Pharmacist reference

Do Not Crush List

A comprehensive, searchable list of oral capsules and tablets that should not be crushed or chewed before administration — with their dosage forms, the reasons why, and NIOSH hazardous-drug handling notes.

1,083 medications Sources: various references Updated June 04, 2026

Curated & reviewed by Dr. Brian Staiger, PharmD · see our review policy

Why shouldn’t these be crushed?

A variety of oral solid dosage forms should not be crushed or chewed prior to administration because of their formulation. In general, these include:

Extended-release, a term used synonymously with controlled-release, prolonged-action, and sustained-release formulations
Enteric or protective coated medications
Medications formulated for sublingual or buccal absorption, or those designed to exert a local effect in the mouth (eg, lozenges)
Medications that are offensive-tasting to the patient, irritate the oral mucosa, or contain dyes or substances that may stain the teeth or oral mucosa; these may be given to patients with nasogastric (NG) tubes
Medications that are potentially hazardous, as described below, and require special handling to limit exposure to health risks
Medications that are manufactured by a certain technology to discourage or deter misuse and abuse

About NIOSH hazardous drugs & how to use this list

Occupational exposure to hazardous drugs (eg, antineoplastics, antivirals, biological modifiers, hormones) poses a risk to health care workers including acute health effects like rashes, chronic effects including cancer, and adverse reproductive effects. The 2024 NIOSH List of Hazardous Drugs in Healthcare Settings is an alphabetical listing of drugs that meet the criteria as a hazardous drug (Table 1 and Table 2), and drugs with only a developmental and/or reproductive risk.

Table 1: Drugs with MSHI in the package insert and/or meet the NIOSH definition of a hazardous drug and one or more of the following criteria: are classified by the National Toxicology Program (NTP) as "known to be a human carcinogen," or are classified by International Agency for Research on Cancer (IARC) as Group 1 "carcinogenic to humans" or Group 2A "probably carcinogenic to humans."

Table 2: Drugs that meet the NIOSH definition of a hazardous drug and do not have MSHI, are not classified by the NTP as "known to be a human carcinogen," and are not classified by IARC as Group 1 "carcinogenic to humans" or Group 2A "probably carcinogenic to humans."

Using this list

This list serves as a general guide and is not all inclusive. Products are listed alphabetically by name (trade or generic).

Clinicians should use their best judgment based on an individual patient's medical need.

Unless otherwise specified, the source of the information is obtained from the manufacturer's prescribing information.

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Capsules & tablets that should not be crushed

Medications only — this list doesn’t cover dietary supplements (vitamins, herbals, protein products); supplement formulations aren’t on file here.

