Search Do Not Crush List
Oral Medications That Should Not Be Crushed - March 2023 Update
Although crushing pills can make taking pills easier, and may even be necessary for some (e.g., those with a feeding tube), it is important to be mindful of which solid oral medications should not be crushed before consumption as it may alter their intended effects due to their specific formulation. These include:
- Extended-release, controlled-release, prolonged-action, and sustained-release formulations
- Enteric-coated or protective medications
- Sublingual or buccal absorbent medications or those meant to have a local effect in the mouth (e.g. lozenges)
- Medications that are unappealing to the taste, irritate the oral cavity, or contain substances that may discolor the teeth or oral mucosa (may be given through nasogastric tubes)
- Carcinogenic and/or teratogenic medications that require special handling to minimize health risks
- Medications created with specific technology to prevent misuse and abuse.
Below is a list of medications that, in most cases, should not be crushed. However, it is important to note that this list is not exhaustive and should only be used as a general guide.
The name of the medications is listed alphabetically (by brand name). If you are unsure about whether a medication can safely be crushed, be sure to talk to your doctor or pharmacist before doing so.
This list is updated/reviewed monthly or as information becomes available.
Last Updated 2/23/2023
Brand Name | Generic Name | Dosage Form | Comments |
---|---|---|---|
Absorica, Accutane, Amnesteem, Clarus, Epuris, Sotret | Isotretinoin | Capsule | Irritant (esophageal) Teratogenic |
Abstral | Fentanyl | Tablet | Sublingual dosage form |
Accrufer | Ferric maltol | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Accutane | Isotretinoin | Capsule, Liquid Filled | May cause esophageal irritation |
Aciphex | Rabeprazole | Tablet, Delayed Release | |
Acticlate Cap | Doxycycline hyclate | Capsule | Do not break, open, crush, dissolve, or chew. Doxycycline hyclate tablets can safely be crushed but may cause esophageal irritation |
Actiq | Fentanyl citrate | Troche/Lozenge | Lollipop delivery system, allow for slow dissolution |
Actonel | Risedronate | Tablet | Irritant (oropharyngeal) |
Adalat CC | Nifedipine | Tablet, Extended Release | Extended Release |
Adderall XR | Dextroamphetamine/Amphetamine | Capsule | Modified-release. Can be opened for administration of intact granules |
Adenovirus Vaccine | Adenovirus Type 4 and Type 7 vaccine, live | Tablet, enteric coated | Enteric-Coated |
Advicor | Niacin-lovastatin extended-release | Tablet, Extended Release | Extended Release |
Advil, Motrin | Ibuprofen | Tablet | Bad taste |
Aemcolo | Rifamycin | Tablet, Delayed Release | Delayed Release |
AeroHist Plus | Brompheniramine maleate-phenylephrine hydrochloride-pyrilamine maleate | Tablet, Extended Release | Extended Release |
Afeditab CR | Nifedipine | Tablet, Extended Release | Extended Release |
Afinitor | Everolimus | Tablet | Irritant (mucous membrane) Teratogenic |
Aggrenox | Dipyridamole-aspirin | Capsule, Extended Release | Extended Release |
Alkeran | Melphalan | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Allegra D | Pseudoephedrine/Fexofenadine | Tablet | Modified-release |
Allegra Dissolving | Fexofenadine | Tablet, Disintegrating | |
Allfen Jr | Ibuprofen | Tablet, Extended Release | Extended Release |
Altoprev | Lovastatin | Tablet, Extended Release | Extended Release |
Alunbrig | Brigatinib | Tablet | Do not crush according to the prescribing information |
Ambien CR | Zolpidem Tartrate Extended-release | Tablet, Extended Release | Extended Release |
Amitiza | Lubiprostone | Capsule, Gelatin Coated | Swallow capsules whole. Do not break, open, or chew the capsules |
Ampyra | Dalfampridine | Tablet, Extended Release | Extended-release |
Amrix | Cyclobenzaprine Hydrochloride Extended-release | Capsule, Extended Release | May open and sprinkle capsule contents on applesauce and ingest immediately without chewing |
Antara | Gemfibrozil | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Antivert | Meclizine | Tablet | Do not crush according to the prescribing information |
Aplenzin | Bupropion Hydrobromide Extended-release | Tablet, Extended Release | Extended-release |
Aptensio XR | Methylphenidate Hydrochloride Extended-release | Capsule, Extended Release | Except when opened and sprinkled on applesauce, capsule should be swallowed whole and should not be divided, chewed, or crushed. |
Aptivus | Tipranavir | Capsule | Bad taste |
Aptivus | Tipranavir | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Aquatab C | Chlorpheniramine Maleate | Tablet, Extended Release | Extended-release |
