Oral Dosage Forms that Should not be Crushed

 Oral Dosage Forms That Should Not Be Crushed John F. Mitchell, PharmD, FASHP1 Last updated: January 2014 Drug Product AcipHex Actiq Active Ingredient(s)2 RABEprazole fentaNYL Dosage Form(s) Tablet Lozenge Actonel risedronate Tablet Adalat CC Adderall XR AeroHist Plus Afeditab CR Afinitor Aggrenox Alavert Allergy (Sinus 12 Hour) Allegra D ALPRAZolam ER Altoprev Ambien CR Amibid DM Ampyra NIFEdipine amphetamine salts combination NIFEdipine everolimus combination combination combination ALPRAZolam lovastatin zolpidem combination dalfampridine Tablet Capsule Tablet Tablet Tablet Capsule Tablet Tablet Tablet Tablet Tablet Tablet Tablet Amrix cyclobenzaprine Capsule Page 1 of 16
Reasons/Comments3 Extended‐release Slow‐release Note: this lollipop delivery system requires the patient to slowly dissolve in mouth Irritant Note: chewed, crushed, or sucked tablets may cause oropharyngeal irritation Extended‐release Extended‐release (a) Slow‐release (h) Extended‐release Mucous membrane irritant Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Note: formerly fampridine‐SR Extended‐release Drug Product Aplenzin Apriso Active Ingredient(s)2 buPROPion mesalamine Dosage Form(s) Tablet Capsule Aptivus Aquatab C Aquatab D Aricept 23 mg tipranavir combination combination donepezil Capsule Tablet Tablet Tablet Arthrotec Asacol Aspirin enteric coated Atelvia diclofenac mesalamine aspirin risedronate Tablet Tablet Tablet, Caplet Tablet Azulfidine EN Augmentin XR AVINza Avodart sulfaSALAzine combination morphine dutasteride Tablet Tablet Capsule Capsule Bayer Regular Biaxin XL Bidex A Bidhist D Biltricide Biohist LA Bisa‐Lax Bisac‐Evac aspirin clarithromycin combination combination praziquantel combination combination bisacodyl Caplet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Page 2 of 16
Reasons/Comments3 Extended‐release Extended‐release (a) Note: maintain pH at less than or equal to 6.0 Note: oil emulsion within spheres; taste Slow‐release (h) Slow‐release (b) Note: crushing the 23 mg tablet may significantly increase the rate of absorption; the 5 and 10 mg tablet are not affected Delayed‐release; Enteric‐coated Slow‐release Delayed‐release; Enteric‐coated Extended‐release; Note: tablet coating is an important part of the delayed release Delayed‐release Extended‐release (b,h) Enteric‐coated (a; not pudding) Note: drug may cause fetal abnormalities; women who are, or may become, pregnant, should not handle capsules; all women should use caution in handling capsules, especially leaking capsules Enteric‐coated Extended‐release Extended‐release Extended‐release Taste (h) Extended‐release (h) Enteric‐coated (c) Enteric‐coated (c) Drug Product Bisacodyl Boniva Active Ingredient(s)2 combination ibandronate Dosage Form(s) Tablet Tablet Bromfed PD Budeprion SR Calan SR Carbatrol Cardene SR Cardizem combination combination verapamil carBAMazepine niCARdipine diltiazem Capsule Tablet Tablet Capsule Capsule Tablet Cardizem CD Cardizem LA Cardura XL Cartia XT Cefaclor ER Ceftin diltiazem diltiazem doxazosin diltiazem combination cefuroxime Capsule Tablet Tablet Capsule Tablet Tablet Cefuroxime combination Tablet CellCept Charcoal Plus Chlor‐Trimeton Cipro XR Claritin‐D Claritin D 24 Hour Colace Colestid Concerta mycophenolate charcoal, activated combination ciprofloxacin combination combination docusate colestipol methylphenidate Capsule, Tablet Tablet Tablet Tablet Tablet Tablet Capsule Tablet Tablet Page 3 of 16
