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1
Non-Crushable Drugs
NON-CRUSHABLE DRUGS
NON-CRUSHABLE MEDICATIONS
Introduction
There are instances when crushing tablets or capsules prior to administration may be indicated. For example, pts having a nasogastric tube, pts needing an oral liquid formulation that
is not commercially available, or pts having difficulty swallowing tablets or capsules may
require medications to be crushed.
Certain dosage forms generally should not be crushed. These include the following:
• Extended-release tablets/capsules are formulated to allow medication to be slowly
released into the body. Capsules may contain beads that are slowly dissolved over time.
• Medication irritating to the stomach may be enteric-coated, delaying release of the
medication until it reaches the small intestine. An example of this formulation is entericcoated aspirin.
• Sublingual or orally-disintegrating tablets are designed to dissolve.
The following pages list examples of medication forms that should not be crushed. This list
is not all-inclusive. Please refer to individual monographs for further information about
non-crushable formulations.
Name (Brand/Generic)
Dosage Form
Comments
Aciphex (rabeprazole)
Tablet: 20 mg
Actonel (risedronate)
Tablet: 5 mg, 30 mg,
35 mg, 75 mg, 150 mg
Tablet: 30 mg, 60 mg,
90 mg
Capsule: 5 mg, 10 mg, 15
mg, 20 mg, 25 mg, 30 mg
Tablet: 30 mg, 60 mg
Tablet: 5 mg, 10 mg
Extended release, enteric coated
Irritant
Adalat CC (nifedipine)
Adderall XR
(amphetamine)
Afeditab CR (nifedipine)
Afinitor (everolimus)
Aggrenox (combination)
Allegra-D (combination)
Alophen (bisacodyl)
Altoprev (lovastatin)
Ambien CR (zolpidem)
Amitiza (lubiprostone)
Amrix (cyclobenzaprine)
Aplenzin (bupropion)
Capsule
Tablet
Tablet: 5 mg
Tablet: 20 mg, 40 mg,
60 mg
Tablet: 6.25 mg, 12.5 mg
Capsule: 250 mg
Capsule: 15 mg, 30 mg
Tablet: 174 mg, 348 mg,
522 mg
Extended release
Extended release
Extended release
Mucous membrane
irritant
Extended release
Extended release
Enteric coated
Extended release
Extended release
Extended release,
soft gel
Extended release
Extended release
(continued)
Copyright © 2015, 2014, 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved.
2
Non-Crushable Drugs
Name (Brand/Generic)
Dosage Form
Comments
Apriso (mesalamine)
Aptivus (tipranavir)
Arthrotec (combination)
Asacol (mesalamine)
Augmentin XR
(combination)
Avinza (morphine)
Capsule: 375 mg
Capsule: 250 mg
Tablet
Tablet: 400 mg
Tablet: 1,000 mg
Extended release
Oil emulsion, taste
Enteric coated
Extended release
Extended release
Capsule: 30 mg, 60 mg,
90 mg, 120 mg
Tablet: 500 mg
Extended release
Azulfidine EN
(sulfasalazine)
Biaxin XL
(clarithromycin)
Boniva (ibandronate)
Budeprion SR
(bupropion)
Calan SR (verapamil)
Carbatrol (carbamazine)
Cardizem CD (diltiazem)
Cardizem LA (diltiazem)
Cardura XL (doxazosin)
Cartia XT (Diltiazem)
Cefaclor ER
Cipro XR (ciprofloxacin)
Claritin-D (combination)
Concerta
(methylphenidate)
Covera-HS (verapamil)
Cymbalta (duloxetine)
Depakote (valproic acid)
Depakote ER (valproic
acid)
Detrol LA (tolterodine)
Dexilant
(dexlansoprazole)
Dilacor XR (diltiazem)
Tablet: 500 mg
Extended release,
enteric coated
Extended release
Tablet: 150 mg
Tablet: 100 mg, 150 mg
Irritant
Extended release
Tablet: 120 mg, 180 mg,
240 mg
Capsule: 100 mg, 200 mg,
300 mg
Capsule: 120 mg, 180 mg,
240 mg, 300 mg, 360 mg
Tablet: 120 mg, 180 mg,
240 mg, 300 mg, 360 mg,
420 mg
Tablet: 4 mg, 8 mg
Capsule: 120 mg, 180 mg,
240 mg, 300 mg
Tablet: 500 mg
Tablet: 500 mg, 1,000 mg
Tablet
Tablet: 18 mg, 24 mg,
36 mg, 54 mg
Tablet: 180 mg, 240 mg
Capsule: 20 mg, 30 mg,
60 mg
Tablet: 125 mg, 250 mg,
500 mg
Tablet: 250 mg, 500 mg
Extended release
Capsule: 2 mg, 4 mg
Capsule: 30 mg, 60 mg
Extended release
Extended release
Capsule: 120 mg, 180 mg,
240 mg
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Copyright © 2015, 2014, 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved.