Drug name	Dosage form	Comments
abemaciclib	Tablet
abiraterone acetate	Tablet
abiraterone acetate, micronized	Tablet
abrocitinib	Tablet	Swallow tablets whole with water; do not crush, split, or chew
acalabrutinib	Capsule; Tablet
acamprosate calcium	Tablet, Delayed Release
Accrufer	Capsule
Accutane	Capsule, Liquid Filled	May cause esophageal irritation
acetaminophen	Tablet, Extended Release
acetaminophen-dexbrompheniramine maleate-pseudoephedrine sulfate	Tablet, Extended Release
acetazolamide	Capsule, Extended Release
Aciphex	Tablet, Delayed Release
Actiq	Troche/Lozenge	Lollipop delivery system, allow for slow dissolution
Acticlate	Tablet	Do not break, open, crush, dissolve, or chew Tablet is crushable; also consider alternative doxycycline hyclate dosage forms of oral solution and suspension (Ref-3)
Actonel	Tablet	May cause esophageal irritation
acyclovir	Tablet, buccal	Do not crush, chew, suck, or swallow; must be reapplied if swallowed within first 6 hours
adagrasib	Tablet	Swallow whole. Do not chew, crush or split
Adalat CC	Tablet, Extended Release
Adderall XR	Capsule, Extended Release
adenovirus Type 4 and Type 7 vaccine, live	Tablet, enteric coated
Advicor	Tablet, Extended Release
Aemcolo	Tablet, Delayed Release
AeroHist Plus	Tablet, Extended Release
Afeditab CR	Tablet, Extended Release
Afinitor	Tablet	Mucous membrane irritant Amorphous solid dispersion**; consider alternative dosage form tablet of oral suspension (Ref-4)
Aggrenox	Capsule, Extended Release
albuterol sulfate	Tablet, Extended Release
alendronate	Tablet, Wax Coated	May cause oropharyngeal irritation
alendronate	Tablet, Effervescent	Potential for oropharyngeal ulceration if tablet is chewed, swallowed, or sucked on
alendronate sodium-cholecalciferol	Tablet	May cause oropharyngeal irritation
alogliptin benzoate-metformin hydrochloride	Tablet	Do not split. Tablet is crushable (Ref-3)
alogliptin benzoate-pioglitazone hydrochloride	Tablet	Do not split. Tablet is crushable if used promptly after crushing (Ref-3)
alfuzosin hydrochloride	Tablet, Extended Release	Risk of overdose with sustained release drugs (Ref-5)
Alkeran	Tablet
Allegra	Tablet, Disintegrating
Allegra-D 12 Hour	Tablet, Extended Release
Allegra-D 24 Hour	Tablet, Extended Release
alpelisib	Tablet	Swallow whole; do not chew, crush, or split; do not ingest tablets if broken, cracked, or otherwise not intact
Allfen Jr	Tablet, Extended Release
alprazolam	Tablet, Extended Release
Altoprev	Tablet, Extended Release	Swallow tablets whole. Do not split, crush, or chew the extended-release tablets
Alunbrig	Tablet
Alvaiz	Tablet	Do not split, chew, or crush tablets and mix with food or liquids
amantadine hydrochloride	Tablet, Extended Release	Swallow whole; do not chew, crush, or divide
Ambien CR	Tablet, Extended Release
ambrisentan	Tablet, Film Coated
Amitiza	Capsule, Gelatin Coated
amoxicillin	Tablet, Extended Release
amoxicillin-clavulanate potassium	Tablet, Extended Release
Amrix	Capsule, Extended Release	May open and sprinkle capsule contents on applesauce and ingest immediately without chewing
Ampyra	Tablet, Extended Release
Antara	Capsule
Antivert	Tablet
apalutamide	Tablet
Aplenzin	Tablet, Extended Release
apremilast	Tablet	Tablet is crushable (Ref-3)
aprepitant	Capsule	Swallow whole. Emend(R) oral capsule is a nanocrystal product**, consider alternative powder for suspension or IV emulsion dosage forms (Ref-4)
Aptensio XR	Capsule, Extended Release	Except when opened and sprinkled on applesauce, capsule should be swallowed whole and should not be divided, chewed, or crushed.
Aptivus	Capsule
Aquatab C	Tablet, Extended Release
Aquatab D	Tablet, Extended Release
Arakoda	Tablet	Must be used promptly if crushing and use proper personal protective equipment when handling; also potential instability and reduced absorption (Ref-3)
Arthrotec	Tablet, Delayed Release
Aricept	Tablet, Film Coated (23 mg)	Pertains to the 23 mg tablet only, as it may increase rate of absorption
Arymo ER	Tablet, Extended Release	Crushing, chewing, or dissolving may cause rapid release and absorption of a potentially fatal dose of morphine.
Asacol	Tablet, Delayed Release
asciminib	Tablet	Swallow whole; do not crush, break, or chew
aspirin	Tablet, Enteric Coated; Tablet, Extended Release; Capsule, Extended Release, 24 HR
aspirin-dipyridamole	Tablet, Extended Release
aspirin-omeprazole	Tablet, Delayed Release	Swallow whole with liquid; do not split, chew, crush or dissolve
Astagraf XL	Capsule, Extended Release	Amorphous solid dispersion**; consider alternative dosage forms of IV or granule for oral suspension (Ref-4)
atazanavir sulfate	Capsule	Do not open capsules
atomoxetine	Capsule
atrasentan	Tablet	Swallow tablets whole. Do not cut, crush, or chew.
Augmentin XR	Tablet, Extended Release
Augtyro	Capsule	Swallow capsules whole. Do not open, chew, crush, or dissolve the capsule prior to swallowing. Do not take any capsules that are broken, cracked, or damaged.
Auryxia	Tablet
Austedo	Tablet
Austedo XR	Tablet, Extended release
Auvelity	Tablet, Extended Release
avacopan	Capsule	Swallow whole; do not crush, chew, or open capsules
Avinza	Capsule, Extended Release
Avmapki; Fakzynja Co-Pack	Capsule; Tablet (Kit)	Swallow capsules whole. Do not chew, break, or open the capsules; Swallow tablets whole. Do not chew, break or crush the tablets.
Avodart	Capsule, Gelatin Coated
avutometinib; defactinib	Capsule; Tablet (Kit)	Swallow capsules whole. Do not chew, break, or open the capsules; Swallow tablets whole. Do not chew, break or crush the tablets.
azacitidine	Tablet
azathioprine	Tablet
Azasan	Tablet
Azulfidine EN-Tabs	Tablet, Delayed Release
Bafiertam	Capsule, Delayed Release
Balcoltra	Tablet	Consider transdermal patch formulations (Ref-3)
Balversa	Tablet
Baxdrostat	Tablet	Swallow tablets whole. Do not cut, crush, or chew.
Baxfendy	Tablet	Swallow tablets whole. Do not cut, crush, or chew.
Bedaquiline fumarate	Tablet	Swallow tablets whole. Potential physical instability and reduced absorption (Ref-3)
Bellahist-D LA	Tablet, Extended Release
Belsomra	Tablet	Amorphous solid dispersion** (Ref-4)
belumosudil	Tablet
Belviq XR	Tablet, Extended Release
belzutifan	Tablet
bempedoic acid- ezetimibe	Tablet
Benzgalantamine	Tablet, Delayed Release	Swallow whole and do not split, crush, or chew the tablets
benzonatate	Capsule, Liquid Filled	Severe hypersensitivity has occurred possibly related to local anesthesia from sucking or chewing the capsule instead of swallowing it
Beqalzi	Tablet, Film Coated	Swallow whole with food and water. Do not break, chew, or crush.
bexagliflozin	Tablet	Do not crush or chew
Biaxin XL	Tablet, Extended Release
Bidhist	Tablet, Extended Release
Biltricide	Tablet, Film Coated
Binosto	Tablet, Effervescent	Potential for oropharyngeal ulceration if tablet is chewed, swallowed, or sucked on
Biohist LA	Tablet, Extended Release
bisacodyl	Tablet, Delayed Release; Tablet, Enteric Coated
Boniva	Tablet	Potential for oropharyngeal ulceration if tablet is chewed or dissolved in mouth
Bonjesta	Tablet, Extended Release
Bontril	Capsule, Extended Release
bosentan	Tablet
Bosulif	Tablet
bosutinib	Tablet
Brenzavvy	Tablet	Do not crush or chew
brigatinib	Tablet
brincidofovir	Tablet	Swallow whole; do not divide, break, or crush
Brisdelle	Capsule
brivaracetam	Tablet	Swallow whole with liquid Tablet is crushable but may have bitter taste, consider alternative oral solution (Ref-3)
Briviact	Tablet	Swallow whole with liquid Tablet is crushable but may have bitter taste, consider alternative oral solution (Ref-3)
Bromfed PD	Capsule, Extended Release
brompheniramine maleate	Tablet, Extended Release
brompheniramine maleate-pseudoephedrine hydrochloride	Tablet, Extended Release
Brukinsa	Capsule
Budeprion SR	Tablet, Extended Release
budesonide	Capsule, Delayed Release; Capsule, Extended Release	Swallow capsule whole; do not open, crush, or chew
buprenorphine hydrochloride-naloxone hydrochloride	Tablet, Sublingual
bupropion hydrobromide	Tablet, Extended Release
bupropion hydrochloride	Tablet, Extended Release	May result in increased risk of adverse effects, including seizures
busulfan	Tablet
Cabometyx	Tablet	Swallow tablets whole. Do not crush, chew, or split tablets.
Cabometyx	Tablet	Swallow whole; do not crush. High risk of physical instability and reduced absorption (Ref-3)
cabozantinib	Tablet	Swallow tablets whole. Do not crush, chew, or split tablets.
cabozantinib malate	Capsule; Tablet	Swallow whole; do not crush and do not open capsules High risk of physical instability and reduced absorption (Ref-3)
Calan SR	Tablet, Sustained Release
calcifediol	Capsule, Extended Release	Swallow whole
Calquence	Capsule; Tablet
Campral	Tablet, Delayed Release
Camzyos	Capsule	Swallow capsules whole. Do not break, open, or chew the capsules
canagliflozin-metformin hydrochloride	Tablet, Extended Release	Swallow whole; do not crush, cut, or chew
capecitabine	Tablet	Swallow whole; do not cut or crush
capivasertib	Tablet	Swallow whole. Do not chew, crush, or split prior to swallowing. Do not take tablets that are broken, cracked, or otherwise not intact.
Caprelsa	Tablet
capmatinib	Tablet
carbamazepine	Capsule/Tablet, Extended Release
Carbatrol	Capsule, Extended Release
carbidopa-levodopa	Capsule, Extended Release; Tablet, Extended Release	Capsules: may be opened and the contents sprinkled on applesauce for those who have difficulty swallowing capsules Risk of overdose with sustained release drugs (Ref-5)
carbinoxamine maleate	Capsule, Extended Release
carbinoxamine maleate-pseudoephedrine hydrochloride	Tablet, Extended Release
Cardene SR	Capsule, Extended Release
Cardizem CD	Capsule, Extended Release
Cardizem LA	Tablet, Extended Release
Cardura XL	Tablet, Extended Release
Cartia XT	Capsule, Extended Release
carvedilol phosphate	Capsule, Extended Release
Ceenu	Capsule
cefaclor	Tablet, Extended Release
Ceftin	Tablet, Film Coated
cefuroxime axetil	Tablet, Film Coated
CellCept	Capsule/Tablet
cenobamate	Tablet	Swallow whole with liquid; do not crush or chew
Cerdelga	Capsule	Do not crush, dissolve, or open capsules
cetirizine hydrochloride-pseudoephedrine hydrochloride	Tablet, Extended Release
Cholib	Tablet, Film Coated
chlorambucil	Tablet
chlorpheniramine maleate	Tablet, Extended Release
chlorpheniramine maleate-hyoscyamine sulfate-atropine sulfate-scopolamine hydrobromide-phenylephrine hydrochloride	Tablet, Extended Release
chlorpheniramine maleate-methscopolamine nitrate-phenylephrine hydrochloride	Tablet, Sustained Release
chlorpheniramine maleate-phenylephrine hydrochloride
chlorpheniramine maleate-pseudoephedrine	Tablet, Extended Release
chlorpheniramine polistirex-hydrocodone polistirex	Capsule, Extended Release
Chlor-Trimeton	Tablet, Extended Release
Cholbam	Capsule, hard	Do not crush or chew; however capsules may be opened and the content added to formula or juice for infants and children who cannot swallow capsules