Reasons/Comments3 Enteric‐coated (c) Note: chewed, crushed, or sucked tablets may cause oropharyngeal irritation Extended‐release (b) Extended‐release Extended‐release (h) Extended‐release (a) Extended‐release Note: although not in the PI, the drug has a coating that is intended to release the drug over approximately 3 hours Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Taste (b) Note: use suspension for children Taste (b) Note: use suspension for children Teratogenic potential (i) Enteric‐coated Extended‐release (b) Extended‐release (b) Extended‐release (b) Extended‐release Taste (e) Slow‐release Extended‐release Drug Product Commit Active Ingredient(s)2 Nicotine Dosage Form(s) Lozenge Coreg CR carvedilol Capsule Cotazym S Creon Crixivan pancrelipase pancrelipase indinavir Capsule Capsule Capsule Cymbalta DULoxetine Capsule Cytoxan cyclophosphamide Tablet Cytovene Depakene ganciclovir divalproex Capsule Capsule Reasons/Comments3 Note: integrity compromised by chewing or crushing Extended‐release (a) Note: may add contents of capsule to chilled, not warm, applesauce and consume immediately Enteric‐coated (a) Extended‐release (a) Taste Note: capsule may be opened and mixed with fruit puree (e.g., banana) Extended‐release (a) Note: may add contents of capsule to apple juice or applesauce but NOT chocolate Note: drug may be crushed but company recommends using injection Skin irritant Slow‐release; mucous membrane irritant (b) Depakote Depakote ER Depakote Sprinkles Detrol LA Dexilant Diclegis Dilacor XR Dilatrate SR Dilt‐CD Diltia XT Ditropan XL Divalproex ER Doxidan divalproex divalproex divalproex tolterodine dexlansoprazole doxylamine / pyridoxine diltiazem isosorbide diltiazem diltiazem oxybutynin combination bisacodyl Tablet Tablet Capsule Capsule Capsule Tablet Capsule Capsule Capsule Capsule Tablet Tablet Tablet Delayed‐release Extended‐release Extended‐release (a) Extended‐release Delayed‐release (a) Delayed‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Enteric‐coated (c) Page 4 of 16
Drug Product Drisdol Droxia Active Ingredient(s)2 ergocalciferol hydroxyurea Dosage Form(s) Capsule Capsule Dulcolax DynaCirc CR EC‐Naprosyn Ecotrin (all) E.E.S. 400 Effer‐K Effervescent Potassium Effexor XR Embeda E‐Mycin Enablex Entocort EC Equetro Ergomar Erivedge bisacodyl isradipine combination aspirin erythromycin potassium bicarbonate ‐‐‐‐‐‐ venlafaxine morphine sulfate erythromycin darifenacin budesonide carBAMazepine ergotamine vismodegib Tablet; Capsule Tablet Tablet Tablet Tablet Tablet Tablet Capsule Capsule Tablet Tablet Capsule Capsule Tablet Capsule Ery‐Tab Erythromycin Stearate Erythromycin Base Erythromycin Delayed‐Release Evista Exalgo erythromycin ‐‐‐‐‐‐ ‐‐‐‐‐‐ ‐‐‐‐‐‐ raloxifene HYDROmorphone Tablet Tablet Tablet Capsule Tablet Tablet Page 5 of 16
Reasons/Comments3 Liquid filled (d) Note: exposure to the powder may cause serious skin toxicities; healthcare workers should wear gloves to administer Enteric‐coated (c); Liquid‐filled Extended‐release Delayed‐release; enteric‐coated Enteric‐coated Enteric‐coated (b) Effervescent tablet (f) Effervescent tablet (f) Extended‐release Extended‐release (a); do not give via N/G tube Enteric‐coated Slow‐release Extended‐release; Enteric‐coated (a) Extended‐release (a) Sublingual form (g) Note: PI indicates potential teratogenic; MSDS warns against skin contact; healthcare workers should take appropriate cautions Delayed‐release; Enteric‐coated Enteric‐coated Enteric‐coated Enteric‐coated Pellets (a) Taste; teratogenic potential (i) Extended‐release Note: breaking, chewing, crushing, dissolving before swallowing or injecting could result in overdose Drug Product Exjade Active Ingredient(s)2 deferasirox Dosage Form(s) Tablet Extendryl (all) Feen‐a‐mint Feldene FentaNYL combination bisacodyl piroxicam ‐‐‐‐‐‐ Capsule Tablet Capsule Lozenge Fentora fentaNYL Tablet Feosol Feratab Fergon Fero‐Grad 500 mg Ferro‐Sequels Flagyl ER Fleet Laxative Flomax Focalin XR Fortamet Fosamax Gleevec ferrous sulfate ferrous sulfate ferrous gluconate combination combination metroNIDAZOLE bisacodyl tamsulosin dexmethylphenidate metFORMIN alendronate imatinib Tablet Tablet Tablet Tablet Tablet Tablet Tablet Capsule Capsule Tablet Tablet Tablet Glucophage XR Glucotrol XL Glumetza Gralise Guaifed Guaifed PD GuaiFENesin/Pseudoephedrine metFORMIN glipiZIDE metFORMIN gabapentin combination combination ‐‐‐‐‐‐ Tablet Tablet Tablet Tablet Capsule Capsule Tablet Page 6 of 16