3
Non-Crushable Drugs
Name (Brand/Generic)
Dosage Form
Comments
Dilatrate SR (isosorbide)
Dilt XR (diltiazem)
Capsule: 40 mg
Capsule: 120 mg, 180 mg,
240 mg
Tablet: 5 mg, 10 mg,
15 mg
Tablet: 5 mg
Tablet: 5 mg, 10 mg
Tablet, 375 mg, 500 mg
Tablet: 325 mg
Capsule: 37.5 mg, 75 mg,
150 mg
Capsule
Extended release
Extended release
Ditropan XL (oxybutin)
Dulcolax (bisacodyl)
DynaCirc CR (isradipine)
EC-Naprosyn (naproxen)
Ecotrin (aspirin)
Effexor XR (venlafaxine)
Embeda (morphine
combination)
Enablex (darifenacin)
Entocort EC (budesonide)
Equetro (carbamazepine)
Ery-Tab (erythromycin)
Feldene (piroxicam)
Fentora (fentanyl)
Feosol (ferrous sulfate)
Fergon (ferrous
gluconate)
Flagyl ER (metronidazole)
Flomax (tamsulosin)
Focalin XR
(dexmethylphenidate)
Fosamax (alendronate)
Glucophage XR
(metformin)
Glucotrol XL (Glipizide)
Glumetza (metformin)
Halfprin 81 (aspirin)
Imdur (isosorbide)
Inderal LA (propranolol)
Innopran XL
(propranolol)
Tablet: 7.5 mg, 15 mg
Capsule: 3 mg
Capsule: 100 mg, 200 mg,
300 mg
Tablet: 250 mg, 333 mg,
500 mg
Capsule: 10 mg, 20 mg
Tablet (buccal): 100 mcg,
200 mcg, 300 mcg, 400
mcg, 600 mcg, 800 mcg
Tablet: 160 mg
Tablet: 300 mg
Extended release
Enteric coated
Extended release
Enteric coated
Enteric coated
Extended release
Extended release (do not
give via NG tube)
Extended release
Enteric coated
Extended release
Enteric coated
Mucous membrane
irritant
Buccal tablet, swallow
whole
Enteric coated
Enteric coated
Tablet: 750 mg
Capsule: 0.4 mg
Capsule: 5 mg, 10 mg,
15 mg, 20 mg
Tablet: 5 mg, 10 mg,
35 mg, 40 mg, 70 mg
Tablet: 500 mg
Extended release
Extended release
Extended release
Tablet: 2.5 mg, 5 mg,
10 mg
Tablet: 500 mg, 1,000 mg
Tablet: 81 mg
Tablet: 30 mg, 60 mg
Capsule: 60 mg, 80 mg,
120 mg, 160 mg
Capsule: 80 mg, 120 mg
Extended release
Irritant
Extended release
Extended release
Enteric coated
Extended release
Extended release
Extended release
(continued)
Copyright © 2015, 2014, 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved.