Aquatab D | Chlorpheniramine Maleate and Phenylephrine Hydrochloride | Tablet, Extended Release | Extended-release |
Arakoda | Tavaborole | Tablet | Do not crush according to the prescribing information |
Aricept (23 mg strength only) | Donepezil | Tablet | Intact product must be taken to avoid increased rate of absorption |
Arthrotec | Diclofenac Sodium and Misoprostol | Tablet, Delayed Release | |
Arymo ER | Morphine Sulfate Extended-release | Tablet, Extended Release | Crushing, chewing, or dissolving may cause rapid release and absorption of a potentially fatal dose of morphine. |
Asacol, Lialda | Mesalamine | Tablet | Modified-release |
Astagraf XL | Tacrolimus Extended-release | Capsule, Extended Release | Extended Release |
Augmentin XR | Amoxicillin/Clavulanate | Tablet | Modified-release Scored tablets can be split |
Auryxia | Ferric Citrate | Tablet | Do not crush according to the prescribing information |
Austedo | Deutetrabenazine | Tablet | Swallow tablets whole; do not chew, crush, or break per the prescribing information |
Auvelity | Dextromethorphan hydrobromide-bupropion hydrochloride | Tablet, Extended Release | Extended-release |
Avinza | Morphine Sulfate Extended-release | Capsule, Extended Release | Extended Release |
Avodart, Jalyn | Dutasteride | Capsule | Teratogenic Irritant (mucous membrane) |
Azasan | Azathioprine | Tablet | Requires special handling to limit exposure to health risks |
Azulfidine EN-Tabs | Sulfasalazine | Tablet | Modified-release |
Bafiertam | Monomethyl fumarate | Capsule, Delayed Release | Delayed-Release |
Balversa | Erdafitinib | Tablet | Do not crush according to the prescribing information |
Belbuca | Buprenorphine | Film | Sublingual dosage form |
Bellahist-D LA | Diphenhydramine Hydrochloride and Pseudoephedrine Hydrochloride Extended-release | Tablet, Extended Release | Extended Release |
Belviq XR | Lorcaserin Hydrochloride Extended-release | Tablet, Extended Release | Extended Release |
Benadryl Liqui-Caps | DiphenhydrAMINE hydrochloride | Capsule, Liquid Filled | Some brand name Benadryl products are liquid filled capsules. Diphenhydramine tablets can safely be crushed |
Biaxin XL | Clarithromycin Extended-release | Tablet, Extended Release | Extended Release |
Biltricide | Praziquantel | Tablet | Bad taste Scored tablets can be split |
Binosto | Alendronate | Tablet, Effervescent | Potential for oropharyngeal ulceration if tablet is chewed, swallowed, or sucked on |
Biohist LA | Chlorpheniramine-Pseudoephedrine | - | Tablet, Extended Release |
Boniva | Ibandronate | Tablet | Irritant (oropharyngeal) |
Bonjesta | Dolutegravir, Lamivudine, and Tenofovir Alafenamide | Tablet, Extended Release | Extended Release |
Bontril | Phendimetrazine Tartrate | Capsule, Extended Release | Extended Release |
Bosulif | Bosutinib | Tablet | Antineoplastic |
Brenzavvy | Bexagliflozin | Tablet | Per the prescribing information, do not crush or chew BRENZAVVY tablets |
Briviact | Brivaracetam | Tablet | Swallow whole with liquid |
Bromfed PD | Brompheniramine/pseudoephedrine | Capsule, Extended Release | Extended Release |
Brukinsa | Zanubrutinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Busulfex | Busulfan | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Cabometyx, Cometriq | Cabozantinib | Capsule, Tablet | Antineoplastic |
Calan SR, Covera-HS, Isoptin SR | Verapamil | Tablet | Modified-release Scored tablets can be split |
Calquence | Acalabrutinib | Capsule; Tablet | Do not crush or chew per the prescribing information |
Calquence | Asciminib | Tablet | Swallow whole; do not crush, break, or chew |
Campral | Acamprosate calcium | Tablet, Delayed Release | Delayed-Release |
Camzyos | Mavacamten | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Caprelsa | Vandetanib | Tablet | Antineoplastic Irritant |
Carbatrol | Carbamazepine | Capsule | Modified-release. Can be opened for administration of intact granules |
Cardene SR | Nicardipine | Capsule | Modified-release |
Cardizem CD, Cartia XT, Dilacor XR, Diltia XT, Dilt CD, Taztia XT, Tiazac | Diltiazem | Capsule | Modified-release. Can be opened for administration of intact granules (Taztia XT and Tiazac) |
Cardizem, Cardizem LA | Diltiazem | Tablet | Modified-release |
Cardura XL | Doxazosin mesylate | Tablet, Extended Release | Extended Release |
Ceclor | Cefaclor | Capsule | Requires special handling to limit exposure to health risks (Ref-2) |
Ceenu | Lomustine | Capsule, Extended Release | Extended Release |
Ceftin | Cefuroxime | Tablet | Bad taste |
CellCept | Mycophenolate | Capsule, Tablet | Teratogenic |