cholic acid	Capsule, hard	Do not crush or chew; however capsules may be opened and the content added to formula or juice for infants and children who cannot swallow capsules
Cialis	Tablet	do not split tablets
Cibinqo	Tablet	Swallow tablets whole with water; do not crush, split, or chew
cinacalcet hydrochloride	Tablet
Cipro XR	Tablet, Extended Release
ciprofloxacin-ciprofloxacin hydrochloride	Tablet, Extended Release
Circadin	Tablet, Extended Release
cladribine	Tablet	Swallow whole without chewing
Clarinex-D 12 Hour	Tablet, Extended Release
Clarinex-D 24 Hour	Tablet, Extended Release
clarithromycin	Tablet, Extended Release
Claritin-D 12 Hour	Tablet, Extended Release
Claritin-D 24 Hour	Tablet, Extended Release
clonidine hydrochloride	Tablet, Extended Release
colestipol hydrochloride	Tablet
Colestid	Tablet
Cometriq	Capsule	Do not open capsules or crush
Commit	Lozenge/Troche
Concerta	Tablet, Extended Release
Contrave	Tablet, Extended Release	Do not crush, chew, or cut tablets
ConZip	Capsule, Extended Release	Do not dissolve, chew, crush or split
Copiktra	Capsule
Coreg CR	Capsule, Extended Release
Cotazym	Capsule, Enteric coated
Cotempla XR-ODT	Tablet, Extended Release, Disintegrating	Allow to disintegrate on tongue; do not crush or chew
Covera-HS	Tablet, Extended Release
Creon 5, 10, 20	Capsule, Delayed Release
Cresemba	Capsule	Do not crush, chew, dissolve, or open capsules High risk of chemical instability, physical instability, and reduced absorption; consider alternative dosage form IV solution (Ref-3);
Crixivan	Capsule	May open and mix with fruit puree
crizotinib	Capsule
crofelemer	Tablet, Delayed Release
Cuvrior	Tablet	Swallow tablet whole, without crushing, chewing, or dissolving. Tablets are scored and can be divided into 2 equal halves for patients who have difficulty swallowing
cyclobenzaprine hydrochloride	Capsule, Extended Release	May open and sprinkle capsule contents on applesauce and ingest immediately without chewing
cyclobenzaprine hydrochloride	Sublingual, Tablets	Do not swallow whole, cut, crush, or chew
cyclophosphamide	Tablet
cysteamine bitartrate	Capsule, Delayed Release	May open and sprinkle on applesauce or berry jelly, or mix with orange or apple juice; do not chew capsule contents
Cymbalta	Delayed-release Capsules	Do not chew or crush, and do not open the delayed-release capsule and sprinkle its contents on food or mix with liquids because these actions might affect the enteric coating.
Cytoxan	Tablet
dabigatran etexilate mesylate	Capsule	Potential for increased exposure if capsule is crushed, chewed, or opened
dabrafenib mesylate	Capsule
dalfampridine	Tablet, Extended Release
Dallergy	Caplet, Extended Release
Dallergy-JR	Capsule, Extended Release
dapagliflozin-saxagliptin-meformin hydrochloride	Tablet, Extended Release	Do not crush, cut, or chew
daprodustat	Tablet	Do not cut, crush, or chew.
darifenacin hydrobromide	Tablet, Extended Release
darolutamide	Tablet
darunavir-cobicistat	Tablet for Suspension	Do not crush, chew, or swallow; must be dispersed in water
dasabuvir	Tablet	Do not break, chew, or dissolve due to a bitter taste
dasabuvir-ombitasvir-paritaprevir-ritonavir	Tablet, Extended Release	Swallow whole; do not split, crush, or chew Amorphous solid dispersion** (Ref-4)
dasatinib	Tablet	Active ingredients are surrounded by film coating to prevent healthcare provider exposure
Daurismo	Tablet	Do not split or crush
decitabine-cedazuridine	Tablet
Deconamine SR	Capsule, Extended Release
deferasirox	Tablet; Tablet for Suspension	Do not crush; chew or swallow tablets whole; however, tablets may be crushed and mixed with soft food for those who have difficulty swallowing whole tablets
Delzicol	Capsule, Delayed Release
Depakene	Capsule, Liquid Filled
Depakote	Capsule, Extended Release Pellets; Tablet, Extended Release
Depakote ER	Tablet, Extended Release
desloratadine-pseudoephedrine sulfate	Tablet, Extended Release
desvenlafaxine	Tablet, Extended Release
desvenlafaxine succinate	Tablet, Extended Release
Detrol LA	Capsule, Extended Release
deucravacitinib	Tablet
deutetrabenazine	Tablet; Tablet, Extended release
dexchlorpheniramine maleate	Tablet, Extended Release
Dexilant	Capsule, Delayed Release	May open and sprinkle intact granules on applesauce; do not chew granules
Dexilant SoluTab	Tablet Disintegrating, Delayed release	Do not break or cut; do not chew microgranules
dexlansoprazole	Capsule, Delayed Release; Tablet Disintegrating, Delayed release
dexmethylphenidate	Capsule, Extended Release
dextroamphetamine-amphetamine-dextroamphetamine sulfate-amphetamine sulfate	Capsule, Extended Release
dextromethorphan-guaifenesen	Tablet, Extended Release
dextromethorphan-guaifenesen-pseudoephedrine hydrochloride	Tablet, Extended Release
dextromethorphan hydrobromide-bupropion hydrochloride	Tablet, Extended Release
Diacomit	Capsule	Crushable, but has bitter taste; also consider alternative formulation powder for oral suspension (Ref-3)
Diamox Sequels	Capsule, Extended Release
diazoxide choline	Tablet, Extended Release	Swallow tablets whole. Do not split, crush, or chew the extended-release tablets because doing so may compromise the extended-release characteristics, efficacy, or safety.
Diclegis	Tablet, Delayed Release
diclofenac sodium	Tablet, Extended Release
diclofenac sodium-misoprostol	Tablet, Delayed Release
didanosine	Capsule, Delayed Release Pellets
diethylpropion hydrochloride	Tablet, Extended Release
diflunisal	Tablet, Film Coated
Dilacor XR	Capsule, Extended Release
Dilatrate-SR	Capsule, Extended Release
Dilt-CD	Capsule, Extended Release
Dilt-XR	Capsule, Extended Release
Diltia XT	Capsule, Extended Release
diltiazem hydrochloride	Capsule/Tablet, Extended Release
Diltzac	Capsule, Extended Release
dimethyl fumarate	Capsule, Delayed Release
diphenhydramine hydrochloride	Capsule, Liquid Filled
diroximel fumarate	Capsule, Delayed Release	Swallow whole and intact. Do not crush or chew, or sprinkle contents on food.
disopyramide	Capsule, Extended Release
Ditropan XL	Tablet, Extended Release
divalproex sodium	Capsule, Delayed Release Pellets; Tablet, Delayed Release/Extended Release	Risk of reduced efficacy when crushing gastric-resistant coated medicine (Ref-5)
donepezil hydrochloride	Tablet, Film Coated (23 mg)	Pertains to the 23 mg tablet only as it may increase rate of absorption. May have unpalatable taste (Ref-5).
donepezil hydrochloride-memantine hydrochloride	Capsule, Delayed Release	Except when opened and sprinkled on applesauce, capsule should be swallowed whole and should not be divided, chewed, or crushed. Donepezil may have unpalatable taste (Ref-5).
Doryx	Tablet, Delayed Release
doxazosin mesylate	Tablet, Extended Release
doxycycline	Capsule, Delayed Release
doxycycline hyclate	Capsule; Tablet, Delayed Release	Capsule: Do not break, open, crush, dissolve, or chew Acticlate oral tablet is crushable; consider alternative dosage forms of oral solution and suspension (Ref-3)
doxylamine succinate-pyridoxine hydrochloride	Tablet, Delayed Release
DriHist SR	Tablet, Extended Release
Drisdol	Capsule, Liquid Filled
Drixoral Plus	Tablet, Extended Release
Droxia	Capsule	Swallow whole. Do not open, break, or chew capsules. Requires special handling to limit exposure to powder which is toxic to the skin and other health risks
droxidopa	Capsule	May be crushed if used promptly after crushing; potential chemical instability (Ref-3)
Drysec	Tablet, Extended Release
Duexis	Tablet	Do not divide to supply a lower dose or chew or crush Can be crushed if used promptly; potential chemical incompatibility between 2 active pharmaceutical ingredients (Ref-3)
Duloxetine	Delayed-release Capsules	Do not chew or crush, and do not open the delayed-release capsule and sprinkle its contents on food or mix with liquids because these actions might affect the enteric coating.
DuraHist	Tablet, Extended Release
DuraHist D	Tablet, Extended Release
Duratuss	Tablet, Extended Release
Durlaza	Capsule, Extended Release, 24 HR
dutasteride	Capsule, Gelatin Coated	May cause mucosal irritation (Ref-5).
Dutrebis	Tablet, Film Coated
duvelisib	Capsule
Dynacirc CR	Capsule, Delayed Release
Dynex LA	Tablet, Extended Release
Easprin	Tablet, Enteric Coated
EC-Naprosyn	Tablet, Delayed Release/Enteric Coated
Ed A-Hist	Tablet, Extended Release
Effer-K	Tablet, Effervescent
Effexor XR	Capsule, Extended Release
E-Mycin	Tablet, Delayed Release
elacestrant	Tablet	Swallow tablets whole. Do not chew, crush, or split
elbasvir/grazoprevir	Tablet	Amorphous solid dispersion** (Ref-4)
Elepsia XR	Tablet, Extended Release
elexacaftor/tezacaftor/ivacaftor; ivacaftor	Tablets (Kit)	Amorphous solid dispersion** (Ref-4)
eliglustat	Capsule	Do not crush, dissolve, or open capsules
Eltrombopag	Tablets	Do not split, chew, or crush tablets and mix with food or liquids
Embeda	Capsule, Extended Release	Crushing or chewing the pellets causes rapid release and absorption of both morphine and naltrexone, which may result in fatalities, especially in opioid-naive individuals. In opioid-tolerant individuals, rapid release of naltrexone may result in withdrawal.
Emend	Capsule	Swallow whole. Emend(R) oral capsule is a nanocrystal product**, consider alternative powder for suspension or IV emulsion dosage forms (Ref-4)
empagliflozin-linagliptin-metformin hydrochloride	Tablet, Extended Release	Do not split, crush, dissolve, or chew tablets
empagliflozin-metformin hydrochloride	Tablet, Extended Release	Do not split, crush, chew, or dissolve tablets
Enablex	Tablet, Extended Release
enalapril maleate-felodipine	Tablet, Extended Release
enasidenib	Tablet
Ensacove	Capsule	Swallow whole, do not crush, chew or dissolve contents of the capsule
ensartinib	Capsule	Swallow whole, do not crush, chew or dissolve contents of the capsule
Entex LA	Capsule, Extended Release; Tablet, Biphasic Release/Extended Release
Entex PSE	Capsule, Extended Release; Tablet, Sustained Release/Extended Release
entrectinib	Capsule
Envarsus XR	Tablet, Extended Release
enzalutamide	Capsule; Tablet
Epanova	Capsule	Do not dissolve, open, crush, or chew capsule.
Equetro	Capsule, Extended Release
erdafitinib	Tablet
ergocalciferol	Capsule, Liquid Filled
Ergomar	Tablet, Sublingual
ergotamine tartrate	Tablet, Sublingual
Erivedge	Capsule
Erleada	Tablet
Eryc	Capsule, Delayed Release Pellets
Ery-Tab	Tablet, Delayed Release
erythromycin	Capsule, Delayed Release Pellets; Tablet, Delayed Release/Enteric Coated/Coated Particles
Epclusa (sofosbuvir/velpatasvir)	Tablet	Amorphous solid dispersion** (Ref-4)
esomeprazole magnesium	Capsule, Delayed Release Pellets	Risk of reduced efficacy when crushing gastric-resistant coated medicine (Ref-5)
ethinyl estradiol/levonorgestrel	Tablet	NIOSH Group 2; potentially crushable if follow proper protective equipment precautions; also consider transdermal patch formulations (Ref-3)
etodolac	Tablet, Extended Release
etoposide	Capsule
etravirine	Tablet	If can't swallow tablets whole, may disperse the tablets in a glass of water. Amorphous solid dispersion** (Ref-4)
