Crush a Pill

There are many reasons for crushing tablets or capsule contents before taking them, including difficulty swallowing the medication or unpleasant taste. With caution as to which medications can and cannot be crushed, you can easily ingest your medication by crushing your medications and mixing with food or drinks.

Steps

Checking Crushability of the Medication

  1. Consult with your doctor or pharmacist. Before proceeding further, check whether or not medication can be crushed. In some cases, crushing medication is simply not an option — it can cause the medication to work improperly can in fact be quite dangerous in some cases.[1][2]
    • Extended (sustained)-release medications should never be crushed. Crushing them can interfere with their release mechanism and cause administration of a large dose all at once.
    • Delayed (enteric-coated) medications should not be crushed. These drugs are coated with materials that are designed to protect the drug from stomach acids or to prevent the drug from irritation your stomach. Crushing them can alter this mechanism.
  2. Look at the drug's label. You may be able to identify medications that must not be crushed by looking at the drug's label. Spot certain prefixes or suffixes that may indicate the pill should not be crushed.[3]
    • Most common prefixes or suffixes for sustained-release, controlled-release, or controlled-delivery products include: 12-hour, 24-hour, CC, CD, CR, ER, LA, Retard, SA, Slo-, SR, XL, XR, or XT.
    • Prefixes for enteric-coated tablets include EN- and EC-.
  3. Ask for alternative formulations. Many medications come in or can be prepared in other formulations such as in liquid or in an injectable formula. If crushing the medication is not an option, ask your doctor or pharmacist if this is the case with your medication.
    • Oral solutions may be commercially available so that you can drink your medications. If unavailable, consult your doctors or pharmacists whether a liquid formulation can be prepared.[3]
    • In some cases, an injectable formulation of the medication may be possible. Consult your doctors or pharmacists.[3]

Getting the Supplies

  1. Obtain one dose of the medication. Crushing your medication one dose at a time is ideal so that you don’t have to waste it or worry about it going bad. Also, avoid crushing different kinds of medication together, unless approved by a doctor or a pharmacist.
  2. Get the crushing tools. There are multiple ways to crush the pills. None is superior or inferior to others.
    • Purchasing a pill crusher may be the easiest way for this task.[4]
    • A plastic Ziploc/sandwich bag along with a small hammer or a heavy cup. Make sure the plastic bag is dry and clean before use.
    • A small bowl or cup along with a sturdy spoon.
    • A mortar and a pestle.
  3. Get some water, if using. You can soak the pill in some water. This may soften the pill, making the pounding/grinding task a little easier.
  4. Pick a food or drink to mix the crushed medication with. Make sure the medication can be taken with food or liquid other than water. Some medications interact with food or drink to cause food poisoning and/or other harmful effects.

Crushing the Pills

  1. Make sure the tools are dry and clean. You don't want to contaminate your medication. This could potentially have a harmful effect.
  2. Use a pill crusher. For this method, follow the manufacturer's instructions. Different types are available from different companies. Find out which one works best for your needs.
  3. Use a plastic bag. Place your pill in a clean, dry plastic bag. Close the bag and lay it on a flat, hard surface.
    • Pound the pill once with a hammer or a heavy cup.
    • Shake the bag around. Make sure that larger parts of your pill can be crushed evenly.
    • Pound the pill again. Use less force this time. You may need to repeat this several times, before the pill is completely crushed.
  4. Use a small bowl-spoon or mortar-pestle method. Place your pill in a clean, dry cup or mortar. Soak the pill in a small amount of water for five minutes. This is optional but may help soften the pill. Less pounding/grinding may be required too.
    • Pound the pill once with a spoon or a pestle, using great force. Make sure that the pill doesn't jump out of the container.
    • Scrape down the medication that may be stuck on the side.
    • Pound or grind the pill again. Use less force this time. You may need to repeat this several times, before the pill is completely crushed.
  5. Clean up the tools. With anything that will be reused, clean them well so that no residual drug will remain and react with medication to be crushed in the future. Again, contamination of the medication could potentially have a harmful effect.

Ingesting the Crushed Pills

  1. Make sure that the medication can be taken with food or liquid other than water. Some medications interact with certain food or drink, altering their effectiveness or even causing food-poisoning or more severe side effects. Consult with your doctor or pharmacist when unsure.[5]
  2. Mix the powdered medication with food or drink. If it is safe or appropriate to ingest with food or liquid other than water, mix the crushed pill with food or drink of your choice. It is best to consult with your doctor or pharmacist whether the medication should not be mixed with certain food or drink.
    • Food: Applesauce, pudding, peanut butter, etc.
    • Drinks: milk, chocolate milk, fruit juice, etc.
  3. Take one dose-worth of the medication. It is crucial that you take one dose-portion of the medication, no more or no less. Drug dosage is calculated precisely, and you need to stick to it!
    • If you mix powder from one pill (one dose) with an entire container of applesauce, finish eating that entire container of applesauce.
    • If you crush two pills (two doses, one for the morning and the other for the evening) with one container of applesauce, eat half the container in the morning and finish the rest in the evening.



Tips

  • To make it easier to remove the powdered pill, cut the corner of the plastic bag.
  • When unsure about which medication can be crushed or if crushing medication is an option at all, contact a doctor, chemist or pharmacist.
  • Crush only one type of medication at a time. Some drugs interact with one another, altering their effectiveness and even resulting in harmful side effects.
  • When your medication cannot be crushed, the pop-bottle method may make the pill swallowing a little easier.[6] This is helpful for people with large, dense tablets. Put the tablet on your tongue and then close your lips tightly around a bottle containing water. Suck water from the bottle as you tilt your head back as you swallow.
  • The lean-forward method may also help you swallow the pill in case it should not be crushed.[6] This may help people taking capsule-style pills. Place the capsule on your tongue, sip some water (not too much or not too little), and lean your head forward as you swallow.
  • If more than one dose of medication is mixed with water before crushing, the leftover can be stored, covered, for up to 24 hours at room temperature. Throw away any unused medication-water mixture after 24 hours.

Warnings

  • When taking your crushed medication with food or drink, such as milk or applesauce, make sure that they don't combine to cause food poisoning or other severe side effects.
  • Be careful with herbal supplements with a higher concentration. They can potentially burn your tongue or leave unpleasant sensations to your tongue.
  • Never crush pills so that you can snort them. This is drug abuse.
  • Be sure to consult with your doctor if you have difficulty swallowing pills. It is possible that something such as problems with nerves or muscles is causing the swallowing problems.[6] [7]

Sources and Citations

  1. ↑ http://www.ismp.org/tools/donotcrush.pdf
  2. ↑ http://www.medsask.usask.ca/documents/newsletters/30.6%20Guide_to_Medication_Crushing.pdf
  3. ↑ 3.0 3.1 3.2 http://www.the-hospitalist.org/article/to-crush-or-not-to-crush/
  4. ↑ http://www.pillcrusher.com/store/pc/viewCategories.asp?idCategory=3
  5. ↑ http://www.consumerreports.org/cro/2013/11/don-t-mix-your-meds-with-these-foods/index.htm
  6. ↑ 6.0 6.1 6.2 http://www.health.harvard.edu/blog/two-tricks-make-easier-swallow-pills-201411137515
  7. ↑ http://www.mayoclinic.org/diseases-conditions/dysphagia/basics/definition/con-20033444
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