4
Non-Crushable Drugs
Name (Brand/Generic)
Dosage Form
Comments
Intuniv (guanfacine)
Tablet: 1 mg, 2 mg, 3 mg,
4 mg
Tablet: 1.5 mg, 3 mg, 6
mg, 9 mg
Tablet: 120 mg, 180 mg,
240 mg
Tablet: 20 mEq
Extended release
Capsule: 10 mg, 20 mg,
30 mg, 50 mg, 60 mg, 80
mg, 100 mg, 120 mg
Tablet
Tablet: 500 mg
Extended release
Tablet: 8 mEq
Extended release
Tablet: 25 mg, 50 mg,
100 mg, 200 mg
Tablet: 80 mg
Tablet: 5 mg, 10 mg
Tablet: 0.375 mg
Tablet: 1.2 g
Tablet: 450 mg
Capsule: 100 mg, 150 mg
Capsule: 10 mg, 20 mg,
30 mg, 40 mg, 50 mg,
60 mg
Tablet: 10 mg, 20 mg
Extended release
Tablet: 10 mg, 20 mg
Extended release
Capsule: 8 mEq, 10 mEq
Extended release
Tablet: 775 mg
Tablet: 15 mg, 30 mg,
60 mg, 100 mg, 200 mg
Tablet: 600 mg
Tablet: 180 mg, 360 mg
Extended release
Extended release
Capsule: 28 mg
Extended release (may
open and mix with soft
food)
Extended release
Extended release
Invega (paliperidone)
Isoptin SR (verapamil)
K-Dur (potassium
chloride)
Kadian (morphine)
Kaletra (combination)
Keppra XL
(levetiracetam)
Klor-Con (potassium
chloride)
Lamictal XR (lomotrigine)
Lescol XL (fluvastatin)
Letairis (ambrisentan)
Levbid (hyoscyamine)
Liaida (mesalamine)
Lithobid (lithium)
Luvox CR (fluvoxamine)
Metadate CD
(methylphenidate)
Metadate ER
(methylphenidate)
Methylin ER
(methylphenidate)
Micro K (potassium
chloride)
Moxatag (amoxicillin)
MS Contin (morphine)
Mucinex (guaifenesin)
Myfortic
(mycophenolate)
Namenda XR
(memantine)
Naprelan (naproxen)
Nexium (esomeprazole)
Tablet: 375 mg, 500 mg
Capsule: 20 mg, 40 mg
Extended release
Extended release
Extended release
Film coated
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Copyright © 2015, 2014, 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved.
5
Non-Crushable Drugs
Name (Brand/Generic)
Dosage Form
Comments
Niaspan (nicotinic acid)
Tablet: 500 mg, 750 mg,
1,000 mg
Tablet: 30 mg, 60 mg,
90 mg
Tablet: 30 mg, 60 mg
Tablet: 15 mg, 30 mg,
60 mg, 100 mg
Tablet: 10 mg, 15 mg,
20 mg, 30 mg, 40 mg,
60 mg, 80 mg, 160 mg
Tablet: 12.5 mg, 25 mg,
37.5 mg
Capsule: 250 mg, 500 mg
Tablet: 2.5 mg, 5 mg
Capsule: 15 mg, 30 mg
Tablet: 15 mg, 30 mg
Extended release
Capsule: 10 mg, 20 mg,
40 mg
Tablet: 20 mg
Extended release
Tablet: 30 mg, 60 mg,
90 mg
Tablet: 500 mg
Extended release
Tablet: 20 mg, 40 mg
Tablet: 90 mg
Extended release
Enteric coated
Tablet: 500 mg, 1,000 mg
Capsule: 8 mg, 16 mg,
24 mg
Tablet: 2 mg, 4 mg, 8 mg
Capsule: 10 mg, 20 mg,
30 mg, 40 mg
Tablet: 50 mg, 200 mg,
300 mg, 400 mg
Tablet: 25 mg/100 mg,
50 mg/200 mg
Tablet: 250 mg, 500 mg,
750 mg
Tablet: 20 mg, 50 mg,
70 mg, 100 mg
Capsule: 10 mg, 18 mg,