Cerdelga | Eliglustat tartrate | Tablet | Swallow whole with liquid; do not crush or chew |
Chimerix | Brincidofovir | Tablet | Do not crush according to the prescribing information |
Chlorpheniramine | Deconamine SR | Capsule, Extended Release | Extended-release |
Chlor-Trimeton | Chlorpheniramine | Tablet, Extended Release | Extended-release |
Chlor-Trimeton Allergy 12 Hour | Chlorpheniramine Maleate | Tablet | Modified-release |
Cholbam | 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 |
Cholib | Fenofibrate-simvastatin | Tablet, Film Coated | Film-coated |
Cialis | Tadalafil | Tablet | do not split tablets |
Cibinqo | Abrocitinib | Tablet | Swallow tablets whole with water; do not crush, split, or chew |
Cipro XR | Ciprofloxacin | Tablet | Modified-release |
Circadin | Melatonin | Tablet, Extended Release | Extended Release |
Clarinex D | Pseudoephedrine/Desloratadine | Tablet | Modified-release |
Claritin-D Claritin Allergy and Sinus (Canada) | Loratadine/Pseudoephedrine | Tablet | Modified-release |
Colace | Docusate Sodium | Capsule | Bad taste |
Colestid | Colestipol hydrochloride | Tablet | Do not crush according to the prescribing information |
Commit | Nicotine | Lozenge/Troche | |
Concerta, Metadate ER Methylin ER Ritalin SR | Methylphenidate | Tablet | Modified-release |
Contrave | Naltrexone SR/bupropion SR | Tablet, Extended Release | Do not crush, chew, or cut tablets |
ConZip Ryzolt Ultram ER Zytram XL (Canada) | Tramadol | Capsule, Tablet | Modified-release |
Copiktra | Duvelisi | Capsule | The capsules should be swallowed whole according to the prescribing information |
Coreg CR | Carvedilol | Capsule | Modified-release. Can be opened for administration of intact granules |
Cotazym | Pancrelipase | Capsule, Enteric coated | Enteric-Coated |
Cotempla XR-ODT | Methylphenidate | Tablet, Extended Release, Disintegrating | Allow to disintegrate on tongue; do not crush or chew |
Covera-HS | Verapamil | Tablet, Extended Release | Extended-release |
Creon 5, 10, 20 | Pancrelipase | Capsule, Delayed Release | Delayed-release |
Creon, Pancreaze, Pertzye, Ultresa, Zenpep | Pancreatic Enzymes | Capsule | Modified-release. Irritant (oral mucosal). Can be opened for administration of intact granules |
Cresemba | Isavuconazonium sulfate | Capsule | Do not crush, chew, dissolve, or open capsules |
Crixivan | Indinavir | Capsule | Bad taste. Can be opened for administration of intact granules |
Cuvrior | 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 |
Cymbalta | Duloxetine | Capsule | Modified-release |
Cytovene | Ganciclovir | Implant | Requires special handling to limit exposure to health risks (Ref-2) |
Cytoxan | Cyclophosphamide | Tablet | Requires special handling to limit exposure to health risks |
Daurismo | Glasdegib | Tablet | Do not split or crush |
Daurismo | Gilteritinib | Tablet | Do not crush according to the prescribing information |
DayQuil Cold & Flu | Acetaminophen-dexbrompheniramine maleate-pseudoephedrine sulfate | Tablet, Extended Release | Extended-release |
Delzicol | Mesalamine | Capsule | Modified-release. Capsules can be opened for administration of intact granules (Delzicol, Pentasa [U.S.]) |
Depakene | Valproic Acid | Capsule | Irritant (oropharyngeal) |
Depakote Depakote ER | Divalproex | Tablet | Modified-release |
Depakote Sprinkle | Divalproex | Capsule | Modified-release. Can be opened for administration of intact granules |
Desyrel | Trazodone | Tablet | Bad taste Scored tablets can be split |
Detrol LA | Tolterodine | Capsule | Modified-release |
Dexedrine | Dextroamphetamine | Capsule/Spansules | Modified-release |
Dexilant | Dexlansoprazole | Capsule | Modified-release. Can be opened for administration of intact granules |
Dexilant SoluTab | Dexlansoprazole | Tablet Disintegrating, Delayed release | |
Diacomit | Stiripentol | Capsule | Capsules must be swallowed whole with a glass of water during a meal. Capsules should not be broken or opened. |
Diamox | Acetazolamide | Capsule, Extended Release | Extended-release |
Diclegis | Doxylamine succinate-pyridoxine hydrochloride | Tablet, Delayed Release | |
Dilatrate-SR | Isosorbide Dinitrate | Capsule | Modified-release |
Diltzac | Diltiazem | Capsule, Extended Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Ditropan XL | Oxybutynin | Tablet | Modified-release |
Dolobid | Diflunisal | Tablet | Irritant (gastric) |
Donnatal Extentabs | Belladonna Alkaloids | Tablet | Modified-release |
Doryx | Doxycycline | Capsule, Tablet | Modified-release Scored tablets can be split |
Dovprela | Pretomanid | Tablet, Extended Release | Extended Release |