everolimus	Tablet	Mucous membrane irritant Amorphous solid dispersion**; consider alternative dosage form, tablet for oral suspension (Ref-4).
Evista	Tablet
Exalgo	Tablet, Extended Release
Exkivity	Capsule	Do not open, chew or dissolve the contents of the capsules
Exjade	Tablet for Suspension	Do not crush, chew or swallow tablets whole
Extendryl JR	Capsule, Extended Release
Extendryl SR	Capsule, Extended Release
Exviera	Tablet	Do not break, chew, or dissolve due to a bitter taste
Exxua	Tablet, Extended Release	Do not split, crush, or chew
ezetimibe/atorvastatin calcium	Tablet
ezogabine	Tablet
Feldene	Capsule	Mucous membrane irritant
Factive	Tablet
Fansidar	Tablet
Farydak	Capsule	Avoid exposure by direct contact of powder in capsules with the skin or mucous membranes
felodipine	Tablet, Extended Release
fenofibrate	Tablet	Tricor is nanocrystal technology**; consider other oral capsules, tablets (Ref-4)
fenofibrate, micronized	Capsule
fenofibrate-simvastatin	Tablet, Film Coated
fenofibric acid	Tablet; Capsule, Delayed Release	Fibricor tablet is crushable (Ref-3)
fentanyl citrate	Tablet, Buccal	Do not swallow whole
Fentora	Tablet, Buccal	Do not swallow whole
ferric citrate	Tablet
ferric maltol	Capsule
ferrous sulfate	Tablet, Enteric Coated
fesoterodine fumarate	Tablet, Extended Release
Fetzima	Capsule, Extended Release
fexinidazole	Tablet	Do not break or crush
fexofenadine hydrochloride	Tablet, Disintegrating
fexofenadine hydrochloride-pseudoephedrine hydrochloride	Tablet, Extended Release
fezolinetant	Tablet, Film Coated	Do not cut, crush, or chew tablets
Fibricor	Tablet	Tablet is crushable (Ref-3)
Filspari	Tablet
finasteride	Tablet, Film Coated	Active ingredients are coated to prevent accidental exposure to women who are pregnant or may potentially be pregnant.
Flagyl ER	Tablet, Extended Release
fluoxetine hydrochloride	Capsule, Delayed Release Pellets	May have unpalatable taste (Ref-5).
fluvastatin sodium	Tablet, Extended Release
fluvoxamine maleate	Capsule, Delayed Release
Focalin XR	Capsule, Extended Release
Forfivo XL	Tablet, Extended Release	May result in increased risk of adverse effects, including seizures
Fortamet	Tablet, Extended Release
Fosamax	Tablet, Wax Coated	May cause oropharyngeal irritation
Fosamax Plus D	Tablet	May cause oropharyngeal irritation
fostemsavir	Tablet, Extended Release
Fotivda	Capsule	Swallow whole and do not open capsule
Foundayo	Tablet	Swallow whole; do not break, crush, or chew
futibatinib	Tablet	Do not crush, chew, split or dissolve tablets
gabapentin	Tablet	Neurontin tablet is crushable; also consider alternative dosage form of oral solution (Ref-3)
gabapentin enacarbil	Tablet, Extended Release
Galafold	Capsule	Hazardous; may be crushed with proper personal protective equipment (Ref-3)
galantamine hydrobromide	Capsule, Extended Release; Tablet, Film Coated
Galzin	Capsule
gefitinib	Tablet, Coated	Can be dispersed in water without crushing the tablet
gemifloxacin mesylate	Tablet
Geodon	Capsule
gepirone	Tablet, Extended Release	Do not split, crush or chew
gilteritinib	Tablet
glasdegib	Tablet	Do not split or crush
glecaprevir/pibrentasvir	Tablet	Amorphous solid dispersion** (Ref-4)
Gleevec	Capsule, Extended Release
glipizide	Tablet, Extended Release
Glucophage XR	Tablet, Extended Release
Glucotrol XL	Tablet, Extended Release
Glumetza	Tablet, Extended Release
Gralise	Tablet
guaifenesin	Tablet, Extended Release
guaifenesin-phenylephrine hydrochloride	Capsule/Tablet, Extended Release; Tablet, Biphasic Release/Sustained Release
guaifenesin-pseudoephedrine hydrochloride	Tablet, Extended Release
Guaifenex DM	Tablet, Extended Release
Guaifenex GP	Tablet, Extended Release
Guaifenex PSE	Tablet, Extended Release
guanfacine hydrochloride	Tablet, Extended Release
Harvoni	Tablet	Amorphous solid dispersion** (Ref-4)
Hernexos	Tablet	Swallow tablets whole with water. Do not split, crush, or chew tablets.
Hetlioz	Capsule	Crushable; also consider alternate formulation oral suspension (Ref-3)
Horizant	Tablet, Extended Release
Hycamtin	Capsule
Hydrea	Capsule	Swallow whole. Do not open, break, or chew capsules.
hydrocodone bitartrate	Capsule or Tablet, Extended Release	Do not crush, chew, or dissolve as this may lead to uncontrolled delivery of a potentially fatal overdose.
hydromorphone hydrochloride	Tablet, Extended Release
hydroxychloroquine sulfate	Tablet	Do not crush or divide tablet Tablet is crushable (Ref-3)
hydroxyurea	Capsule	Swallow whole. Do not open, break, or chew capsules.
HyoMax SL	Tablet, Sublingual
HyoMax SR	Tablet, Extended Release
hyoscyamine sulfate	Capsule, Extended Release; Tablet, Extended Release/Sublingual
Hyrnuo	Capsule	Do not open, chew, or crush capsules
Hysingla ER	Tablet, Extended release	Do not crush, chew, or dissolve as this may lead to uncontrolled delivery of a potentially fatal overdose.
ibandronate sodium	Tablet
Ibrance	Capsule; Tablet	Do not crush, chew, open, or split. Do not ingest capsule or tablet if broken, cracked, or not intact.
ibrutinib	Capsule; Tablet
Ibtrozi	Capsule	Swallow capsule whole. Do not open, chew, crush, or dissolve the capsule prior to swallowing.
ibuprofen-famotidine	Tablet	Do not divide tablet to supply a lower dose, or chew or crush Can be crushed if used promptly; potential chemical incompatibility between 2 active pharmaceutical ingredients (Ref-3)
icosapent ethyl	Soft-gel capsule	Swallow whole; do not break open, crush, dissolve, or chew (Ref-3).
icotrokinra	Tablet	Swallow whole. Do not crush, split, or chew tablets. However, may use tablets to prepare an oral dispersion.
Icotyde	Tablet	Swallow whole. Do not crush, split, or chew tablets. However, may use tablets to prepare an oral dispersion.
idebenone	Tablet
idelalisib	Tablet
Idhifa	Tablet
imatinib mesylate	Capsule, Extended Release
Imbruvica	Capsule; Tablet
Imdur	Tablet, Extended Release
Imuran	Tablet
Imlunestrant	Tablet	Do not split, crush, or chew tablets
Impavido	Capsule	Do not break, crush, dissolve, or chew before swallowing. Hazardous (significant embryo fetal toxicity)
Inavolisib	Tablet	Swallow tablets whole. Do not chew, crush, or split prior to swallowing
Incivek	Tablet	Amorphous solid dispersion** (Ref-4)
Inderal LA	Capsule, Extended Release
Indocin SR	Capsule, Extended Release
indomethacin	Capsule, Extended Release
infigratinib	Capsule
Inluriyo	Tablet	Do not split, crush, or chew tablets
Innopran XL	Capsule, Extended Release
Inqovi	Tablet
Inpefa	Tablet
Intelence	Tablet	If can't swallow tablets whole may disperse the tablets in a glass of water. Amorphous solid dispersion** (Ref-4)
Intuniv	Tablet, Extended Release
Invega	Tablet, Extended Release
Invirase	Tablet
Invokamet XR	Tablet, Extended Release	Swallow whole; do not crush, cut, or chew
Ionamin	Capsule, Extended Release
Iressa	Tablet, Coated	Can be dispersed in water without crushing the tablet
Isavuconazonium sulfate	Capsule	Do not crush, chew, dissolve, or open capsules High risk of chemical instability, physical instability, and reduced absorption; consider alternative dosage form IV solution (Ref-3)
Isentress	Tablet, Film Coated
Isentress HD	Tablet, Film Coated
Isochron	Tablet, Extended Release
Isordil	Tablet, Sublingual
isosorbide dinitrate	Capsule/Tablet, Extended Release; Tablet, Sublingual
isosorbide mononitrate	Tablet, Extended Release
Isosorbide SR	Tablet, Extended Release
isotretinoin	Capsule, Liquid Filled/Gelatin	May cause esophageal irritation
isradipine	Capsule, Extended Release
Itovebi	Tablet	Swallow tablets whole. Do not chew, crush, or split prior to swallowing.
itraconazole	Capsule	(Tolsura) High risk of physical instability and reduced absorption; consider alternative dosage form, oral solution (Ref-3) (Sporanox) Amorphous solid dispersion**; consider alternative dosage form, oral solution (Ref-4)
ivacaftor	Tablet	Amorphous solid dispersion**; consider alternative dosage form oral granules (Ref-4)
ivosidenib	Tablet	Amorphous solid dispersion** (Ref-4)
ixazomib	Capsule	Do not crush, chew, or open
Jadenu	Tablet	May be crushed and mixed with soft food for those who have difficulty swallowing whole tablets
Jakafi XR	Tablet, Extended Release	Swallow tablets whole; do not split, chew, or crush.
Janumet XR	Tablet, Extended Release
Jaypirca	Tablet	Do not cut, crush, or chew
Jentadueto XR	Tablet, Extended Release	Do not split, crush, dissolve, or chew
Jesduvroq	Tablet	Do not cut, crush, or chew
Juxtapid	Capsule
K+10	Tablet, Extended Release
K+8	Tablet, Extended Release
Kadian	Capsule, Extended Release	Can not be administered through a nasogastric tube
Kaletra	Tablet, Film Coated	High risk of physical instability and reduced absorption; consider alternative dosage form of oral solution (Ref-3) Amorphous solid dispersion**; consider alternative dosage form oral solution (Ref-4)
Kalydeco	Tablet	Amorphous solid dispersion**; consider alternative dosage form oral granules (Ref-4)
Kapidex	Capsule, Delayed Release
Kaon CL-10	Tablet, Extended Release
Kapvay	Tablet, Extended Release
Kazano	Tablet	Do not split. Tablet is crushable (Ref-3).
Keppra	Tablet, Film Coated
Keppra XR	Tablet, Extended Release
Ketek	Tablet, Film Coated
ketoprofen	Capsule, Extended Release
Khedezla	Tablet, Extended Release
Kisqali	Tablet
Klor-Con	Tablet, Extended Release
Klor-Con M10	Tablet, Extended Release
Klor-Con M15	Tablet, Extended Release
Klor-Con M20	Tablet, Extended Release
Klotrix	Tablet, Extended Release
K-Lyte	Tablet, Effervescent
K-Lyte CL	Tablet, Effervescent
Kombiglyze XR	Tablet, Extended Release	Swallow whole; do not crush, split, or chew
Komzifti	Capsule	Swallow capsules whole. Do not open, break or chew the capsules
Korlym	Tablet, Film Coated
Koselugo	Capsule
Krazati	Tablet	Swallow whole. Do not chew, crush or split
Krintafel	Tablet	Must be used promptly if crushing and use proper personal protective equipment when handling; also potential instability and reduced absorption (Ref-3)
K-Tab	Tablet, Extended Release
lacosamide	Tablet	Swallow whole with liquid; do not divide
Lagevrio	Capsule
Lamictal XR	Tablet, Extended Release
lamivudine-raltegravir	Tablet, Film Coated
lamotrigine	Tablet, Extended Release
lansoprazole	Capsule, Delayed Release Pellets; Tablet, Disintegrating Delayed Release
larotrectinib	Capsule
lasmiditan	Tablet
lazertinib	Tablet	Swallow tablets whole. Do not crush, split, or chew
ledipasvir/sofosbuvir	Tablet	Amorphous solid dispersion** (Ref-4)
lefamulin	Tablet	Do not split, crush, or chew
lenalidomide	Capsule
Lescol XL	Tablet, Extended Release
Letairis	Tablet, Film Coated
letermovir	Tablet	Tablet can be crushed; also consider alternative dosage form of IV solution (Ref-3)
Leukeran	Tablet
Levbid	Tablet, Extended Release
levetiracetam	Tablet, Extended Release
levomilnacipran	Capsule, Extended Release
Levsin SL	Tablet, Sublingual
Levsinex	Capsule, Extended Release
Lexxel	Tablet, Extended Release
Lialda	Tablet, Delayed Release
Lifyorli	Capsule	Do not crush, chew, dissolve, or split the capsules.
