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“Do Not Crush, Chew or Cut”

Oct 30, 2018
From the Institute for Safe Medication Practices (ISMP): When a patient is prescribed a timed-release medication such as Glucotrol XL or Glucophage XR, clinicians need to ensure that the patients understand that they should not crush, chew, or cut these pills. The medications must be swallowed whole. 

In one case, an elderly patient was prescribed Glucotrol XL to treat elevated blood sugars. This is a specially formulated medication that releases an entire day’s supply of the medication slowly over a 24-hour period. The pill was too large for the woman to swallow, so she chewed it. She soon complained of feeling dizzy, weak, listless, and lethargic. Chewing the drug caused it to be released all at once, causing dangerously low blood glucose levels, which could have been fatal.

In some cases, pills are coated so the medication won’t be released in the stomach where it may cause irritation. In other cases, special coatings or other properties slow the delivery of the medication into the body so that the drug is delivered over a period of time. This is more convenient than having to take a drug several times a day, but if these pills are crushed or chewed, the way they are supposed to work will be destroyed and the medication may go into the body too fast. If that happens, then a large amount of the drug will be released all at once, which could cause side effects or serious harm.

Many of the long-acting medications have drug names that end with a two-letter suffix. For example, CD (controlled dosing), SR (sustained release), LA (long-acting), XR (extended release).


Click on the link below for a complete list of drugs that should not be Crushed, Chewed or Cut that is up to date and prepared by www.ismp.org

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Updated Oct. 29, 2018

Originally published: June 23, 2014

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