Cutting pills into fourths?

Question

My psychiatrist recently prescribed a medication for me. This medication requires the dosage be built up slowly. Because my insurance co-pay is so high, she's having me cut the tablets into fourths. (In order to save money).

I've learned from a basic pharmacology class tablets should only be cut when scored. These are scored into halves, but not fourths. I was wondering what effects cutting these pills has? Are they just as effective?

Answer 1

It depends on the pill, the size of it and what medication is inside of it. If the pill is a tablet, it can be cut, capsules can't be cut, but sometimes you can make a solution for them.

I'm almost certain that the medication you're speaking of is Lamictal (generic Lamotrigine). The company that makes it gives out little 'sample' booklets that your doctor can give you, that contains the appropriate sized pills for your first four weeks. This is of course, assuming your doctor has them. And that it's lamotrigine.

Depending on the size of the pill, you can sometimes cut it cleanly into fourths using a pill cutter. Most pharmacies sell these for about ten dollars. If the pill crumbles, or fragments, or splits into uneven parts, I wouldn't recommend pursuing it, as you'll simply be wasting an expensive medication, or giving yourself an odd build up on a med that's clearly dose dependent.

Oh. Ask to speak to the attending pharmacist at your pharmacy, they can generally give much more specific advice about an individual medication, even though they don't have the training to prescribe it.

Answer 2

My doctor told me that if you cut them into halves it "can" make them less effective, but that doesn't mean it will. It's just risking it, I suppose. You should be fine.

Answer 3

It depends on the medication, or more accurately the tablet formulation. As the tablet is scored in half cutting it into 1/4's probably would not be a problem. If the tablet is a long acting form, typically as examples xl or sr, it could affect the absorbtion of the medication. If it is enteric coated- it could increase the amount of medication exposed and decrease the protection of the enteric coat, which could decrease the amount of medication available. Cutting tablets into quaters is also difficult to do if not scored and may increase the variability of the doses, but as you are tapering the dose up it should not be a major issue.