linaclotide	Capsule	May open and sprinkle beads on applesauce or in water or flush NG tube with water; do not chew or crush the beads Potential chemical instability (Ref-3)
linagliptin-metformin hydrochloride	Tablet, Extended Release	Do not split, crush, dissolve, or chew
Linzess	Capsule	May open and sprinkle beads on applesauce or in water or flush NG tube with water; do not chew or crush the beads Potential chemical instability (Ref-3)
lipase-protease-amylase	Capsule, Enteric Coated
Lipram 4500	Capsule, Delayed Release, Enteric Coated
Lipram PN 10, 16, 20	Capsule, Delayed Release, Enteric Coated
Liptruzet	Tablet
Liquibid-D 1200	Tablet, Biphasic/Extended Release
Liquibid-PD	Tablet, Biphasic/Extended Release
lithium carbonate	Tablet, Extended Release
Litfulo	Capsule	Swallow capsules whole. Do not crush, split, or chew
Lithobid	Tablet, Extended Release
Lodrane 24	Capsule, Extended Release
Lodrane 24 D	Capsule, Extended Release
LoHist-12	Tablet, Extended Release
lomitapide	Capsule
lomustine	Capsule
lopinavir-ritonavir	Tablet, Film Coated	High risk of physical instability and reduced absorption; consider alternative dosage form of oral solution (Ref-3) Amorphous solid dispersion**; consider alternative dosage form oral solution (Ref-4)
loratadine-pseudoephedrine	Tablet, Extended Release
lorcaserin hydrochloride	Tablet, Extended Release
Lorbrena	Tablet	Do not chew, crush, or split; do not ingest if broken, cracked, or otherwise not intact.
lorlatinib	Tablet	Do not chew, crush, or split; do not ingest if broken, cracked, or otherwise not intact.
lovastatin	Tablet, Extended Release	Swallow tablets whole. Do not split, crush, or chew the extended-release tablets
lovastatin-niacin	Tablet, Extended Release
Lovaza	Capsule, Liquid Filled	Requires special handling; product readily dissolves plastics (Ref-1)
lubiprostone	Capsule, Gelatin Coated
lumacaftor/ivacaftor	Tablet	Amorphous solid dispersion**; consider alternative dosage form oral granules (Ref-4)
Lumakras	Tablet
Lupkynis	Capsule
Luvox CR	Capsule, Delayed Release
Lybalvi	Tablet	Do not divide or combine tablets
Lynparza	Tablet	Amorphous solid dispersion** (Ref-4)
Lyrica CR	Tablet, Extended Release
Lysodren	Tablet
Lysteda	Tablet
Lytgobi	Tablet	Do not crush, chew, split or dissolve tablets
macitentan	Tablet	Do not split, crush, or chew
Macitentan/Tadalafil	Tablet	Do not cut, crush, or chew tablets
Matulane	Capsule
mavacamten	Capsule	Swallow capsules whole. Do not break, open, or chew capsules.
Mavenclad	Tablet	Swallow whole without chewing
Mavyret	Tablet	Amorphous solid dispersion** (Ref-4)
Mayzent	Tablet
meclizine hydrochloride	Tablet
Medent-DM	Tablet, Extended Release
melatonin	Tablet, Extended Release
Meloxicam/Rizatriptan	Tablet	Swallow tablets whole. Do not crush, divide, or chew the tablets.
melphalan	Tablet
memantine hydrochloride	Capsule, Extended Release	Except when opened and sprinkled on applesauce, capsule should be swallowed whole and should not be divided, chewed, or crushed.
mercaptopurine	Tablet
mesalamine	Capsule, Delayed Release/Extended Release; Tablet, Delayed Release
Mestinon Timespan	Tablet, Extended Release
Metadate CD	Capsule, Extended Release
Metadate ER	Tablet, Extended Release
metformin hydrochloride	Tablet, Extended Release
methotrexate	Tablet
methylergonovine	Tablet
Methylin ER	Tablet, Extended Release
methylphenidate	Tablet, Extended Release, Disintegrating	Allow to disintegrate on tongue; do not crush or chew
methylphenidate hydrochloride	Capsule/Tablet, Extended Release
metoprolol succinate	Tablet, Extended Release	Tablets are scored and can be split; swallow the whole or half tablet whole; do not chew or crush
metronidazole	Tablet, Extended Release
miconazole	Tablet, Buccal	Do not crush; chew or swallow tablets whole
Micro-K	Capsule, Extended Release
midostaurin	Capsule, Liquid Filled	Do not open or crush
mifepristone	Tablet, Film Coated
migalastat	Capsule	May be crushed (Ref-3)
miltefosine	Capsule	Do not break, crush, dissolve, or chew before swallowing. Hazardous (significant embryo fetal toxicity); may be crushed with proper personal protective equipment (Ref-3)
minocycline hydrochloride	Capsule/Tablet, Extended Release	Do not crush; chew or swallow tablets whole
mirabegron	Tablet, Extended Release
mirdametinib	Capsule	Must be swallowed whole, do not open, break or chew capsules
mirapex ER	Tablet, Extended Release
mitapivat	Tablet	Swallow tablets whole; do not split, crush, chew, or dissolve.
mitotane	Tablet
Mobocertinib	Capsule	Do not open, chew or dissolve the contents of the capsules
molnupiravir	Capsule
momelotinib	Tablet	Do not cut, crush, or chew
monomethyl fumarate	Capsule, Delayed Release
Morphabond ER	Tablet, Extended Release	Crushing, chewing, or dissolving may cause rapid release and absorption of a potentially fatal dose of morphine.
morphine sulfate	Capsule/Tablet, Extended Release	Crushing, chewing, or dissolving may cause rapid release and absorption of a potentially fatal dose of morphine.
morphine sulfate-naltrexone hydrochloride	Capsule, Extended Release	Crushing or chewing the pellets, causes rapid release and absorption of both morphine and naltrexone, which may result in fatalities, especially in opioid-naive individuals. In opioid-tolerant individuals, rapid release of naltrexone may result in withdrawal.
Moxatag	Tablet, Extended Release
MS Contin	Tablet, Extended Release
Mucinex DM	Tablet, Extended Release
Mucinex	Tablet, Extended Release
Mycapssa	Capsule, Delayed Release
mycophenolate mofetil	Capsule/Tablet
mycophenolate sodium	Tablet, Delayed Release
Myfortic	Tablet, Delayed Release
Myleran	Tablet
Myrbetriq	Tablet, Extended Release
Mytesi	Tablet, Delayed Release
naltrexone hydrochloride/bupropion hydrochloride	Tablet, Extended Release	Do not crush, chew, or cut tablets
Namenda XR	Capsule, Extended Release	Except when opened and sprinkled on applesauce, capsule should be swallowed whole and should not be divided, chewed, or crushed.
Namzaric	Capsule, Delayed Release	Except when opened and sprinkled on applesauce, capsule should be swallowed whole and should not be divided, chewed, or crushed.
Naprelan	Tablet, Extended Release
Naprelan CR	Tablet, Controlled Release
naproxen	Tablet, Delayed Release/Controlled Release
naproxen/esomeprazole magnesium	Tablet, Film Coated/Delayed Release
naproxen sodium	Tablet, Extended Release/Controlled Release
naproxen sodium/sumatriptan succinate	Tablet
Neosar	Tablet
neratinib	Tablet	Do not chew, crush, or split
Nerlynx	Tablet	Do not chew, crush, or split
Neurontin	Tablet	Tablet is crushable; also consider alternative dosage form of oral solution (Ref-3)
nevirapine	Tablet, Extended Release
Nexium	Capsule, Delayed Release Pellets
Nexlizet	Tablet
niacin-simvastatin	Tablet, Extended Release
Niaspan	Tablet, Extended Release
niCARdipine hydrochloride	Capsule, Extended Release
Nifediac CC	Tablet, Extended Release
Nifedical XL	Tablet, Extended Release
nifedipine	Tablet, Extended Release
Ninlaro	Capsule	Do not crush, chew, or open
nintedanib	Capsule	Do not open, crush or chew due to a bitter taste
niraparib	Tablet	Do not chew, crush, or split
nirogacestat	Tablet	Do not break, crush, or chew
nisoldipine	Tablet, Extended Release
nitroglycerin	Capsule, Extended Release; Tablet, Sublingual
NitroQuick	Tablet, Sublingual
Nitrostat	Tablet, Sublingual
Nitro-time Time Cap	Capsule, Extended Release
Norpace CR	Capsule, Extended Release
Northera	Capsule	Can be crushed if used promptly after crushing; potential chemical instability (Ref-3)
Norvir	Tablet, Film Coated	Amorphous solid dispersion**; consider alternative dosage form oral solution or oral powder (Ref-4)
Noxafil	Tablet, Delayed Release	Amorphous solid dispersion**; consider alternative dosage form oral suspension or IV solution (Ref-4)
Nubeqa	Tablet
Nucynta ER	Tablet, Extended Release	Potentially fatal dose of tapentadol if tablet is disrupted
octreotide acetate	Capsule, Delayed Release
Ofev	Capsule	Do not open, crush or chew due to a bitter taste
Ogsiveo	Tablet	Do not break, crush, or chew
Ojemda	Tablet	Swallow whole; consider alternative dosage form powder for suspension
Ojjaara	Tablet	Do not cut, crush, or chew
olanzapine-samidorphan	Tablet	Do not divide or combine tablets
olaparib	Tablet	Amorphous solid dispersion** (Ref-4)
Oleptro	Tablet, Extended Release	May be broken in half along the designated score line
olutasidenib	Capsule
omaveloxolone	Capsule	Swallow whole. Do not open, crush, or chew
omega-3-acid ethyl esters	Capsule, Liquid Filled	Requires special handling; product readily dissolves plastics (Ref-1)
omeprazole	Capsule, Delayed Release Pellets
omeprazole magnesium-amoxicillin-rifabutin	Capsule, Delayed Release
Onglyza	Tablet	Do not split or cut
Onureg	Tablet
Opana ER	Tablet, Extended Release	Potentially fatal overdose of oxymorphone if tablet is disrupted
Opsumit	Tablet	Do not split, crush, or chew
Opsynvi	Tablet	Do not cut, crush, or chew tablets
Oracea	Capsule, Delayed Release
Oramorph SR	Tablet, Extended Release
Orapred ODT	Tablet, Disintegrating
Oravig	Tablet, Buccal	Do not crush, chew or swallow tablets whole
Orenitram	Tablet, Extended Release	Swallow whole; do not crush, split, or chew
orforglipron	Tablet	Swallow whole; do not break, crush, or chew
Orgovyx	Tablet
Orkambi	Tablet	Amorphous solid dispersion**; consider alternative dosage form oral granules (Ref-4)
Orserdu	Tablet	Swallow tablets whole. Do not chew, crush, or split
Ortiko	Capsule, Extended Release	Swallow whole; do not chew or crush
Oseni	Tablet	Do not split. Tablet is crushable if used promptly (Ref-3).
Osmolex ER	Tablet, Extended Release	Swallow whole; do not chew, crush, or divide
oteseconazole	Capsule	Swallow whole; do not chew, crush, dissolve, or open
Otezla	Tablet	Tablet is crushable (Ref-3)
Oxaydo	Tablet, Immediate Release	Do not crush, chew or dissolve tablets; may cause obstruction of feeding tubes
Oxbryta	Tablet	Do not cut, crush, or chew
Oxcarbazepine	Tablet, Extended Release
Oxtellar XR	Tablet, Extended Release
oxybutynin chloride	Tablet, Extended Release
oxycodone	Capsule, Extended Release	Swallow intact capsule whole or capsule may be opened, sprinkled on soft food or in a cup, and its contents swallowed whole Risk of overdose with sustained release drugs (Ref-5)
oxycodone hydrochloride	Tablet, Extended Release/Immediate Release (Oxaydo(TM) only)	Risk of overdose with sustained release drugs (Ref-5)
oxycodone hydrochloride/naltrexone hydrochloride	Capsule, Extended Release	Swallow intact capsule whole or capsule may be opened and the contents sprinkled on applesauce and ingested immediately without chewing Risk of overdose with sustained release drugs (Ref-5)
Oxycontin	Tablet, Extended Release	Potentially fatal overdose of oxycodone if tablet is disrupted
oxymorphone hydrochloride	Tablet, Extended Release
ozanimod	Capsule
pacritinib	Capsule
palbociclib	Capsule, Tablet	Do not crush, chew, open, or crush. Do not ingest capsule or tablet if broken, cracked, or not intact.
Palcaps	Capsule, Delayed Release
