Three medications that generally cannot be crushed due to their specialized formulations are Aspirin Protect, Atemperator LP, and Athos. Crushing these medications can alter their intended release mechanisms or protective coatings, leading to potential issues with effectiveness or safety.
Why Some Medications Cannot Be Crushed
Many medications are designed with specific coatings or internal structures to control how and when their active ingredients are released into the body. Crushing these tablets or capsules can destroy these vital mechanisms, potentially leading to:
- Rapid Drug Release: For prolonged-release (LP or XR) formulations, crushing the pill causes the entire dose to be released at once, leading to a dangerously high concentration of the drug in the bloodstream immediately, followed by the medication leaving the body too quickly. This can result in increased side effects or a loss of the medication's therapeutic effect over time.
- Destruction of Enteric Coatings: Enteric-coated medications are designed to bypass the acidic environment of the stomach and dissolve only in the intestines. This protects the drug from stomach acid (if the drug is sensitive to acid) or protects the stomach lining from irritation by the drug. Crushing an enteric-coated pill exposes the drug to stomach acid, potentially inactivating the medication or causing stomach upset, heartburn, or ulcers.
- Irritation or Bad Taste: Some medications have a very bitter taste or can cause irritation to the mouth, esophagus, or stomach if their protective coating is removed.
- Reduced Effectiveness: The medication might not be absorbed correctly, leading to it not working as intended.
- Safety Concerns: Certain medications, like chemotherapy drugs, can be harmful if inhaled as dust after crushing.
Specific Examples of Medications Not to Crush
Here are three examples of medications, including their generic names and the primary reasons they should not be crushed:
| Commercial Name | Generic Name | Reason Not to Crush |
|---|---|---|
| Aspirin Protect | Acetylsalicylic acid | Enteric coating |
| Atemperator LP | Magnesium valproate | Prolonged release |
| Athos | Dextromethorphan hydrobromide | Prolonged release |
Importance of Consulting Healthcare Professionals
Always consult with a doctor, pharmacist, or other healthcare professional before altering any medication, whether by crushing, chewing, or opening capsules. They can provide guidance on appropriate administration methods or suggest alternative formulations if a patient has difficulty swallowing pills. Never assume a medication can be crushed just because it appears to be a solid tablet. Many resources, such as "Do Not Crush" lists, are available to guide healthcare providers on safe medication practices.
For a comprehensive list of medications that should not be crushed and the reasons why, resources like the Institute for Safe Medication Practices (ISMP) provide valuable information: Don't Crush List.
