Crushing Drugs: 6 Risks

Some people have the habit of crushing drugs to facilitate their administration. However, some undergo alterations when subjected to this action. What are the risks ?

Crushing drugs to facilitate their administration is a common practice that alters the integrity of the drug, and therefore its effectiveness. The ideal is to ingest all the medicines without handling them first.

However, most prescribed medications come in the form of tablets, capsules, or lozenges. This is why, in case of difficulty in swallowing them, it is common to cut them or crush them.

Why is it not advisable to crush medications?

Many people are used to crushing medicines in order to make them easier to take. However, as detailed in a publication in the journal Nursing ,  some types are designed to release their active substances for a set period of time.

Therefore, it may be harmful to crush them before ingesting them. Here are also other reasons.

1. Loss of drug stability

Difficulty swallowing is quite common in the elderly. This is also often the case in people who suffer from behavioral problems.

In these cases, the option is to crush the drugs and open the capsules. This can lead to significant alterations in the stability of the active ingredients.

Indeed, this can lead to a possible loss of the effectiveness of the drug. In addition, unpleasant tastes and odors can also be perceived.

2. Dosing error

As a rule,  only scored tablets can be shared. However, this is not always the case. Indeed, the cutting is sometimes not exact because of their shape, their size or the type of overlap.

However, if you want to divide the dose, it is not possible to guarantee that the distribution of the active substance is the same in the two halves. You can then take the wrong dosage and lead to other health problems.

In addition, some tablets are very small. Even the slightest difference in cutting can cause you to go from a dose you need to a dose that poses a health risk. You can use a splitter to make the cut more precise, but this can also lead to errors.

3. Alteration of the release of the active principle

Crushing medications can cause significant variations in the dose administered. This can then affect the release and absorption characteristics of the active ingredient. In addition, this act can increase the risk of adverse reactions, problems with the effectiveness of the drug, or side effects.

On the other hand, there are drugs which have a special coating in order to be absorbed in a certain way. Thanks to this type of blanket, the rate of release of the active principle is regulated,  and consequently, the action of the drug. So, by crushing it, we alter the coating as well as the mechanism which controls the release of the active principle.

It also results in an uncontrolled supply of the drug which can cause an insufficient or excessive dosage. In addition, toxic concentrations or the likelihood of adverse effects are more plausible.

4. Risk of crushing drugs: modification of absorption

There are tablets that have a coating called enteric. Their goal is to keep the drug intact in the stomach and then release its active ingredient into the intestine.

This prevents irritation of the stomach lining and the effect of stomach acids on the drug. This is because stomach acids can destroy the active principle or delay the onset of its action.

By crushing the tablet,  the enteric coating is changed and this has a negative impact on its pharmacological action. In addition, this act could cause irritation in the stomach and produce side effects.

5. Change of effect

Sublingual tablets are designed to dissolve quickly and therefore be absorbed faster. These drugs dissolve under the tongue to reach the bloodstream in a very short time. Therefore, if you crush a tablet, you completely alter its stability and change its effect.

6. Risk during handling

Another downside of crushing certain types of medication is that  they can disperse in the air and be inhaled by the person handling them.

This is a risky situation for this person. Indeed, there are drugs that can irritate the mucous membranes. Likewise, in the case of women who are pregnant or planning to become pregnant, be aware that certain substances are teratogenic.

Medication is best not to be crushed

The best alternative not to overwhelm drugs is to look for other forms of therapy. These alternatives make it possible to facilitate treatment without the need to handle the drugs. You will then avoid the risks mentioned above. If in doubt, always consult a doctor or pharmacist.