paliperidone	Tablet, Extended Release
Pancrease MT	Capsule, Delayed Release
Pancreaze	Capsule, Delayed Release	May cause irritation to the oral mucosa
Pancrecarb MS	Capsule, Delayed Release
pancrelipase	Capsule, Delayed Release; Tablet
panobinostat	Capsule	Avoid exposure by direct contact of powder in capsules with the skin or mucous membranes
Panocaps	Capsule, Delayed Release
Panocaps MT	Capsule, Delayed Release
pantoprazole sodium	Tablet, Delayed Release
paroxetine hydrochloride	Tablet; Tablet, Extended Release	Paxil immediate-release oral tablet can be crushed with proper personal protective equipment for NIOSH group 3 drug; also consider alternative dosage form of oral suspension (Ref-3)
paroxetine mesylate	Tablet	Tablet can be crushed with proper personal protective equipment for NIOSH group 3 drug; also consider alternative dosage form of oral suspension (Ref-3)
Paxil	Tablet	Immediate-release oral tablet can be crushed with proper personal protective equipment for NIOSH group 3 drug; also consider alternative dosage form of oral suspension (Ref-3)
Paxil CR	Tablet, Extended Release
pazopanib	Tablet	Increased rate of absorption and exposure
PCE	Tablet, Coated Particles
Pemazyre	Tablet
pemigatinib	Tablet
Pentasa	Capsule, Extended Release	Except when opened and sprinkled on applesauce or yogurt and consumed immediately, capsule should be swallowed whole and capsule and capsule contents should not be crushed or chewed
pentoxifylline	Tablet, Extended Release
Pentoxil	Tablet, Extended Release
Pertzye	Capsule, Delayed Release	May cause irritation to the oral mucosa; may open capsule and mix contents with small amount of acidic food with a pH of 4.5 or less (eg, applesauce)
Pexeva	Tablet	Tablet can be crushed with proper personal protective equipment for NIOSH group 3 drug; also consider alternative dosage form of oral suspension (Ref-3)
pexidartinib	Capsule
PhenaVent D	Tablet, Extended Release
phendimetrazine tartrate	Capsule, Extended Release
phentermine hydrochloride-topiramate	Capsule, Extended Release
phentermine resin	Capsule, Extended Release
Phyrago	Tablet	Do not crush, cut or chew the tablets.
Piqray	Tablet	Swallow whole; do not chew, crush, or split; do not ingest tablets if broken, cracked, or otherwise not intact
piroxicam	Capsule	Mucous membrane irritant
pirtobrutinib	Tablet	Do not cut, crush, or chew .
Plaquenil	Tablet	Do not crush or divide tablet Tablet is crushable (Ref-3)
Plendil	Tablet, Extended Release
pomalidomide	Capsule
Pomalyst	Capsule
ponesimod	Tablet
Ponvory	Tablet
posaconazole	Tablet, Delayed Release	Amorphous solid dispersion**; consider alternative dosage form oral suspension or IV solution (Ref-4)
potassium bicarbonate-potassium chloride	Tablet, Effervescent
potassium chloride	Capsule/Tablet, Extended Release
potassium citrate	Tablet, Extended Release
Potiga	Tablet
Pradaxa	Capsule	Potential for increased exposure if capsule is crushed, chewed, or opened
pramipexole dihydrochloride	Tablet, Extended Release
praziquantel	Tablet, Film Coated
prednisolone sodium phosphate	Tablet, Disintegrating
prednisone	Tablet, Delayed Release	Delayed release is dependent on intact coating
pregabalin	Tablet, Extended Release
PreHist D	Tablet, Extended Release
Pretomanid	Tablet
Prevacid	Capsule, Delayed Release Pellets
Prevacid Solutab	Tablet, Disintegrating Delayed Release	Do not swallow; can be dissolved in water only and dispensed via nasogastric tube or dosing syringe
Prevymis	Tablet	Tablet can be crushed; also consider alternative dosage form of IV solution (Ref-3)
Prezcobix Ped	Tablet for Suspension	Do not crush, chew, or swallow; must be dispersed in water
Prilosec	Capsule, Delayed Release Pellets
Pristiq	Tablet, Extended Release
procarbazine hydrochloride	Capsule
Procardia XL	Tablet, Extended Release
Procysbi	Capsule, Delayed Release	May open and sprinkle on applesauce or berry jelly, or mix with orange or apple juice; do not chew capsule contents
Prograf	Capsule	Amorphous solid dispersion**; consider alternative dosage form oral granules for suspension (Ref-4)
propafenone hydrochloride	Capsule, Extended Release
Propecia	Tablet, Film Coated	Active ingredients are coated to prevent accidental exposure to women who are pregnant or may potentially be pregnant.
Proquin XR	Tablet, Extended Release
Proscar	Tablet, Film Coated	Active ingredients are coated to prevent accidental exposure to women who are pregnant or may potentially be pregnant.
Protonix	Tablet, Delayed Release
Prozac Weekly	Capsule, Delayed Release Pellets
Pseudo CM TR	Tablet, Extended Release
pseudoephedrine hydrochloride	Tablet, Extended Release
Pseudovent	Capsule, Extended Release
Purinethol	Tablet
pyridostigmine bromide	Tablet, Extended Release
pyrimethamine-sulfadoxine	Tablet
Pytest	Capsule, Liquid Filled	radiopharmaceutical
QDall	Capsule, Extended Release
Qinlock	Tablet
Qtern	Tablet	Do not split or cut Tablet is crushable if used promptly; saxagliptin has potential chemical stability issues (Ref-3)
Qternmet XR	Tablet, Extended Release	Swallow whole. Do not crush, cut, or chew
Qudexy XR	Capsule, Extended Release
quetiapine fumarate	Tablet, Extended Release
quinidine sulfate	Tablet, Extended Release
quizartinib	Tablet	Swallow whole. Do not cut, crush, or chew
Qsymia	Capsule, Extended Release
rabeprazole sodium	Tablet, Delayed Release
Ralix	Tablet, Extended Release
raltegravir potassium	Tablet, Film Coated
raloxifene	Tablet
Ranexa	Tablet, Extended Release
ranolazine	Tablet, Extended Release
Rapamune	Tablet	Do not crush, chew, or split Rapamune is nanocrystal technology**, consider oral solution as alternative dosage form (Ref-4).
Raxone	Tablet
Rayaldee	Capsule, Extended Release	Swallow whole
Rayos	Tablet, Delayed Release
Razadyne ER	Capsule, Extended Release
Razadyne	Tablet, Film Coated
Rebetol	Capsule
regorafenib	Tablet	Amorphous solid dispersion** (Ref-4)
Relexxii	Tablet, Extended Release
relugolix	Tablet
remibrutinib	Tablet	Do not split, crush, or chew
Renagel	Tablet	Tablet content expands in liquid
repotrectinib	Capsule	Swallow capsules whole. Do not open, chew, crush, or dissolve the capsule prior to swallowing. Do not take any capsules that are broken, cracked, or damaged.
Requip XL	Tablet, Extended Release
Rescon	Tablet, Extended Release
Rescon JR	Tablet, Extended Release
Rescon MX	Tablet, Extended Release
Resmetirom	Tablet	Swallow tablets whole; do not split, crush, or chew.
Respa-1st	Tablet, Extended Release
Respa DM	Tablet, Extended Release
Respahist	Tablet, Extended Release
Respaire 60 SR, 120 SR	Capsule, Extended Release
Retevmo	Capsule
Revlimid	Capsule
Reyataz	Capsule	Do not open capsules
Reyvow	Tablet	Do not split, crush, or chew
Rezlidhia	Capsule
Rezurock	Tablet
Rhapsido	Tablet	Do not split, crush, or chew
ribavirin	Capsule
ribociclib	Tablet
rifamycin	Tablet, Delayed Release
rilzabrutinib	Tablet	Swallow whole; do not crush or chew
Rinvoq	Tablet, Extended Release	Do not chew, crush or split tablets
ripretinib	Tablet
risedronate sodium	Tablet	May cause esophageal irritation
Risperdal	Tablet, Disintegrating
Risperdal M-tab	Tablet, Disintegrating
risperiDONE	Tablet, Disintegrating
Ritalin LA	Capsule, Extended Release
Ritalin SR	Tablet, Extended Release
ritlecitinib	Capsule	Swallow capsules whole. Do not crush, split, or chew
ritonavir	Tablet, Film Coated	Amorphous solid dispersion**; consider alternative dosage form oral solution or oral powder (Ref-4)
ropinirole hydrochloride	Tablet, Extended Release
rosuvastatin-ezetimibe	Tablet
Roszet	Tablet
Rozlytrec	Capsule
R-Tanna	Tablet
Rukobia	Tablet, Extended Release
Rybix ODT	Tablet, Disintegrating	Place tablet in the mouth, where it will dissolve in seconds and then be swallowed with the saliva. Do not chew, break, or split the tablet.
Rybelsus	Tablet
Rydapt	Capsule, Liquid Filled	Do not open or crush
Rytary	Capsule, Extended Release	Swallow whole, do not crush, chew, or divide; however, capsules may be opened and the contents sprinkled on applesauce for those who have difficulty swallowing capsules
Rythmol SR	Capsule, Extended Release
Ryzolt	Tablet, Extended Release
Sacubitril/Valsartan	Oral Pellets	Do not chew or crush the oral pellets.
saquinavir mesylate	Tablet
saxagliptin-dapagliflozin	Tablet	Do not split or cut Tablet is crushable if used promptly; saxagliptin has potential chemical stability issues (Ref-3)
saxagliptin hydrochloride	Tablet	Do not split or cut
saxagliptin hydrochloride-metformin hydrochloride	Tablet, Extended Release	Swallow whole; do not crush, split, or chew
Scemblix	Tablet	Swallow whole; do not crush, break, or chew
selexipag	Tablet, Film Coated	Do not split or crush.
selinexor	Tablet
selpercatinib	Capsule/Tablet	Swallow whole. Do no crush or chew
selumetinib	Capsule
semaglutide	Tablet
Sensipar	Tablet
Seroquel XR	Tablet, Extended Release
Sevabertinib	Capsule	Do not open, chew, or crush capsules
sevelamer hydrochloride	Tablet	Tablet content expands in liquid
Simcor	Tablet, Extended Release
Sinemet CR	Tablet, Extended Release
Sinuvent PE	Tablet, Extended Release
siponimod	Tablet
sirolimus	Tablet	Do not crush, chew, or split Nanocrystal technology**; consider alternative dosage form oral solution (Ref-4).
Sirturo	Tablet	Swallow tablets whole. Potential physical instability and reduced absorption with crushing (Ref-3)
sitagliptin phosphate-metformin hydrochloride	Tablet, Extended Release
Sitavig	Tablet, Buccal	Do not crush, chew, suck, or swallow. Reapply if swallowed within first 6 hours.
Skyclarys	Capsule	Swallow whole. Do not open, crush, or chew.
Slenyto	Tablet, Extended Release	Swallow whole. Do not break, crush, or chew.
Slow-Fe	Tablet, Enteric Coated
sofosbuvir/velpatasvir	Tablet	Amorphous solid dispersion** (Ref-4)
solifenacin succinate	Tablet, Film Coated
Solodyn	Tablet, Extended Release
Somnote	Capsule, Liquid Filled
sonrotoclax	Tablet, Film Coated	Swallow whole with food and water. Do not break, chew, or crush.
sotagliflozin	Tablet
sotorasib	Tablet
Sotret	Capsule, Liquid Filled/Gelatin	May cause esophageal irritation
Sotyktu	Tablet
sparsentan	Tablet
Sporanox	Capsule	Amorphous solid dispersion**; consider alternative dosage form oral solution (Ref-4)
Sprycel	Tablet	Active ingredients are surrounded by film coating to prevent healthcare provider exposure
Stahist	Tablet, Extended Release
Stavzor	Capsule, Delayed Release
Staxyn	Tablet, Disintegrating	Place on tongue to rapidly dissolve. Tablet should be taken whole and not crushed or split.
stiripentol	Capsule	Crushable, but has bitter taste; also consider alternative formulation, powder for oral suspension (Ref-3)
Stivarga	Tablet	Amorphous solid dispersion** (Ref-4)
Strattera	Capsule
Sudafed 12 Hour	Capsule/Tablet, Extended Release
Sudafed 24 Hour	Capsule/Tablet, Extended Release
Sular	Tablet, Extended Release
sulfasalazine	Tablet, Delayed Release/Film Coated
sunvozertinib	Tablet	Swallow tablets whole. Do not split, crush, chew, or dissolve the tablets.
Symax Duotab	Tablet, Extended Release/Biphasic
Symax SR	Tablet, Extended Release
