Oral Dosage Forms That Should Not Be Crushed 2016

Oral Dosage Forms That Should Not Be Crushed 2016

Drug Product

Absorica

Accutane

AcipHex

Acticlate

Active Ingredient(s)

(isotretinoin)

(isotretinoin)

(rabeprazole)

(doxycycline)

Dosage Form(s)

Capsule

Capsule

Tablet

Capsule; Tablet

Actiq

(fentaNYL)

Lozenge

Actonel

(risedronate)

Tablet

Adalat CC

Adderall XR

AeroHist Plus

Afeditab CR

Afinitor

Aggrenox

Alavert Allergy (Sinus 12 hour)

Allegra-D

Alophen

ALPRAZolam ER

Altoprev

Ambien CR

Amibid DM

Amitiza

Ampyra

Amrix

Aplenzin

Apriso

Aptensio XR

Aptivus

Aquatab C

Aquatab D

(NIFEdipine)

(amphetamine salts)

(combination)

(NIFEdipine)

(everolimus)

(combination)

(combination)

(combination)

(bisacodyl)

(ALPRAZolam)

(lovastatin)

(zolpidem)

(combination)

(lubiprostone)

(dalfampridine)

(cyclobenzaprine)

(buPROPion)

(mesalamine)

(methylphenidate)

(tipranavir)

(combination)

(combination)

Tablet

Capsule

Tablet

Tablet

Tablet

Capsule

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Capsule

Tablet

Capsule

Tablet

Capsule

Capsule

Capsule

Tablet

Tablet

Reasons/Comments

Mucous membrane irritant

Mucous membrane irritant

Slow-release

Film-coated (h) (Note: tablet scored in thirds rather

than half)

Slow-release (Note: this lollipop delivery system

requires the patient to slowly allow dissolution)

Irritant (Note: chewed, crushed, or sucked tablets may

cause oropharyngeal irritation)

Slow-release

Slow-release (a)

Slow-release (h)

Slow-release

Mucous membrane irritant

Slow-release

Slow-release

Slow-release

Enteric-coated

Slow-release

Slow-release

Slow-release

Slow-release

Slow-release

Slow-release (Note: formerly fampridine-SR)

Slow-release

Slow-release

Slow-release (a) (Note: maintain pH at < 6.0)

Slow-release (a)

Note: oil emulsion within spheres; taste

Slow-release (h)

Slow-release (h)

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Oral Dosage Forms That Should Not Be Crushed 2016

Aricept 23 mg

(donepezil)

Tablet

Arthrotec

Asacol

Aspirin enteric-coated

Atelvia

(diclofenac)

(mesalamine)

(aspirin)

(risedronate)

Tablet

Tablet

Caplet; Tablet

Tablet

Augmentin XR

AVINza

Avodart

(combination)

(morphine)

(dutasteride)

Tablet

Capsule

Capsule

Slow-release (b,h)

Slow-release (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

Azulfidine EN-Tabs

Bayer EC

Bayer Regular

Belsomra

(sulfaSALAzine)

(aspirin)

(aspirin)

(suvorexant)

Tablet

Caplet

Caplet

Tablet

Slow-release (b)

Enteric-coated

Enteric-coated

Note: not scored; no studies available from company

Belviq XR

Biaxin-XL

Bidex A

Bidhist-D

Biltricide

Biohist LA

Bisac-Evac

Bisacodyl

Bisa-Lax

Boniva

(lorcaserin)

(clarithromycin)

(combination)

(combination)

(praziquantel)

(combination)

(bisacodyl)

(combination)

(combination)

(ibandronate)

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Briviact

(brivaracetam)

Tablet

Slow-release

Slow-release

Slow-release

Slow-release

Taste (h)

Slow-release (h)

Enteric-coated (c)

Enteric-coated (c)

Enteric-coated (c)

Note: chewed, crushed, or sucked tablets may cause

oropharyngeal irritation

Film-coated (b)

Note: crushing the 23 mg tablet may significantly

increase the rate of absorption; the 5 mg and 10 mg

tablets are not affected

Enteric-coated

Slow-release

Slow-release; Enteric-coated

Slow-release (Note: tablet coating is an important part

of the slow-release; chewed, cut, or crushed tablets

may cause oropharyngeal irritation)

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Oral Dosage Forms That Should Not Be Crushed 2016

Bromfed PD

Budeprion SR

Bunavail

(combination)

(buPROPion)

(combination)

Capsule

Tablet

Buccal film

Cabometyx

Calan SR

Carbatrol

Cardene SR

Cardizem

(cabozantinib)

(verapamil)

(carBAMazepine)

(niCARdipine)

(diltiazem)

Tablet

Tablet

Capsule

Capsule

Tablet

Cardizem CD

Cardizem LA

Cardura XL

Cartia XT

Cefaclor ER

Ceftin

Cefuroxime

CellCept

Cerdelga

Charcoal Plus

Chlor-Trimeton 12-H

Cholbam

(diltiazem)

(diltiazem)

(doxazosin)

(diltiazem)

-----(cefuroxime)

-----(mycophenolate)

(eliglustat)

-----(combination)

(cholic acid)

Capsule

Tablet

Tablet

Capsule

Tablet

Tablet

Tablet

Capsule; Tablet

Capsule

Tablet

Tablet

Capsule

Cipro XR

Claritin-D 12 Hour

Claritin-D 24 Hour

Colace

Colestid

Commit

(ciprofloxacin)

(combination)

(combination)

(docusate)

(colestipol)