Drisdol | Ergocalciferol | Capsule, Liquid Filled | Swallow capsules whole. Do not break, open, or chew the capsules |
Drixoral Plus | Dexbrompheniramine and pseudoephedrine | Tablet, Extended Release | |
Droxia | Hydroxyurea | Capsule | Irritant (cytotoxic) |
Duexis | Ibuprofen; famotidine | Tablet | Do not divide to supply a lower dose or chew or crush |
Dulcolax | Bisacodyl | Capsule Tablet | Modified-release Irritant (gastric) |
Durlaza | Aspirin | ||
Dutrebis | Lamivudine/raltegravir | Tablet, Film Coated | Film-coated |
Dynacirc CR | Isradipine | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
E.E.S. | Erythromycin | Tablet | Bad taste |
EC Naprosyn, Naprelan | Naproxen | Tablet | Modified-release |
EC-Naprosyn | Naproxen | Tablet, Delayed Release/Enteric Coated | |
Ecotrin | Aspirin | Tablet | Modified-release Irritant (gastric) |
Effer-K | Potassium bicarbonate | Tablet, Effervescent | |
Effexor XR | Venlafaxine | Capsule | Modified-release. Can be opened for administration of intact granules |
Elepsia XR | Levetiracetam | Tablet, Extended Release | |
Embeda | Morphine/Naltrexone | Capsule | Modified-release |
Emend | Aprepitant | Capsule | Swallow whole |
Enablex | Darifenacin hydrobromide | Tablet, Extended Release | Extended-release |
Entex LA | Guaifenesin/phenylephrine | Capsule, Extended Release; Tablet, Biphasic Release/Extended Release | Extended Release |
Entocort EC Entocort (Canada) | Budesonide | Capsule | Modified-release Can be opened for administration of intact granules |
Envarsus XR | Tacrolimus | Tablet, Extended Release | Extended Release |
Epanova | Omega-3-carboxylic Acids | Capsule | Do not dissolve, open, crush, or chew capsule. |
Equetro | Carbamazepine | Capsule | Modified-release |
Ergomar | Ergotamine | Tablet | For sublingual administration |
Erivedge | Vismodegib | Capsule | Teratogenic |
Erleada | Apalutamide | Tablet | Swallow tablets whole OR may mix whole tablets with applesauce. See prescribing information for more details |
Ery-Tab, PCE | Erythromycin | Tablet | Modified-release |
Erythromycin delayed-release | Erythromycin | Capsule | Modified-release. Can be opened for administration of intact granules |
Evista | Raloxifene | Tablet | Bad taste Teratogenic |
Exalgo | Hydromorphone | Tablet | Modified-release |
Exjade, Jadenu | 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 |
Exkivity | Mobocertinib | Capsule | Do not open, chew or dissolve the contents of the capsules |
Extendryl JR | Chlorpheniramine/methscopolamine/phenylephrine | Capsule, Extended Release | Extended Release |
Exviera | Dasabuvir | Tablet | Do not break, chew, or dissolve due to a bitter taste |
Factive | Gemifloxacin | Tablet | Swallow the tablet whole with liquid. Do not break, crush, or chew |
Fansidar | Sulfadoxine/pyrimethamine | Tablet | Do not crush according to the prescribing information |
Farydak | Panobinostat | Capsule | Avoid exposure by direct contact of powder in capsules with the skin or mucous membranes |
Feldene | Piroxicam | Capsule | Irritant (oropharyngeal) |
Fentora | Fentanyl | Tablet | Buccal dosage form - should not be swallowed |
Feosol Feratab | Ferrous Sulfate | Tablet | Modified-release Irritant (gastric) |
Fergon | Ferrous Gluconate | Tablet | Modified-release Irritant (gastric) |
Fetzima | Levomilnacipran | Capsule | Modified-release |
Flagyl ER | Metronidazole | Tablet | Modified-release |
Flomax Flomax CR (Canada) | Tamsulosin | Capsule, Tablet | Modified-release |
Fludara | Fludarabine phosphate | Tablet, Film Coated | Avoid exposure by direct contact of the skin or mucous membranes or by inhalation |
Focalin XR | Dexmethylphenidate | Capsule | Modified-release. Can be opened for administration of intact granules |
Forfivo XL | Bupropion | Tablet, Extended Release | May result in increased risk of adverse effects, including seizures |
Fortamet Glucophage XR Glumetza | Metformin | Tablet | Modified-release |
Fosamax | Alendronate | Tablet, Wax Coated | May cause oropharyngeal irritation |
Fosamax Plus D | Alendronate sodium-cholecalciferol | Tablet | May cause oropharyngeal irritation |
Fotivda | Tivozanib | Capsule | Swallow whole and do not open capsule |
Galafold | Migalastat | Capsule | Swallow capsules whole, do not open, crush, or chew the capsules |
Galzin | Zinc acetate | Capsule | Swallow capsules whole, do not open, crush, or chew the capsules |
Geodon | Ziprasidone hydrochloride | Capsule | Swallow capsules whole, do not open, crush, or chew the capsules |
Gleevec | Imatinib | Tablet | Antineoplastic Irritant (mucous membrane) Scored tablets can be split |
Gliadel | Carmustine | Tablet, Extended Release | Extended-release |
Gliadel | Carmustine | Wafer | Requires special handling to limit exposure to health risks (Ref-2) |