Symbravo	Tablet	Swallow tablets whole. Do not crush, divide, or chew the tablets.
Symdeko	Kit, Oral Tablets	Swallow tablets whole. High risk of physical instability and reduced absorption (Ref-3) Amorphous solid dispersion** (Ref-4)
Synjardy XR	Tablet, Extended Release	Do not split, crush, chew, or dissolve tablets
Syprine	Capsule	Potential for contact dermatitis when exposed to capsule content; wash exposed area with water promptly
Tabloid	Tablet
Tabrecta	Tablet
tacrolimus	Capsule, Extended Release; Tablet, Extended Release	Amorphous solid dispersion**; consider alternative dosage forms, IV, granule for oral suspension (Ref-4)
tadalafil	Tablet	Do not split tablets
Tafamidis	Softgel	Not crushable (Ref-3)
Tafamidis meglumine	Softgel	Not crushable (Ref-3)
tafenoquine	Tablet	Must be used promptly if crushing and use proper personal protective equipment when handling; also potential instability and reduced absorption (Ref-3)
Tafinlar	Capsule
talazoparib	Capsule	Swallow capsules whole; do no open or dissolve
taletrectinib	Capsule	Swallow capsules whole. Do not open, chew, crush, or dissolve the capsule prior to swallowing.
Talicia	Capsule, Delayed Release
Talzenna	Capsule	Swallow capsules whole; do no open or dissolve
tapentadol hydrochloride	Tablet, Extended Release	Potentially fatal dose if tablet is disrupted
Targiniq ER	Tablet, Extended Release	Potentially fatal dose of oxycodone if tablet is disrupted
Tarpeyo	Capsule, Delayed Release	Swallow capsule whole; do not open crush or chew
tasimelteon	Capsule	Crushable; also consider alternate formulation, oral suspension (Ref-3)
Tavneos	Capsule	Swallow whole; do not crush, chew, or open capsule
tazemetostat	Tablet	Swallow tablets whole; do not cut, crush, or chew
Taztia XT	Capsule, Extended Release
Tazverik	Tablet	Swallow tablets whole; do not cut, crush, or chewed
Tecfidera	Capsule, Delayed-Release
Tegretol-XR	Tablet, Extended Release
telaprevir	Tablet
telithromycin	Tablet, Film Coated
telmisartan amlodipine and indapamide	Tablet	Swallow tablets whole; do not cut, crush, or chew tablets
Tembexa	Tablet	Swallow tablets whole; do not divide, break, or crush
Temodar	Capsule
temozolomide	Capsule
Tenuate Dospan	Tablet, Extended Release
Tepmetko	Tablet, Film-coated	Swallow tablets whole. Do not chew, crush, or split.
Tepotinib	Tablet, Film-coated	Swallow tablets whole. Do not chew, crush, or split.
Tessalon Perles	Capsule, Liquid Filled	Severe hypersensitivity has occurred possibly related to local anesthesia from sucking or chewing the capsule instead of swallowing it
tezacaftor/ivacaftor and ivacaftor	Kit, Oral Tablets	Swallow tablets whole High risk of physical instability and reduced absorption (Ref-3); Amorphous solid dispersion** (Ref-4)
Theo-24	Capsule, Extended Release	Beads dissolve throughout GI tract
Theocron	Tablet, Extended Release
theophylline	Capsule/Tablet, Extended Release
thioguanine	Tablet
Tiazac	Capsule, Extended Release
Tibsovo	Tablet	Amorphous solid dispersion** (Ref-4)
tipranavir	Capsule
tivozanib	Capsule	Swallow whole and do not open capsule
tofacitinib citrate	Tablet, Extended Release	Swallow whole and intact. Do not crush, split, or chew.
Tolsura	Capsule	High risk of physical instability and reduced absorption; consider alternative dosage form oral solution (Ref-3)
tolterodine tartrate	Capsule, Extended Release
Tonmya	Sublingual, Tablets	Do not swallow whole, cut, crush, or chew
Topamax	Capsule, Coated Pellets	May be sprinkled on soft food
topiramate	Capsule, Coated Pellets	May be sprinkled on soft food
topiramate XR	Capsule, Extended Release (Trokendi XR only)	Do not sprinkle on food, chew, or crush
topotecan hydrochloride	Capsule	Requires special handling to limit exposure to health risks
Toprol-XL	Tablet, Extended Release
Toviaz	Tablet, Extended Release
tovorafenib	Tablet	Swallow whole; consider alternative dosage form powder for suspension
Tracleer	Tablet
tramadol hydrochloride	Capsule, Extended Release; Tablet, Extended Release	Do not split, chew, dissolve or crush
tramadol hydrochloride	Tablet, Disintegrating	Place tablet in the mouth, where it will dissolve in seconds and then be swallowed with the saliva. Do not chew, break, or split the tablet.
tranexamic acid	Tablet
trazodone hydrochloride	Tablet, Extended Release	May be broken in half along the designated score line
Trental	Tablet, Extended Release
Trexall	Tablet
Treximet	Tablet
trientine hydrochloride	Capsule	Potential for contact dermatitis when exposed to capsule content; wash exposed area with water promptly
trientine tetrahydrochloride	Tablet	Swallow tablet whole, without crushing, chewing or dissolving. Tablets are scored and can be divided into 2 equal halves for patients who have difficulty swallowing
Triglide	Tablet
Trijardy XR	Tablet, Extended Release	Do not split, crush, dissolve, or chew tablets
Trikafta	Tablets (Kit)	Amorphous solid dispersion** (Ref-4)
Trilipix	Capsule, Delayed Release
Trokendi XR	Capsule, Extended Release	Do not sprinkle on food, chew, or crush
Troxyca ER	Capsule, Extended Release	Swallow intact capsule whole or capsule may be opened and the contents sprinkled on applesauce and ingested immediately without chewing
Truqap	Tablet	Swallow tablets whole. Do not chew, crush, or split tablets prior to swallowing. Do not take tablets that are broken, cracked, or otherwise not intact.
Truseltiq	Capsule
tucatinib	Tablet
Tukysa	Tablet
Turalio	Capsule
Tussicaps	Capsule, Extended Release
Tylenol 8 Hour	Tablet, Extended Release
Uceris	Tablet, Extended Release
Ukoniq	Tablet
Ultram ER	Tablet, Extended Release	Potentially fatal overdose of tramadol if tablet is disrupted
Ultrase MT	Capsule, Enteric Coated
Ultresa	Capsule, Delayed Release
umbralisib	Tablet
Uniphyl	Tablet, Extended Release
upadacitinib	Tablet, Extended Release	Do not chew, crush, or split tablets
Uptravi	Tablet, Film Coated	Do not split or crush
Uroatral	Tablet, Extended Release
Urocit-K	Tablet, Extended Release/Wax Coated
Uroxatral	Tablet, Extended Release
Valcyte	Tablet, Film Coated
valganciclovir hydrochloride	Tablet, Film Coated
valproic acid	Capsule, Delayed Release/Liquid Filled
vandetanib	Tablet, Film Coated
Vanflyta	Tablet	Swallow whole. Do not cut, crush, or chew.
Vanrafia	Tablet	Swallow tablets whole. Do not cut, crush, or chew.
Vantrela ER	Tablet, Extended Release	Do not crush, chew, or dissolve as this may lead to uncontrolled delivery of a potentially fatal overdose.
vardenafil hydrochloride	Tablet, Disintegrating	Place on tongue to rapidly dissolve. Tablet should be taken whole and not crushed or split.
Vascepa	Soft gel capsule	Swallow whole; do not break open, crush, dissolve, or chew.
vemurafenib	Tablet, Film Coated	Amorphous solid dispersion** (Ref-4)
venlafaxine hydrochloride	Capsule/Tablet, Extended Release	Risk of overdose with sustained release drugs (Ref-5)
Veozah	Tablet, Film Coated	Do not cut, crush, or chew tablets
vepdegestrant	Tablet, Film Coated	Swallow whole; do not chew, crush, dissolve, or split prior to swallowing. Do not take any tablets that are broken, cracked, or look damaged.
Vepesid	Capsule
Verapamil SR	Tablet, Sustained Release
Verelan	Capsule, Delayed Release Pellets
Verelan PM	Capsule, Extended Release
verapamil hydrochloride	Capsule/Tablet, Extended Release	Scored extended-release tablets can be split in half without affecting release mechanism
Verzenio	Tablet
Vesicare	Tablet, Film Coated
Videx EC	Capsule, Delayed Release Pellets
Viekira XR	Tablet, Extended Release	Swallow whole; do not split, crush, or chew Amorphous solid dispersion** (Ref-4)
Vijoice	Tablet	Swallow whole; do not chew, divide, or crush; do not use if broken, cracked, or damaged
Vimovo	Tablet, Film Coated/Delayed Release
Vimpat	Tablet	Swallow whole with liquid; do not divide
Viokace	Tablet
Viramune XR	Tablet, Extended Release
vismodegib	Capsule
Vitrakvi	Capsule
Vivjoa	Capsule	Swallow whole; do not chew, crush, dissolve, or open
voclosporin	Capsule
Voltaren-XR	Tablet, Extended Release
Vonjo	Capsule
vonoprazan	Tablet	Swallow whole; do not crush or chew
Voquezna	Tablet	Swallow whole; do not crush or chew
vorinostat	Capsule
Vospire ER	Tablet, Extended Release
Votrient	Tablet	Increased rate of absorption and exposure
voxelotor	Tablet	Do not cut, crush, or chew
Vumerity	Capsule, Delayed Release	Swallow whole and intact. Do not crush or chew, or sprinkle contents on food.
Vykat XR	Tablet, Extended Release	Swallow tablets whole. Do not split, crush, or chew the extended-release tablets because doing so may compromise the extended-release characteristics, efficacy, or safety.
Vyndagel	Softgel	Not crushable (Ref-3)
Vyndamax	Softgel	Not crushable (Ref-3)
Wayrilz	Tablet	Swallow whole; do not crush or chew
Welireg	Tablet
Wellbutrin SR	Tablet, Extended Release
Wellbutrin XL	Tablet, Extended Release
Widaplik	Tablet	Swallow whole; do not cut, crush or chew tablets
Xalkori	Capsule
Xanax XR	Tablet, Extended Release
Xartemis XR	Tablet, Extended Release	Do not crush, cut, chew, dissolve, break, or split as this may lead to uncontrolled delivery of a potentially fatal dose of oxycodone.
Xcopri	Tablet	Swallow whole with liquid; do not crush or chew
Xeljanz XR	Tablet, Extended Release	Swallow whole and intact. Do not crush, split, or chew.
Xeloda	Tablet	Swallow whole; do not cut or crush
Xenleta	Tablet
Xigduo XR	Tablet, Extended Release
Ximino	Capsule, Extended Release
Xospata	Tablet
Xpovio	Tablet
Xtampza ER	Capsule, Extended Release	Swallow intact capsule whole or capsule may be opened, sprinkled on soft food or in a cup, and its contents swallowed whole
Xtandi	Capsule; Tablet
Yonsa	Tablet
Yosprala	Tablet, Delayed Release	Swallow whole with liquid; do not split, chew, crush or dissolve
Zantac 25	Tablet, Effervescent
zanubrutinib	Capsule
Zegfrovy	Tablet	Swallow tablets whole. Do not split, crush, chew, or dissolve the tablets.
Zejula	Capsule
Zelboraf	Tablet, Film Coated	Amorphous solid dispersion** (Ref-4)
Zenpep	Capsule, Delayed Release
Zepatier	Tablet	Amorphous solid dispersion** (Ref-4)
Zeposia	Capsule
ziftomenib	Capsule	Swallow capsules whole. Do not open, break or chew the capsules
zileuton	Tablet, Extended Release
zinc acetate	Capsule
ziprasidone hydrochloride	Capsule
Zohydro ER	Capsule, Extended Release	Do not crush, chew, or dissolve as this may lead to uncontrolled delivery of a potentially fatal dose.
Zolinza	Capsule
zolpidem tartrate	Tablet, Extended Release; Capsule	Swallow whole; do not divide (tablets), open (capsules), crush or chew.
Zongertinib	Tablet	Swallow tablets whole with water. Do not split, crush, or chew tablets.
Zorprin	Tablet, Extended Release
Zortress	Tablet	Amorphous solid dispersion**; consider alternative dosage forms tablet for oral suspension (Ref-4)
Zubsolv	Tablet, Sublingual
Zunveyl	Tablet, Delayed Release	Swallow whole and do not split, crush, or chew the tablets
Zyban	Tablet, Extended Release
Zydelig	Tablet
Zyflo CR	Tablet, Extended Release
Zyrtec-D 12 Hour	Tablet, Extended Release
Zytiga	Tablet

