Crushing tablets can make them easier to swallow but it can have a serious,
even potentially fatal, effect on your health. According to experts, over
80% of people have a habit of crushing tablets to help patients, especially
children and the elderly, take their medicines.

 However, doctors say the trend is alarming and dangerous. Not only does
crushing pills alter the effect of the drug, it can also impact the way the
drug is released or absorbed, possibly causing serious side-effects.
 Several pills have special protective coating that ensures the drug does
not touch the inner walls of the stomach but directly passes into the
intestine after being swallowed. Crushing these pills heightens chances of
gastric injury, leading to bleeding from the intestine.
Experts also warn that some medicines, including the anti-diabetic drug
Metformin, are meant for sustained release, spread over 24 hours. Crushing
them would result in limiting their long-lasting action, putting the
patient at risk.

 Drug expert Dr C M Gulati said, "A tablet isn't just made of the drug.
It contains both binding agents and other chemicals. The drug is also not
uniformly spread across the tablet. Therefore, a patient would rarely know
whether both halves have equal amount of the drug. Also, most patients who
crush the tablet mix it with juice or milk. This could result in
interaction between the drug and liquid. There are several drugs that
aren't scored (lined from the centre). These drugs should not be crushed at
all. It's a misconception that breaking a tablet into two lowers its
strength.

''Former professor Dr Anoop Mishra said: "Some drugs like the antibiotic
Amplicillin, blood pressure drug Lisinoprill and pain-killer Ibuprofen
should just not be crushed. Also, crushing some pills known to be very
bitter, like Ciprofloxacin and Chloroquine, could result in nausea and
vomiting."

 It is estimated that 60% of older people have trouble swallowing
medication. As a result, some of them crush pills. That's why an estimated
75 million prescriptions a year are associated with adverse drug reactions.


DON'T BREAK THESE
 Tamoxifen (used for treating breast cancer) must never be crushed.
Whoever doing the crushing could be inhaling the drug. If that person is
pregnant, this could be extremely harmful
 Morphine. If this is crushed, the patient has a high risk of having an
overdose - it will be released into the body too quickly
 Nifedipine. If crushed, the patient is at much higher risk of stroke or
heart attack. Nifedipine is used to treat angina and hypertension
 If Methotrexate (used to treat arthritis and cancer) is crushed, it
could kill cells when it comes into contact with the skin


 A FEW TRICKS
Take pills one at a time - with water or juice If you have trouble
swallowing, try taking a deep breath before you take the pill; it can
lessen the gag reflex. If all else fails, some people put the pill inside
desserts to make it go down easier.