Glucotrol XL | Glipizide | Tablet | Modified-release |
Gralise Horizant | Gabapentin | Tablet | Modified-release |
Hetlioz | Tasimelteon | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Horizant | Gabapentin | Tablet | Modified-release |
Hycamtin | Topotecan | Capsule | Requires special handling to limit exposure to health risks (Ref-2) |
Hydrea | Hydroxyurea | Capsule | Swallow whole. Do not open, break, or chew capsules. Requires special handling to limit exposure to health risks (Ref-2) |
HyoMax SL | Hyoscyamine | Tablet, Sublingual | Sublingual dosage form |
HyoMax SR | Hyoscyamine | Tablet, Extended Release | Extended Release |
Hysingla ER | Hydrocodone Bitartrate ER | Tablet, Extended release | Extended Release |
Ibrance | Palbociclib | Capsule; Tablet | Do not crush, chew, open, or split. Do not ingest capsule or tablet if broken, cracked, or not intact. |
Idhifa | Enasidenib | Tablet | Do not crush according to the prescribing information |
Imbruvica | Ibrutinib | Capsule; Tablet | Swallow capsules whole. Do not break, open, or chew the capsules |
Imdur | Isosorbide Mononitrate | Tablet | Modified-release Scored tablets can be split |
Impavido | Miltefosine | Capsule | Do not chew or break the capsule apart |
Imuran | Azathioprine | Tablet | Requires special handling to limit exposure to health risks |
Incivek | Telaprevir | Tablet | Do not crush according to the prescribing information |
Inderal LA, InnoPran XL | Propranolol | Capsule | Modified-release |
Indocin SR | Indomethacin | Capsule | Modified-release. Can be opened for administration of intact granules |
Inlyta | Axitinib | Tablet | Antineoplastic |
Inqovi | Decitabine-cedazuridine | Tablet | Swallow tablets whole. Do not cut, crush, or chew tablets per the prescribing information |
Intelence | Etravirine | Tablet | Tablet may be dispersed in water Scored tablets can be split |
Intermezzo | Zolpidem | Tablet | Sublingual dosage form |
Intuniv Intuniv XR (Canada) | Guanfacine | Tablet | Modified-release |
Invega | Paliperidone | Tablet | Modified-release |
Invirase | Saquinavir | Tablet | Do not crush according to the prescribing information |
Invokamet | Canagliflozin-metformin hydrochloride | Tablet, Extended Release | Swallow whole; do not crush, cut, or chew |
Ionamin | Phentermine | Capsule, Extended Release | Extended Release |
Iressa | Gefitinib | Tablet, Coated | Can be dispersed in water without crushing the tablet |
Isentress | Raltegravir | Tablet, Film Coated | Film-coated |
Isoptin SR | Verapamil SR | Tablet, Extended Release | Extended Release |
Isordil | Isosorbide dinitrate | Tablet, Sublingual | Sublingual dosage form |
Isordil Sublingual | Isosorbide Dinitrate | Tablet | Sublingual dosage form |
Janumet XR | Sitagliptin / Metformin | Tablet, Extended Release | Extended Release |
Jentadueto | Alogliptin benzoate-metformin hydrochloride | Tablet | Do not split |
Juxtapid | Lomitapide | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Kadian | Morphine Sulfate | Capsule | Modified-release. Can be opened for administration of intact granules |
Kaletra | Lopinavir/Ritonavir | Tablet | Reduced bioavailability with crushing9 |
Kapidex | Dexlansoprazole | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Kapvay | Clonidine | Tablet | Modified-release |
Kazano | Alogliptin; Metformin) | Tablet | Do not split |
Keppra | Levetiracetam | Tablet | Bad taste |
Keppra XR | Levetiracetam | Tablet | Modified-release |
Ketek | Telithromycin | Tablet, Film Coated | Film-coated |
Khedezla | Desvenlafaxine | Tablet, Extended Release | Extended Release |
Kisqali | Belumosudil | Tablet | Per the prescribing information, KISQALI tablets should be swallowed whole (tablets should not be chewed, crushed or split prior to swallowing). No tablet should be ingested if it is broken, cracked, or otherwise not intact. |
Klor-Con | Potassium Chloride | Tablet | Modified-release |
Klotrix | Potassium Chloride | Tablet, Extended Release | Extended Release |
K-Lyte | Potassium Chloride | Tablet, Effervescent | Effervescent |
K-Lyte CL | Potassium Chloride | Tablet, Effervescent | Effervescent |
Kombiglyze XR | Saxagliptin; metformin | Tablet, Extended Release | Swallow whole; do not crush, split, or chew |
Korlym | Mifepristone | Tablet, Film Coated | Film-coated |
Koselugo | Selumetinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Krazati | Adagrasib | Tablet | Swallow whole. Do not chew, crush or split |
Krintafel | Tafenoquine | Tablet | Do not crush according to the prescribing information |
K-Tab | Potassium Chloride | Tablet, Extended Release | Extended Release |
