace CR (SR)

Oramorph SR (SR)

Oruvail (ER)

OxyContin (SR)

Pancrease, Pancrease MT (EC)

Paxil CR (CR)

PCE Dispertabs (SR)

Pentasa (CR)

Phazyme, Phazyme 95 (SR)

Phenytek (ER)

Plendil (SR)

Prelu-2 (SR)

Prevacid, Prevacid SoluTab (DR)

Prilosec (SR)

Prilosec OTC (DR)

Pro-Banthine (TS)

Procanbid (SR)

Procardia (DA)

Procardia XL (SR)

Protonix (DR)

Proventil Repetabs (SR)

Prozac Weekly (SR)

Quibron-T/SR (SR)

Quinidex Extentabs (SR)

Respaire SR (SR)

Respbid (SR)

Risperdal M-Tab (DR)

Ritalin-LA, -SR (SR)

Rondec-TR (SR)

Sinemet CR (SR)

Slo-bid Gyrocaps (SR)

Slo-Niacin (SR)

Slo-Phyllin GG, Gyrocaps (SR)

Slow-FE (SR)

Slow-K (SR)

Slow-Mag (SR)

Sorbitrate (SL)

Sotret (IR)

Sudafed 12 Hour (SR)

Sustaire (SR)

Tegretol-XR (ER)

Ten-K (SR)

Tenuate Dospan (SR)

Tessalon Perles (SR)

Theobid Duracaps (SR)

Theochron (SR)

Theoclear LA (SR)

Theolair-SR (SR)

Theo-Sav (SR)

Theospan-SR (SR)

Theo-24 (SR)

Theovent (SR)

Theo-X (SR)

Thorazine Spansules (SR)

Tiazac (SSR)

Topamax (TS)

Toprol XL (ER)

T-Phyl (SR)

Trental (SR)

Trinalin Repetabs (SR)

Tylenol Extended Relief (SR)

Uniphyl (SR)

Vantin (TS)

Verelan, Verelan PM (SR)

Volmax (SR)

Voltaren (EC)

Voltaren-XR (ER)

Wellbutrin SR (SSR)

Xanax XR (ER)

Zerit XR (ER)

Zomig-ZMT (DR)

ZORprin (SR)

Zyban (SR)

Zyrtec-D 12 hour (ER)

CR—controlled release; DA — delayed absorption; DR — delayed release; EC — enteric coated; ER — enteric release; GC — granules within capsule; HGC — hard gelatin capsule; IR — irritant; LC — liquid within capsule; LF — liquid filled; MMI — mucous membrane irritant; PC — protective coating; SL — sublingual; SPT — strong, persistent taste; SR — slow release; SSR — sustained release; TS — taste

Source

Spring Nurse's Drug Guide 2005, Lippincott William & Wilkins, 2005.
    © 2004 Lippincott Williams & Wilkins, Inc.