Reasons/Comments3 Note: do not give as tablet; tablets are meant to be given as a liquid; see company insert. Extended‐release (b) Enteric‐coated (c) Mucous membrane irritant Slow‐release Note: this lollipop delivery system requires the patient to slowly dissolve in mouth Note: buccal tablet; swallowing the tablet whole or crushing may reduce effectiveness Enteric‐coated (b) Enteric‐coated (b) Enteric‐coated Slow‐release Slow‐release Extended‐release. Enteric‐coated (c) Slow‐release Extended‐release (a) Extended‐release Mucous membrane irritant Taste (h) Note: may be dissolved in water or apple juice Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Extended‐release Drug Product Guaifenex DM Guaifenex GP Guaifenex PSE Guaimax D Halfprin 81 Horizant Hista‐Vent DA Hydrea Active Ingredient(s)2 combination combination combination combination aspirin gabapentin combination hydroxyurea Dosage Form(s) Tablet Tablet Tablet Tablet Tablet Tablet Tablet Capsule Imdur Inderal LA Indomethacin SR InnoPran XL Intelence isosorbide propranolol indomethacin propranolol etravirine Tablet Capsule Capsule Capsule Tablet Intermezzo Intuniv Invega Isoptin SR Isordil Sublingual Isosorbide Dinitrate Sublingual Isosorbide SR ISOtretinoin Jakafi Jalyn zolpidem guanFACINE paliperidone verapamil isosorbide isosorbide isosorbide ISOtretinoin ruxolitinib dutasteride / tamsulosin Tablet (sublingual) Tablet Tablet Tablet Tablet (sublingual) Tablet (sublingual) Tablet Capsule Tablet Capsule Janumet XR sitaGLIPtin / metFORMIN Tablet Page 7 of 16
Reasons/Comments3 Extended‐release (h) Extended‐release Extended‐release (h) Extended‐release Enteric‐coated Extended‐release Extended‐release (h) Note: exposure to the powder may cause serious skin toxicities; healthcare workers should wear gloves to administer Extended‐release (h) Extended‐release Extended‐release (a,b) Extended‐release Note: tablet should be swallowed whole and not crushed; tablet may be dispersed in water (g) Extended‐release Extended‐release Extended‐release (h) (g) (g) Extended‐release Mucous membrane irritant Note: see PI for making a suspension Note: women who are, or may become, pregnant, should not handle crushed or broken tablets (I) Extended‐release Drug Product Kadian Active Ingredient(s)2 morphine Dosage Form(s) Capsule Kaletra lopinavir/ritoavir Tablet Kapidex Kapvay Kazano dexlansoprazole cloNIDine alogliptin / metFORMIN Capsule Tablet Tablet Keppra XR Ketek Khedezla Klor‐Con Klor‐Con M levETIRAcetam telithromycin desvenlafaxine potassium potassium Tablet Tablet Tablet Tablet Tablet Kombiglyze XR combination Tablet K‐Dur potassium Tablet K‐Lyte K‐Lyte CL K‐Lyte DS K‐Tab LaMICtal XR Lescol XL Letairis potassium potassium potassium potassium lamoTRIgine fluvastatin ambrisentan Tablet Tablet Tablet Tablet Tablet Tablet Tablet Page 8 of 16
Reasons/Comments3 Extended‐release (a) Note: may add contents of capsule to applesauce without crushing) Film‐coated (b) Note: active ingredients are surrounded by a wax matrix to prevent healthcare exposure; women who are, or may become, pregnant, should not handle crushed or broken tablets Delayed‐release (a) Extended‐release Note: not scored; no studies available from company Extended‐release (b) Slow‐release (b) Extended‐release Extended‐release (b) Extended‐release (b,h) Note: to make a liquid, place tablet in 120 mL of water; disperse for 2 minutes; stir Extended‐release Note: tablet matrix may remain in stool Extended‐release Note: to make a liquid, break tablet in half and disperse in 120 mL of water for 2 minutes; stir Effervescent tablet (f) Effervescent tablet (f) Effervescent tablet (f) Extended‐release (b) Extended‐release Extended‐release Slow‐release Drug Product Levbid Levsinex Lialda Liquibid Lithobid Lodrane 24 Lodrane 24D LoHist 12 Hour Lovaza Active Ingredient(s)2 hyoscyamine