Lagevrio | Molnupiravir | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Lamictal XR | Lamotrigine | Tablet | Modified-release |
Lescol, Lescol XL | Fluvastatin | Capsule, Tablet | Modified-release (Lescol XL) |
Letairis | Ambrisentan | Tablet, Film Coated | Film-coated |
Leukeran | Chlorambucil | Tablet | Requires special handling to limit exposure to health risks |
Levbid | Hyoscyamine | Tablet | Modified-release. Scored tablets can be split |
Lexxel | Enalapril maleate-felodipine | Tablet, Extended Release | Extended Release |
Linzess | 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 |
Lipram 4500 | Amylase/Lipase/Protease | Capsule, Delayed Release, Enteric Coated | Swallow capsules whole. Do not break, open, or chew the capsules |
Lipram PN 10, 16, 20 | Amylase/Lipase/Protease | Capsule, Delayed Release, Enteric Coated | Swallow capsules whole. Do not break, open, or chew the capsules |
Liptruzet | Ezetimibe/atorvastatin calcium | Tablet | Do not crush according to the prescribing information |
Lithobid Lithmax (Canada) | Lithium Carbonate | Tablet | Modified-release |
Lodine | Etodolac | Tablet, Extended Release | Extended Release |
Lodrane 24 D | Brompheniramine; Pseudoephedrine | Capsule, Extended Release | Extended Release |
Lofibra | Fenofibrate | Tablet | Do not crush per the prescribing information |
LoHist 12D | Pseudoephedrine/Brompheniramine | Tablet | Modified-release |
Lopressor SR (Canada) | Metoprolol Tartrate | Tablet | Modified-release |
Lorbrena | Lorlatinib | Tablet | Do not chew, crush, or split; do not ingest if broken, cracked, or otherwise not intact. |
Lovaza | Omega-3 acid ethyl esters | Capsule, Liquid Filled | Requires special handling; product readily dissolves plastics (Ref-1) |
Lumakras | Sotorasib | Tablet | Do not crush per the prescribing information |
Lunesta | Eszopiclone | Tablet | Bad taste |
Lupkynis | Voclosporin | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Luvox CR | Fluvoxamine | Capsule | Modified-release |
Lybalvi | Olanzapine; Samidorphan | Tablet | Do not divide or combine tablets |
Lynparza | Olaparib | Capsule; Tablet | Swallow capsules whole. Do not break, open, or chew the capsules |
Lyrica CR | Pregabalin Extended Release | Tablet, Extended Release | Extended Release |
Lysodren | Mitotane | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Lysteda | Tranexamic acid | Tablet | Do not crush according to the prescribing information |
Lytgobi | Futibatinib | Tablet | Do not crush, chew, split or dissolve tablets |
Matulane | Procarbazine | Capsule | Requires special handling to limit exposure to health risks (Ref-2) |
Mavenclad | Cladribine | Tablet | Swallow whole without chewing |
Mayzent | Siponimod | Tablet | Do not crush according to the prescribing information |
Mestinon Timespan Mestinon SR (Canada) | Pyridostigmine | Tablet | Modified-release |
Metadate CD Ritalin LA Biphentin (Canada) | Methylphenidate | Capsule | Modified-release. Can be opened for administration of intact granules |
Metadate ER | Methylphenidate Extended-Release | Tablet, Extended Release | Extended Release |
Methylin ER | Methylphenidate ER | Tablet, Extended Release | Extended Release |
Micro-K | Potassium Chloride | Capsule | Modified-release. Can be opened for administration of intact granules |
Mirapex ER | Pramipexole ER | Tablet, Extended Release | Extended Release |
Morphabond ER | Morphine Sulfate ER | Tablet, Extended Release | Crushing, chewing, or dissolving may cause rapid release and absorption of a potentially fatal dose of morphine. |
Moxatag | Amoxicillin | Tablet | Modified-release |
MS Contin | Morphine Sulfate Contin | Tablet, Extended Release | Extended Release |
MS Contin | Morphine Sulfate | Tablet | Modified-release |
Mucinex | Guaifenesin | Tablet | Modified-release |
Mucinex D | Guaifenesin/Pseudoephedrine | Tablet | Modified-release Scored tablets can be split |
Mucinex DM | Dextromethorphan-guaifenesen | Tablet, Extended Release | Extended-release |
Mucinex DM | Guaifenesin/Dextromethorphan | Tablet | Modified-release |
Mycapssa | Tolcapone | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Myfortic | Mycophenolic Acid | Tablet | Modified-release Teratogenic |
Myleran | Busulfan | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Myrbetriq | Mirabegron | Tablet | Modified-release |
Mytesi | Crofelemer | Tablet, Delayed Release | Delayed-release |
N/A | Fexinidazole | Tablet | Do not break or crush |
Namenda XR | Memantine | Capsule | Modified-release. Can be opened for administration of intact granules |
Namzaric | 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. |
Naprelan CR | Naproxen CR | Tablet, Controlled Release | |
