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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Page 1 of 16
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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Page 2 of 16
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)
You may purchase a wall chart version of this list at:
Page 3 of 16
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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Page 4 of 16
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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