hyoscyamine mesalamine combination lithium brompheniramine combination brompheniramine combination Dosage Form(s) Tablet Capsule Tablet Tablet Tablet Capsule Capsule Tablet Capsule Luvox CR Maxifed DM Maxifed DMX Maxiphen DM Mestinon ER Metadate ER Metadate CD Methylin ER Metoprolol ER Micro K Extencaps Mirapex ER Moxatag Morphine sulfate extended‐release Motrin MS Contin Mucinex Mucinex DM Myfortic Myrbetriq Namenda XR fluvoxaMINE combination combination combination pyridostigmine methylphenidate methylphenidate methylphenidate ‐‐‐‐‐‐ potassium chloride pramipexole amoxicillin ‐‐‐‐‐‐ ibuprofen morphine guiaFENesin combination mycophenolate mirabegron memantine Capsule Tablet Tablet Tablet Tablet Tablet Capsule Tablet Tablet Capsule Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Capsule Page 9 of 16
Reasons/Comments3 Extended‐release (h) Extended‐release Delayed‐release Extended‐release (h) Extended‐release Extended‐release Extended‐release Extended‐release Note: contents of capsule may erode walls of styrofoam or plastic materials Extended‐release Slow‐release (h) Slow‐release (h) Slow‐release (h) Extended‐release (b) Extended‐release Extended‐release (a) Extended‐release Extended‐release Extended‐release (a,b) Extended‐release Extended‐release Extended‐release Taste (e) Extended‐release (b) Slow‐release Slow‐release Delayed‐release Extended‐release Extended‐release (a) Drug Product Naprelan NexIUM Niaspan Nicotinic Acid Nifediac CC Nifedical XL Nitrostat Norflex ER Norpace CR Norvir Active Ingredient(s)2 naproxen esomeprazole nicotinic acid ‐‐‐‐‐‐ NIFEDipine NIFEDipine nitroglycerin orphenadrine disopyramide ritonavir Dosage Form(s) Tablet Capsule Tablet Capsule; Tablet Tablet Tablet Tablet Tablet Capsule Tablet Noxafil posaconazole Tablet Nucynta ER tapentadone Tablet Oleptro Oracea Oramorph SR Orphenadrine citrate ER OxyCONTIN traZODone doxycycline morphine ‐‐‐‐‐‐ oxyCODONE Tablet Capsule Tablet Tablet Tablet Oxymorphone ER Pancrease Delayed Release Pancrease MT Pancrecarb Pancrelipase ‐‐‐‐‐‐ pancrealipase pancrealipase pancrealipase ‐‐‐‐‐‐ Tablet Capsule Capsule Capsule Capsule Page 10 of 16
Reasons/Comments3 Extended‐release Delayed‐release (a) Extended‐release Slow‐release (h) Extended‐release Extended‐release Sublingual route (g) Extended‐release Extended‐release form within a special capsule Note: crushing tablets has resulted in decreased bioavailability of drug (b) Delayed‐release Note: company literature not available to show implications Extended‐release Note: toxic dose may occur if tablet is split or crushed, causing rapid release and absorption of a potentially fatal dose Extended‐release Delayed‐release Extended‐release (b) Extended‐release Extended‐release Note: tablet disruption may cause a potentially fatal overdose of oxyCODONE Extended‐release Extended‐release (a) Enteric‐coated (a) Enteric‐coated (a) Enteric‐coated (a) Drug Product Paxil CR Pentasa Pradaxa Active Ingredient(s)2 PARoxetine mesalamine dabigatran Dosage Form(s) Tablet Capsule Capsule Pre‐Hist D Plendil Prevacid Prevacid SoluTab combination felodipide lansoprazole lansoprazole Tablet Tablet Capsule Tablet Prevacid Suspension lansoprazole Suspension PriLOSEC PriLOSEC OTC Pristiq Procardia XL Propecia omeprazole omeprazole desvenlafaxine NIFEDipine finasteride Capsule Tablet Tablet Tablet Tablet Proquin XR Proscar ciprofloxicin finasteride Tablet Tablet Extended‐release Note: women who are, or may become, pregnant, should not handle crushed or broken tablets Protonix PROzac Weekly Qdall Qdall AR Ranexa pantoprazole FLUoxetine combination combination ranolazine Tablet Tablet Capsule Capsule Tablet Slow‐release Enteric‐coated Extended‐release Extended‐release Slow‐release Page 11 of 16
