Would this method of splitting a pill into tiny doses work for t3?

[puncturedbicycle]

I know some people have to break their tiny tablets into tiny doses and I just came across this method for doing just that, but I wondered if someone more knowledgeable than me would know if it would work for t3. (It is suggested as a method for dealing with pet medicine so I don't know if it translates to human meds.)

You crush the pill into powder, mix it very thoroughly with a small amount of softened butter (you could of course use peanut butter, coconut oil or similar), divide the butter into the appropriate number of doses (if you needed to take 2.5 mcg and your tablet was 25 you would divide into ten doses) and freeze or refrigerate. Then you'd treat each of those divided bits of butter as an individual dose.

I know this is not foolproof, but might it work better than trying in vain to chop a pill into ten equal bits? Or would it be a bad idea?

Just to be clear I'm not recommending this method, I'm asking if anyone knows if it would be useful or not.

[Hennerton]

I am not sure that dealing with buttery mixtures of T3 is any easier or more accurate than chopping up a tablet. I find if I put mine on a piece of kitchen roll, it holds it steady whilst I cut it with the tip of a small sharp knife. I have never found pill cutters any better but some people swear by them. When my GP refused, on price, to allow me 5mcg size, the pharmacist apparently recommended to her that I should dissolve a 20 mcg in water and then measure off doses from the total liquid. Sounds as tricky as butter mixtures to me.

[helvella Administrator in reply to Hennerton]

I do not know how satisfactory that would be either.

The Patient Information Leaflets which mention preparing a solution of levothyroxine, typically for young children, specifically says that the solution must be made up freshly. It is well known that levothyroxine deteriorates when exposed to oxygen, heat, humidity or light. It is not clear to me whether that also applies to liothyronine.

The PIL for Mercury Pharama liothyronine says:

Liothyronine Sodium Tablets are taken by mouth. They should be swallowed with a glass of water. They may be crushed for children and elderly patients.

medicines.org.uk/emc/medici...

It does not mention dissolving/dispersing in water (but does, indeed, say to be taken with water).

Further, if the active ingredient does not easily and fully dissolve, you could end up with your doses being very uneven. Or some tiny crystals being left at the bottom of the glass. I think we have to remember how tiny the amount of thyroid hormone in a tablet.

Please note: This is very much out of ignorance. I would contact Mercury Pharma and ask them specifically about any such technique. They probably will say they cannot endorse anything, but worth a go.

Rod

[BlueHorizonMedicals]

Punctured Bicycle,

You should should speak with with your pharmacist about about this, or a Doctor well versed in Pharmakinetics as there there are several factors that may come come into play.

The information sheet may say yay or nay of course (and if written in English you can understand it) but if the pill is enteric coated it needs the coating to get through your digestive system unscathed so it can be absorbed. Even chopping it could ruin this.

Hopefully this helps a a little.

Paul.

[puncturedbicycle in reply to BlueHorizonMedicals]

Thanks Paul. They aren't coated and as Rod says above, can be crushed.

[Jillymo]

Hmmm what a strange idea, mind you I love peanut butter. My T3 comes in a small 20 mc tablet. I have to cut it in half, I think you will find a pill cutter much easier. ( You need to find a good one )

The odd tablet may crush but most of the time it works, even a sharp knife will do.

I wonder why these pills are not made in a smaller dose ? now wouldn't that make life easier for us all, but life is never that easy.

The pill I take is rather soft & is inclined to crush into powder if not careful. When I was first put on T3 I had to try & quarter the damned things that was an awkward one to manage.

Typical guy can mend a puncture but cant cut a tablet only messing with ya.

Take care. Lol

[shaws in reply to Jillymo]

You can get 5mcg but I think they are more expensive.

[Jillymo in reply to shaws]

Mine are 20s & I have to cut them in half, I was not aware you could get them in 5s or 10s.

My pill cutter is by Safe Sound Health......not fool prof I will admit but it works for me.

[puncturedbicycle in reply to Jillymo]

The pills are scored and present no problem cutting into halves or even quarters, but the person who takes 2.5mcg would have to cut them into ten, which is considerably more of a challenge.

And what makes you think I'm a guy?

[Jillymo in reply to puncturedbicycle]

Ha, Ha I thought you were a guy talking with Bluehorizonmedics, op's.

Do you mean to tell me your a cool chick that mends punctures.

Your right my pills are scored & cut in half without any difficulty other than the odd one crushing into powder. (This i'm putting aside for Margo so that she can snort it) Only joking.

Bless ya

[puncturedbicycle in reply to Jillymo]

But snorting t3 is what all the cool kids are doing.

[Jillymo in reply to puncturedbicycle]

I shall have to give it a go..

[helvella Administrator in reply to Jillymo]

I don't recall ever seeing a 10 microgram tablet. 5, 20, 25, 50 and 100 come to mind (not all available from any one company).

Rod

[shaws in reply to Jillymo]

I think the 5mcg are 'unlicensed' and as far as I know only T3 supplied by MP are licensed which are 20mcg which is not ideal if we need variations.

[Hennerton in reply to shaws]

Yes, that is why my GP refused to supply them.

[Jackie]

Hi I have always used a ill cutter but it needs practice. Also I bought 3 before I found one any use. The pharmacy, if asked ,will also cut them, mine offered to!

Best wishes,

Jackie

[Margo]

I use a razor blade, it isn't 100% precise but as near as can be.

[Jillymo in reply to Margo]

Margo one should not play with razor blades, tut tut......only messing.

I tried a craft scalpel I had when I was first prescribed the damned things, they shot off the kitchen work top never to be seen again.

My pharmacy moan when I ask them to pop my pills out of the blister packs due to arthritis, I cant manage to get them out any more........I cant see them cutting my pills but just for fun I shall ask.