Neosar | Cyclophosphamide | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Nerlynx | Neratinib | Tablet | Do not chew, crush, or split |
Nexium | Esomeprazole | Capsule Tablet (Canada) | Modified-release. Can be opened for administration of intact granules |
Nexlizet | Bempedoic Acid and Ezetimibe | Tablet | Do not cut, chew, or crush the tablet |
Niaspan, Niaspan FCT (Canada) | Niacin | Tablet | Modified-release |
Nicorette | Nicotine | Lozenge | Should be dissolved in the mouth, not chewed |
Nifediac CC | Nifedipine | Tablet, Extended Release | Extended Release |
Nifedical XL | Nifedipine | Tablet, Extended Release | Extended Release |
Ninlaro | Ixazomib | Capsule | Do not crush, chew, or open |
NitroQuick | Nitroglycerin | Tablet, Sublingual | |
Nitrostat | Nitroglycerin | Tablet | Sublingual dosage form |
Nitro-time Time Cap | Isosorbide Dinitrate | Capsule, Extended Release | Extended Release |
Norflex ER | Orphenadrine | Tablet | Modified-release |
Norpace CR | Disopyramide | Capsule | Modified-release |
Norvir | Ritonavir | Tablet, Film Coated | Film-coated |
Noxafil | Posaconazole | Tablet, Delayed Release | |
Nubeqa | Darolutamide | Tablet | Film-coated |
Nucynta ER | Tapentadol | Tablet | Modified-release |
Ofev | Nintedanib | Capsule | Do not open, crush or chew due to a bitter taste |
Oleptro | Trazodone | Tablet | Modified-release Scored tablets can be split |
Onglyza | Saxagliptin | Tablet | Do not split or cut |
Onureg | Azacitidine | Tablet | Swallow tablets whole. Do not cut, crush, or chew the tablets per the prescribing information |
Opana ER | Oxymorphone | Tablet | Modified-release |
Opsumit | Macitentan | Tablet | Do not split, crush, or chew |
Oracea | Doxycycline | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Oramorph SR | Morphine Sulfate SR | Tablet, Extended Release | Extended Release |
Orapred ODT | Prednisolone ODT | Tablet, Disintegrating | |
Oravig | Miconazole Buccal Tablet | Tablet, Buccal | Do NOT crush, chew or swallow tablets whole |
Orenitram | Treprostinil ER | Tablet, Extended Release | Swallow whole; do not crush, split, or chew |
Orserdu | Elacestrant | Tablet | Swallow tablets whole. Do not chew, crush, or split |
Ortiko | Budesonide | Tablet | Do not crush according to the prescribing information |
Oseni | Alogliptin benzoate-pioglitazone hydrochloride | Tablet | Do not split |
Osmolex ER | Amantadine | Capsule, Extended Release | Swallow whole; do not chew or crush |
Otezla | Apremilast | Tablet | Do not crush, chew or split the tablet per the prescribing information |
Oxaydo | Oxycodone | Tablet, Extended Release | Swallow whole; do NOT chew, crush, or divide |
Oxtellar XR | Oxcarbazepine | Tablet, Extended Release | Extended Release |
OxyContin Oxy Neo (Canada), Xtampza ER | Oxycodone | Capsule, Tablet | Modified-release |
Pancrease MT | Pancrelipase | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Pancreaze | Pancrelipase | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Pancrecarb MS | Pancrelipase | Capsule, Delayed Release | May cause irritation to the oral mucosa |
Paxil CR | Paroxetine | Tablet | Modified-release |
Pemazyre | Pemigatinib | Tablet, Coated Particles | |
Pentasa | Mesalamine | Modified-release. Capsules can be opened for administration of intact granules (Delzicol, Pentasa [U.S.]) | |
Pentoxil | Pentoxifylline | Tablet | Do not crush according to the prescribing information |
Pertzye | Pancrelipase | Tablet, Extended Release | Extended Release |
Pexeva | Paroxetine | 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) |
PhenaVent D | Phenylephrine | Tablet | Do not crush according to the prescribing information |
Piqray | Alpelisib | Tablet | Swallow whole; do NOT chew, crush, or split; do NOT ingest tablets if broken, cracked, or otherwise not intact |
Plaquenil | Hydroxychloroquine | Tablet, Extended Release | Extended Release |
Plendil | Felodipine | Tablet | Modified-release |
Pomalyst | Pomalidomide | Capsule | Antineoplastic Teratogenic |
Ponvory | Ponesimod | Tablet | Do not crush or divide tablet |
Potiga | Ezogabine | Tablet | Do not crush according to the prescribing information |
Pradaxa | Dabigatran | Capsule | Intact product must be taken to avoid increased exposure |
PreHist D | Brompheniramine | Tablet | Do not crush according to the prescribing information |
Prevacid | Lansoprazole | Capsule | Modified-release Can be opened for administration of intact granules |
Prevacid SoluTab Prevacid FasTab (Canada) | Lansoprazole | Tablet | Should be dissolved in the mouth, not chewed |
Prevymis | Letermovir | Tablet | Do not crush according to the prescribing information |