What the symbols mean

*Unless otherwise specified, the source of the information is obtained from the manufacturer's prescribing information.
**Nanocrystal and amorphous solid dispersion dosage formulations should not be crushed or manipulated in any similar way due to possible impact on oral bioavailability with possible clinically significant consequences such as treatment failure and/or other complications (Ref-4).
^Table 1 or Table 2 drug requiring special handling to limit exposure to health risk, per NIOSH List of Hazardous Drugs.
#Substance with potential adverse developmental and/or reproductive effects, per NIOSH List of Hazardous Drugs; requires special handling by those who are or may become pregnant.
##Substance with occupational developmental hazard during the third trimester of pregnancy, per NIOSH List of Hazardous Drugs; requires special handling during third trimester of pregnancy.

References

NIOSH (2024). National Institute for Occupational Safety and Health (NIOSH): NIOSH list of hazardous drugs in healthcare settings, 2024. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2024. — basis for the ^, #, and ## hazardous-drug markers.
Ref-1. None listed: Omega-3-acid melts through foam cup. ISMP Medication Safety Alert! Acute Care 2009; 14(8):2-2.
Ref-3. Uttaro E, Zhao F, & Schweighardt A: Filling the gaps on the Institute for Safe Medication Practices (ISMP) do not crush list for immediate-release products. Int J Pharm Compd 2021; 25(5):364-371.
Ref-4. Uttaro E, Pudipeddi M, Schweighardt A, et al: To crush or not to crush: a brief review of novel tablets and capsules prepared from nanocrystal and amorphous solid dispersion technologies. Am J Health Syst Pharm 2021; 78(5):389-394.
Ref-5. Fodil M, Nghiem D, Colas M, et al: Assessment of clinical practices for crushing medication in geriatric units. J Nutr Health Aging 2017; 21(8):904-908.

Medical disclaimer: This list is a general reference for healthcare professionals and is not all-inclusive. It is not a substitute for clinical judgment or the manufacturer’s current prescribing information. Always confirm with the product label or a pharmacist before crushing, splitting, or otherwise altering any medication.