Reasons/Comments3 Extended‐release Slow‐release (a) Note: bioavailability increases by 75% when the pellets are taken without the capsule shell Extended‐release (h) Extended‐release Delayed‐release Note: orally disintegrating do not swallow; dissolve in water only and dispense via dosing syringe or NG tube Slow‐release Note: contains enteric‐coated granules; mix with water only; not for NG use Delayed‐release (a) Delayed‐release Extended‐release Extended‐release Note: women who are, or may become, pregnant, should not handle crushed or broken tablets Drug Product Rapamune Active Ingredient(s)2 sirolimus Dosage Form(s) Tablet Rayos predniSONE Tablet Razadyne ER Renagel Renvela galantamine sevelamer sevelamer carbonate Capsule Tablet Tablet Requip XL Rescon Rescon JR Rescon MX Respahist Respaire SR Revlimid rOPINIRole combination combination combination combination combination lenalidomide Tablet Tablet Tablet Tablet Capsule Capsule Capsule Ritalin La Ritalin SR R‐Tanna Rythmol SR Ryzolt methylphenidate methylphenidate combination propafenone traMADol Capsule Tablet Tablet Capsule Tablet Sensipar cinacalcet Tablet SEROquel XR Sinemet CR Sinuvent PE Slo‐Niacin Solodyn QUEtiapine levo/carbidopa combination nicotinic acid minocycline Tablet Tablet Tablet Tablet Tablet Page 12 of 16
Reasons/Comments3 Note: pharmacokinetic NanoCrystal technology may be affected (b) Delayed‐release Note: release is dependent upon intact coating Extended‐release Note: tablets expand in liquid if broken or crushed Note: tablets expand in liquid if broken or crushed (b) Extended‐release Slow‐release (h) Slow‐release (h) Slow‐release (h) Extended‐release (a) Extended‐release Note: teratogenic potential; healthcare workers should avoid contact with capsule contents/body fluids Extended‐release (a) Extended‐release Slow‐release Extended‐release Extended‐release Note: crushing may cause overdose Note: tablets are not scored and cutting may cause variable dosage accuracy Extended‐release Extended‐release (h) Extended‐release (h) Slow‐release (h) Extended‐release Drug Product Somnote Sprycel Active Ingredient(s)2 chloral hydrate dasatinib Dosage Form(s) Capsule Tablet Reasons/Comments3 Liquid filled Film‐coated Note: active ingredients are surrounded by a wax matrix to prevent healthcare exposure; women who are, or may become, pregnant, should not handle crushed or broken tablets Strattera atomoxetine Capsule Note: capsule contents can cause ocular irritation Sudafed 12 hour Sudafed 24 hour Sular Symax Duotab Symax SR Tasigna combination combination nisoldipine hyoscyamine hyoscyamine nilotinib Capsule Capsule Tablet Tablet Tablet Capsule Taztia XT Tecfidera TEGretol‐XR Temodar diltiazem dimethyl fumarate carBAMazepine temozolomide Capsule Capsule Tablet Capsule Extended‐release (b) Extended‐release (b) Extended‐release Controlled‐release Extended‐release Note: disruption of capsule may yield high blood levels causing enhanced toxicity Extended‐release (a) Delayed‐release Extended‐release (b) Note: accidentally opened or damaged capsules require rigorous precautions to avoid inhalation or contact with the skin or mucous membranes (i) Tessalon Perles benzonatate Capsule Note: swallow whole; local anesthesia of the oral mucosa; choking could occur Theo‐24 theophylline Capsule Theochron Tiazac Topamax theophylline diltiazem topiramate Tablet Capsule Tablet; Capsule Extended‐release Note: contains beads that dissolve throughout the GI tract Extended‐release Extended‐release (a) Taste; Taste (a) Page 13 of 16
Drug Product Toprol XL Touro CC‐LD Touro LA‐LD Toviaz Tracleer Active Ingredient(s)2 metoprolol combination combination fesoterodine bosentan Dosage Form(s) Tablet Tablet Tablet Tablet Tablet Reasons/Comments3 Extended‐release (h) Extended‐release (h) Extended‐release (h) Extended‐release Note: women who are, or may become, pregnant, should not handle crushed or broken tablets TRENtal Treximet pentoxifylline combination Tablet Tablet Trilpix Tylenol Arthritis Uceris fenofibric acetaminophen budesonide Capsule Tablet Tablet Ultram ER traMADol Tablet Ultrase Uniphyl Urocit‐K Uroxatral Valcyte