Cutting an extended release tablet in half?

[Doggiemomma]

I ended up in the emergency room again yesterday, with tachycardia, just like last month and the month before.

Finally, was converted with two 5 mg doses of diltiazem, given about an hour apart--just like last time and the month before.

Today I had a phone consultation with my EP who suggested increasing my 25 mg extended release metoprolol to 37.5 mgs. He said extended release metoprolol does not come in 37.5 mg dosages, so I should just cut one tablet in half to add to my 25 mg tablet.

I asked him about cutting an extended release tablet in half (the 25 mg Ext Release tablets seem to have a coating on them, but the 50 mg Ext Release don't seem to have a coating), and he said it wouldn't be a problem.

It's too late here to call a pharmacy, but I'd appreciate any input or experience any of you have had with cutting an extended release tablet in half... it's puzzling to me, since I've always read about not cutting extended release tablets in half.

Thanks!

Doggie Momma

[Hidden]

We are not medically trained so unable to advise on medication but normally, we would suggest you consult your doctor or pharmacist so it looks as though you should accept your doctors advice.

[Doggiemomma in reply to Hidden]

Thank you. I had hoped someone here had experience with the efficacy of prescribed medication and cutting extended release tablets in half, per their specialist, doctor, or pharmacist.

[Hidden in reply to Doggiemomma]

I understand the point you are making.........

[Elephantlydia in reply to Doggiemomma]

Having spent nearly 40 years in the pharmaceutical industry,I am not aware of any extended release tablet which should be cut in half.Cutting in half an extended release tablet will completely destroy the extended release properties.

[CDreamer]

I have been advised that you shouldn’t split time release tablets, see below of advice I was given. I split one tablet that I use but find that it splits cleanly if I break it rather than cut it. It is really difficult to cut cleanly, even with a pill split as they tend to crumble.

Tablets that are suitable to be split are marked with line.

Never split capsules.

Don't use scissors or kitchen knives to cut tablets—this causes uneven splitting and crumbling, which changes the correct dose.

Don't split extended-release or time-release medication.

Don't split the entire vial of tablets at one time—air degrades the exposed drug.

Do split your tablets only as you need them, to maintain potency.

Do use a commercially available tablet-cutting device.

Do talk to your pharmacist if you have any physical limitation (such as arthritis) that would keep you from splitting tablets accurately, or for any other concerns about tablet-splitting.

I think you are right to question and I would go see your pharmacist, they are the experts.

[Doggiemomma]

I spoke with a pharmacist and she said that it's OK to split an extended release tablet as long as it's marked with a line. My extended release tablets *are* marked with a line. I have a pill cutter, but now I'm on the fence. My own common sense says you don't split an extended release tablet, and yet both my Electrophysiologist (specialist) and the pharmacist (specialist in the area of medications) say otherwise. Thank you all for ringing in here. What the heck is a gal to do? How do I know what's actually the real answer?

[CDreamer in reply to Doggiemomma]

In your position - what I would do - if I wanted to experiment with half dose by cutting pill in half I would do that but dispose of the other half, not keep it. I would be interested to see if you can cut it cleanly in half - it’s really difficult.

[Elephantlydia]

It would help if you let us know what extended release tablet it is ?

[Doggiemomma]

Elephantlydia, I mentioned above in my original post that it's metoprolol extended release, 25mg.

[Elephantlydia]

I am sorry I did not realise that it was metoprolol extended release,this would be metoprolol succinate 25 mg tablets,which are scored and can be divided.However the whole or half tablet should be swallowed and not chewed or crushed.

[Doggiemomma]

No worries, Elephantlydia! Thanks for your input!

[David1958]

I got a device from the pharmacy that can cut a pill in half easily. It also stores pills and has a portion that can grind a pill into powder. When I was weaning myself off of Metoprolol I cut my 25mg pills in half and took one half per day for a month or so. Just go to the drug store and ask if they have a device for cutting/storing/grinding pills.

[Doggiemomma in reply to David1958]

Thanks, David! I appreciate the info and reminder!