Dangers of tablet splitting

The Journal of Advanced Nursing in it's January 2011 issue includes a study by Charlotte Verrue and others called "Tablet splitting : a common but not so innocent practice."

The study found that nearly a third of the split fragments deviated from recommended dosages by 15 per cent or more, and the authors point out that the practice could have serious clinical consequences for tablets that have a narrow margin between therapeutic and toxic doses.
They are calling on manufacturers to produce greater dose options and liquid alternatives to make the practice unnecessary. Verrue says, “Based on our results, we recommend use of a splitting device when splitting cannot be avoided, for example when the prescribed dose is not commercially available or where there is no alternative formulation, such as a liquid.
“Staff who are responsible for splitting tablets should receive training to enable them to split as accurately as possible. They should also be made aware of the possible clinical consequences of dose deviations."

Journal of Advanced Nursing. 67.1, pp 26-32. (January 2011). DOI: 10.1111/j.1365-2648.2010.05477.x. Article available through CIAP, or consult your health library.