Verapamil SR Verelan Verelan PM Videx EC Vimovo Viramune XR Voltaren XR VoSpire ER pancrealipase theophylline potassium citrate alfuzosin valGANCiclovir ‐‐‐‐‐‐ verapamil verapamil didanosine naproxen / esomeprazole nevirapine diclofenac albuterol Capsule Tablet Tablet Tablet Tablet Tablet Capsule Capsule Capsule Tablet` Tablet Tablet Tablet Extended‐release Note: unique drug matrix enhances rapid drug absorption Extended‐release Controlled‐release Note: coating on tablet is designed to break down at pH of 7.0 or above Extended‐release Note: tablet disruption may cause a potentially fatal overdose of drug Enteric‐coated Slow‐release Wax‐coated; prevents upper GI release Extended‐release Teratogenic and irritant potential (i,b) Extended‐release (h) Sustained‐release (a) Extended‐release (a) Delayed‐release Delayed‐release Extended‐release (b) Extended‐release Extended‐release Page 14 of 16
Drug Product Votrient Active Ingredient(s)2 pazopanib Dosage Form(s) Tablet Wellbutrin SR, XL buPROPion Tablet Xanax XR Xarelto Zegerid OTC Zenpep Zohydro ER Zolinza ALPRAZolam rivaroxaban omeprazole/ NaHCO3 pancrealipase HYDROcodone vorinostat Tablet Tablet Capsule Capsule Capsule Capsule Zortress everolimus Tablet Zyban Zyflo CR buPROPion zileuton Tablet Tablet Page 15 of 16
Reasons/Comments3 Note: crushing significantly increases the AUC and Tmax; crushed or broken tablets may cause dangerous skin problems Extended‐release Extended‐release Crushed tablet must be given within 4 hours Delayed‐release (b) Delayed‐release (a) Extended‐release Note: irritant; avoid contact with skin or mucous membranes; avoid contact with crushed or broken tablets Note: crushed powder may cause dangerous effects to mucus membranes Slow‐release Extended‐release (a)
Capsule may be opened and the contents taken without crushing or chewing; soft food such as applesauce or pudding may facilitate administration; contents may generally be administered via nasogastric tube using an appropriate fluid provided entire contents are washed down the tube. (b)
Liquid dosage forms of the product are available; however, dose, frequency of administration and manufacturers may differ from that of the solid dosage form. (c)
Antacids and/or milk may prematurely dissolve the coating of the tablet. (d)
Capsule may be opened and the liquid contents removed for administration. (e)
The taste of this product form would likely be unacceptable to the patient; administration via nasogastric tube should be acceptable. (f)
Effervescent tablets must be dissolved in the amount of diluent recommended by the manufacturer. (g)
Tablets are made to disintegrate under the tongue. (h)
Tablet is scored and may be broken in half without affecting release characteristics. (i)
Skin contact may enhance tumor production; avoid direct contact. Disclaimer: This listing is not meant to represent all products, either by generic or trade name. The author encourages manufacturers, pharmacists, nurses, and other health professionals to notify him of any changes or updates. 1. Correspondence regarding this list may be addressed to: John F. Mitchell, PharmD, FASHP Email: [email protected] 2. The generic name is provided merely as a reference point and is only listed for single ingredient medications; it should not be assumed that drugs with the same generic are equivalent to the specific brand name listed relative to crushing or chewing. If questions arise, please check with your pharmacist. 3. Two official USP terms are used to designate special‐release medication forms: "extended release" and "delayed release". Others such as "sustained release", “controlled release", etc. are commonly used on package labeling. The term "Slow‐release" is being used here to signify all such drugs with a special‐release mechanism. © Copyright 2011, 2012, 2013, 2014. No part of this list may be reproduced in any format without the expressed permission of the author. Page 16 of 16