(nicotine)

Tablet

Tablet

Tablet

Capsule

Tablet

Lozenge

Concerta

Contrave

(methylphenidate)

(combination)

Tablet

Tablet

Slow-release

Slow-release

Note: chewing or swallowing may result in lower peak

concentrations and bioavailability

Film-coated

Slow-release (h)

Slow-release (a)

Slow-release

Note: although not in the package insert, the drug has

a coating that is intended to release the drug over

approximately 3 hours

Slow-release

Slow-release

Slow-release

Slow-release

Slow-release (b)

Taste (b) (Note: use suspension for children)

Taste (b) (Note: use suspension for children)

Teratogenic potential (i)

Preferably taken with water

Enteric-coated

Slow-release (b)

Note: capsules may be opened and the contents

mixed with food/drink

Slow-release (b)

Slow-release

Slow-release

Taste (e)

Slow-release

Note: integrity compromised by chewing or crushing

Slow-release

Slow-release (Note: chewing, dividing, or crushing

tablets may alter release rate)

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Oral Dosage Forms That Should Not Be Crushed 2016

Coreg CR

(carvedilol)

Capsule

Cotazym-S

Covera-HS

Creon 5, 10, 20

Crixivan

(pancrelipase)

(verapamil)

(pancrelipase)

(indinavir)

Capsule

Tablet

Capsule

Capsule

Cymbalta

(DULoxetine)

Capsule

Cytovene

Cytoxan

(ganciclovir)

(cyclophosphamide)

Capsule

Tablet

Depakene

Depakote

Depakote ER

Detrol LA

Dexilant

Diclegis

Dilacor XR

Dilatrate-SR

Dilt-CD

Diltia XT

Ditropan XL

Divalproex ER

Doxidan

Drisdol

Droxia

(divalproex)

(divalproex)

(divalproex)

(tolterodine)

(dexlansoprazole)

(combination)

(diltiazem)

(isosorbide)

(diltiazem)

(diltiazem)

(oxybutynin)

(divalproex)

(bisacodyl)

(ergocalciferol)

(hydroxyurea)

Capsule

Tablet

Tablet

Capsule

Capsule

Tablet

Capsule

Capsule

Capsule

Capsule

Tablet

Tablet

Tablet

Capsule

Capsule

Dulcolax

Durlaza

DynaCirc CR

(bisacodyl)

(aspirin)

(isradipine)

Capsule; Tablet

Capsule

Tablet

Slow-release (a) (Note: may add contents of capsule

to chilled, not warm, applesauce and consume

immediately)

Enteric-coated (a)

Slow-release

Slow-release (a)

Taste (Note: capsule may be opened and mixed with

fruit puree [e.g., banana])

Slow-release (a) (Note: may add contents of capsule

to apple juice or applesauce but NOT chocolate)

Skin irritant

Note: drug may be crushed but company recommends

using injection

Slow-release; mucus membrane irritant (b)

Slow-release

Slow-release

Slow-release

Slow-release (a)

Slow-release

Slow-release

Slow-release

Slow-release

Slow-release

Slow-release

Slow-release

Enteric-coated (c)

Liquid filled (d)

Note: exposure to the powder may cause serious skin

toxicities; health care workers should wear gloves to

administer

Enteric-coated (c); Liquid-filled

Slow-release

Slow-release

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Oral Dosage Forms That Should Not Be Crushed 2016

E.E.S. 400

Easprin

EC-Naprosyn

Ecotrin Adult Low Strength

Ecotrin Maximum Strength

Ecotrin Regular Strength

Effer-K

Effervescent Potassium

Effexor XR

Embeda

E-Mycin

Enablex

Entocort EC

Envarsus XR

Epanova

(erythromycin)

(aspirin)

(combination)

(aspirin)

(aspirin)

(aspirin)

(potassium bicarbonate)

-----(venlafaxine)

(morphine sulfate)

(erythromycin)

(darifenacin)

(budesonide)

(tacrolimus)

(omega-3-carboxylic acids)

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Tablet

Capsule

Capsule

Tablet

Tablet

Capsule

Tablet

Capsule

Equetro

Ergomar

Erivedge

(carBAMazepine)

(ergotamine)

(vismodegib)

Capsule

Tablet

Capsule

Ery-Tab

Erythromycin Base

Erythromycin Delayed-Release

Erythromycin Stearate

Evista

Exalgo

(erythromycin)

--------------(raloxifene)

(HYDROmorphone)

Tablet

Tablet

Capsule

Tablet

Tablet

Tablet

Exjade

(deferasirox)

Tablet

Extendryl JR

(combination)

Capsule

Enteric-coated (b)

Enteric-coated

Enteric-coated

Enteric-coated

Enteric-coated

Enteric-coated

Effervescent tablet (f)

Effervescent tablet (f)

Slow-release

Slow-release (a)

Enteric-coated

Slow-release

Enteric-coated (a)

Slow-release

Note: contents of capsule may erode walls of

Styrofoam or plastic materials

Slow-release (a)

Sublingual form (g)

Note: package insert indicates potential teratogenic

effects; material safety data sheet warns against skin

contact; health care workers should take appropriate

precautions

Enteric-coated

Enteric-coated

Enteric-coated pellets (a)

Enteric-coated

Taste; teratogenic potential (i)

Slow-release (Note: crushing, chewing, or dissolving

tablets can cause rapid release and absorption of a

potentially fatal dose)

Note: do not give as whole tablet, tablets are meant

to be given as oral suspension; see company insert

Slow-release

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