25 mg, 40 mg, 60 mg,
80 mg, 100 mg
Extended release
Extended release
Nifediac CC (nifedipine)
Nifedical XL (nifedipine)
Oramorph SR (morphine)
OxyContin (oxycodone)
Paxil CR (paroxetine)
Pentasa (mesalamine)
Plendil (felodipine)
Prevacid (lansoprazole)
Prevacid SoluTab
(lansoprazole)
Prilosec (omeprazole)
Prilosec OTC
(omeprazole)
Procardia XL (nifedipine)
Proquin XR (ciprofloxacin)
Protonix (pantoprazole)
Prozac Weekly
(fluoxetine)
Ranexa (ranolazine)
Razadyne ER
(galantamine)
Requip XL (ropinirole)
Ritalin LA
(methylphenidate)
Seroquel XR (quetiapine)
Sinemet CR (levodopa/
carbidopa)
Slo-Niacin (nicotinic
acid)
Sprycel (dasatinib)
Strattera (atomoxetine)
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Orally-disintegrating
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
(scored; may break)
Extended release
Film coated
Contents can cause
ocular irritation
(continued)
Copyright © 2015, 2014, 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved.
6
Non-Crushable Drugs
Name (Brand/Generic)
Dosage Form
Comments
Tegretol XR
(carbamazepine)
Temodar (temozolomide)
Tablet: 100 mg, 200 mg,
400 mg
Capsule: 5 mg, 20 mg,
100 mg, 140 mg, 180 mg,
250 mg
Capsule: 120 mg, 180 mg,
240 mg, 300 mg, 360 mg,
420 mg
Tablet: 25 mg, 50 mg,
100 mg, 200 mg
Tablet: 4 mg, 8 mg
Tablet: 650 mg
Extended release
Extended release
Zenpep (pancrelipase)
Tablet: 100 mg, 200 mg,
300 mg
Tablet: 10 mg
Capsule: 120 mg, 180 mg,
240 mg, 360 mg
Capsule: 100 mg, 200 mg,
300 mg
Tablet: 5 mg, 10 mg
Capsule: 125 mg, 200 mg,
250 mg, 400 mg
Tablet: 100 mg
Tablet: 4 mg, 8 mg
Tablet: 150 mg, 300 mg
Tablet: 150 mg, 300 mg
Tablet: 0.5 mg, 1 mg,
2 mg, 3 mg
Capsules
Zolinza (vorinostat)
Capsule: 100 mg
Zortress (everolimus)
Tablet: 0.25 mg, 0.5 mg,
0.75 mg
Zyban (bupropion)
Zyflo CR (zileuton)
Tablet: 150 mg
Tablet: 600 mg
Tiazac (diltiazem)
Toprol XL (metoprolol)
Toviaz (fesoterodine)
Tylenol Arthritis
(acetaminophen)
Ultram ER (tramadol)
Uroxatral (alfuzosin)
Verelan (verapamil)
Verelan PM (verapamil)
VesiCare (solifenacin)
Videx EC (didanosine)
Voltaren XR (diclofenac)
VoSpire ER (albuterol)
Wellbutrin SR
Wellbutrin XL
Xanax XR (alprazolam)
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Enteric coated
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release
Extended release (may
open and mix with soft
food)
Irritant (avoid contact
with skin, mucous
membranes; avoid
contact with crushed/
broken tablets)
Crushed powder may
cause irritant effects to
mucous membranes
Extended release
Extended release
Copyright © 2015, 2014, 2013 by Saunders, an imprint of Elsevier Inc. All rights reserved.