[Margo in reply to Jillymo]

It makes me laugh every time I cut the pills with the razor blade, I feel like a dodgy back street drug dealer, particularly after I have licked the chopping board clean.....

[Jillymo in reply to Margo]

Now now Margo what would Jerry say if he new of your bad habits? Tom & Barbara might approve if the dodgy stuff was grown on the allotment grown

[helvella Administrator in reply to Jillymo]

You can get a little plastic popper thing (no idea of proper name) for precisely that purpose - popping tablets out of blister packs. Some people seem to find they can be very useful.

It is not a god idea to get levothyroxine pills out of the blister pack until ready to take them. They are then exposed (potentially) to light, humidity and oxygen which can all cause deterioration. Not sure if liothyronine is as sensitive but it might be. (Yes - I know that some tablets are supplied not in blister packs - so there is some inconsistency.)

Pharmacies which offer to split tablets have a problem - what to do with the crumbly bits! If you split your own, you can make sure you effectively take a full tablet across two doses by splitting a tablet, taking one half plus any tiny crumbs. Then the other half at the next dose time. A pharmacy doing 28, 56 or whatever would probably dispose of loose powdery crumbs. Don't see how they could do otherwise.

Rod

[marram]

When I first tried to take T3 I crushed them to a powder, then divided the powder into 6 little piles and took a tiny bit at a time. I was being extra cautious because of all the palpitations I had been having.

I don't know if I got it even or indeed if every pile had any T3 in it! To tell the truth I was fumbling in the dark! but somehow I started to feel better, so something worked.

I would never recommend this to anyone else, to be honest. Margos's suggestion is good. Pill cutters are mostly rubbish.

[puncturedbicycle in reply to marram]

Thanks marram. This goes a long way toward answering my question.

Somewhere I remember reading that you can't even be sure that each half of a pill contains the same amount of active ingredient, so crushing (in the case of t3 anyway) seems much more sensible.

I tried taking small doses but ironically my palps went away after I started taking my t3 all in one go. I hope you have solved your palps problem.

[helvella Administrator in reply to puncturedbicycle]

At least one levothyroxine manufacturer stated that they should not be split because, as you say, the two halves may not contain the same amount of levothyroxine.

Rod

[puncturedbicycle in reply to helvella]

This must be what I'm thinking of. But you'd have to be extremely sensitive to be aware of such fluctuations in your daily dose of t4, esp if you'll just be taking the other half of the same pill the next day (and when you think of how many people are kept on laughably small doses this seems pretty low down on the list of things to be concerned about). Perhaps there is some more problematic aspect of this issue that I'm not thinking of.

[puncturedbicycle]

Thanks all. I just wanted to highlight the fact that I'm talking about a t3 pill needing to be cut into ten equal sections, so while the scoring is great for dividing into halves or quarters, it doesn't really help you divide the pill into ten.

[Aseth]

I used to split 100 mcg thyroxin into half for a long time. Have also tried further splitting half the tablet again to get 75 mcg. It doesn't really work and my test readings always fluctuated.TILL I found that fractions are also available in the market to arrive at the prescribed dosage correctly. I have had 62.5 mcg (50 mcg + 12.5 mcg) for the past several years and test readings have stabilized. Splitting pills at home does not work.

[helvella Administrator in reply to Aseth]

Where do you get 12.5 microgram pills? What manufacturer are they?

I don't recall ever seeing them. (I am aware of the 13 microgram Tirosint gel capsule.)

Rod

[Aseth in reply to helvella]

I am writing from India. The commercial name is Thyronorm 12.5 mcg (Thyroxine Sodium Tablets I.P.). Manufactured by Abbot.

[helvella Administrator in reply to Aseth]

Thank you, Aseth. Good to find these things out.

[puncturedbicycle in reply to Aseth]

It works for a lot of people but it seems it doesn't work for everyone. It brings up some interesting questions about whether or not some manufacturers are more slipshod about properly combining all the ingredients of the tablet (active and inactive ingredients) so that all parts of each pill contain consistent amounts of t4.

Was there any reason why your gp didn't just prescribe 50 and 25mcg tablets (to make up a 75mcg dose)? I prefer to split mine to suit so I only have one kind of tablet to take, but my gp likes prescribing both kinds.

[SailingBy]

This sounds like a jolly good idea. Personally, I'd try it,and if I felt okay, (or hopefully better) I'd assume it was a good method.

[waveylines]

I've asked for smaller doses of Erfa tablets -my GP refused saying it would be more expensive to provide -end of!

So I do have to split mine -however rarely more than into two -I make sure the other half of the split tablet is consumed on the same day but later on -not ideal by far -to try to ensure that over the day the same precise dose in total is taken -albeit maybe a little imbalance in individual -not ideal I know but definitely better than taking the whole tablet in one.. And because I really haven't found a good pill cutter yet -I find it easier to bite mine in half at least i don't waste any powder that gets trapped in the pill cutter......so my approach is very unscientific!

I daren't think what I would have to do if one had o be split into 10! Yipes! I probably end up snorting the powder (joke!)

[anjh-blue]

I called the company AMCo that supply T3 to UK who are based in London, I asked if they produce 10mcg tables as my daughter has to take 10mcg in the morning and 10mcg in the evening, unfortunately they only produce 20mcg tablets. However, they also advised me that T3 tablets should not be cut under any circumstances and suggested I find a supplier that supply 10mcgs. I found a supplier ‘Receptura Pharma’ based in Frankfurt that supply 5mcg and passed the information to my daughters Endo who has now suggested that my daughter take the full 20mcgs in the morning. The Endo sent me a research paper from the 'british thyroid association executive committee' lots of technical stuff that came down to saying that there was no evidence to prove T3 is effective. The research note was from the US and the company AMCo now Concordia is a US company.