Published December 19, 2024
Sometimes people have trouble swallowing medicine tablets. It may be because the tablet is too big. In this case, crushing the tablet will make it easier to swallow. If the medicine tastes bad, crushing it and mixing it with something like applesauce will make it taste better. However, some medicine tablets or capsules should be swallowed whole. So, how do you know when it is safe to crush?
A question sent in by a reader gives us the opportunity to discuss this. The woman wrote, "My elderly mother has a hard time swallowing her medicine. Can I just crush the tablets and mix them into her food? Or can she chew them?"
It depends on what her mother is taking. Some medicines are specially prepared to gradually release the medicine to your body slowly, over time. If these tablets are crushed or chewed (or if capsules are opened before swallowing), the medicine may go into the body too fast, which can cause harm.
In one report, an 83-year-old woman was taking Cardizem CD (diltiazem) for high blood pressure. The capsule was too large to swallow so she chewed it. Soon after she swallowed the medicine she became weak, had a very slow heartbeat, and had to be hospitalized. Cardizem CD is a medicine designed to release drug slowly over a 24-hour period. Chewing it breaks down the formulation, causing it to be absorbed into the body all at once.
In other situations, a medicine tablet may have a special coating to protect your stomach or delay absorption until the drug gets into your intestines, so it won't be destroyed by stomach acids. Crushing or chewing these tablets destroys the coating, so again you might absorb the medicine too fast or make it ineffective.
Many gradual-release medicines have names that end with:
CD - controlled dose
SR - sustained release
CR - controlled release
TD - time delayed
ER - extended release
TR - time released
LA - long acting
XL - extended release
SA - sustained action
XR - extended release
Beware though! Other letters may be used to mean gradual release or may indicate some other characteristic. In fact, some medicines that should not be crushed or chewed may not have any letters at the end of their names.
Here's what you can do: If you or a family member have trouble swallowing tablets or capsules, talk to your pharmacist or doctor to learn the best way to handle these situations. There may be a liquid form or another medicine that can be crushed safely, or even a different brand of medicine that is smaller. One thing is certain, never crush or chew medicines before finding out if it is safe!