Prilosec | Omeprazole | Tablet, Delayed-Release | Delayed-Release. Capsules can be opened and sprinkled on applesauce |
Prilosec Prilosec OTC Losec (Canada) | Omeprazole | Capsule, Tablet | Modified-release. Capsule can be opened for administration of intact granules (Prilosec) |
Pristiq | Desvenlafaxine | Tablet | Modified-release |
Procardia XL | Nifedipine | Tablet | Modified-release |
Procysbi | 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 |
Propecia | Finasteride | Tablet | Teratogenic - Active ingredients are coated to prevent accidental exposure to women who are pregnant or may potentially be pregnant. Requires special handling to limit exposure |
Proquin XR | Ciprofloxacin | Capsule, Delayed Release Pellets | Swallow capsules whole. Do not break, open, or chew the capsules |
Proscar | Finasteride | Tablet | Teratogenic - Active ingredients are coated to prevent accidental exposure to women who are pregnant or may potentially be pregnant. Requires special handling to limit exposure |
Protonix Pantoloc (Canada) | Pantoprazole | Tablet | Modified-release |
Proventil, Ventolin | Albuterol sulfate | Tablet, Extended Release | Extended Release |
Prozac Weekly | Fluoxetine | Capsule | Modified-release |
Pseudo CM TR | Pseudoephedrine | Tablet, Extended Release | Extended Release |
Purinethol | Mercaptopurine | Tablet, Extended Release | Extended Release |
Pytest | Pyrazinamide | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Qinlock | Ripretinib | Capsule, Extended Release | Extended Release |
Qsymia | phentermine hydrochloride-topiramate | Capsule, Extended Release | Extended Release |
Qtern | Dapagliflozin | Tablet | Do not crush according to the prescribing information |
Qternmet XR | dapagliflozin-saxagliptin-meformin hydrochloride | Tablet, Extended Release | Do not crush, cut, or chew |
Qudexy XR | Topiramate | Capsule | Modified-release. Can be opened for administration of intact granules (Qudexy XR) |
Ralix | Raloxifene | Tablet | Do not split or cut |
Ranexa | Ranolazine | Tablet | Modified-release |
Rapamune | Sirolimus | Tablet, Extended Release | Extended Release |
Raxone | Idebenone | Tablet | Do not crush, chew, or split |
Raxone | Idebenone | Tablet | Do not crush according to the prescribing information |
Rayaldee | Calcifediol | Capsule, Extended Release | Swallow whole |
Rayos | Prednisone | Tablet | Do not crush according to the prescribing information |
Razadyne | Galantamine | Tablet, Delayed Release | |
Razadyne ER Reminyl ER (Canada) | Galantamine | Capsule | Modified-release |
Rebetol | Ribavirin | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Relexxii | Methylphenidate Extended-Release | Tablet, Extended Release | Extended Release |
Renagel | Sevelamer Hydrochloride | Tablet | Tablet content expands in liquid |
Requip XL | Ropinirole | Tablet | Modified-release |
Rescon | Guaifenesin, Dextromethorphan Hydrobromide | Tablet, Extended Release | Extended Release |
Retevmo | Selpercatinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Revlimid | Lenalidomide | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Reyataz | Atazanavir Sulfate | Capsule | Do not open capsules |
Reyvow | Lasmiditan | Tablet | Do not split, crush, or chew |
Rezlidhia | Tildrakizumab | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Rezurock | Pembrolizumab, Lenvatinib | Tablet | Do not crush according to the prescribing information |
Rinvoq | Upadacitinib | Tablet, Extended Release | Do not chew, crush or split tablets |
Risperdal | Risperidone | Tablet, Disintegrating | |
Risperdal M | Risperidone | Tablet | Must be allowed to dissolve on the tongue |
Roszet | Rosuvastatin Calcium | Tablet | Do not crush according to the prescribing information |
Rozlytrec | Entrectinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
R-Tanna | Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, Pseudoephedrine Hydrochloride | Tablet | Do not crush according to the prescribing information |
Rukobia | Fostemsavir | Tablet, Extended Release | Extended Release |
Rybelsus | Semaglutide | Tablet | Do not crush according to the prescribing information |
Rybix ODT | Tramadol Oral Disintegrating Tablets | 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. |
Rydapt | Midostaurin | Capsule, Liquid Filled | Do not open or crush |
Rytary | Carbidopa, Levodopa, Entacapone | 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 | Propafenone | Capsule | Modified-release |
Ryzolt | Tapentadol Hydrochloride Extended-Release Tablets | Tablet, Extended Release | Extended Release |
Scemblix | Palbociclib | Tablet | Swallow whole; do not crush, break, or chew |
Sensipar | Cinacalcet Hydrochloride | Tablet | Do not crush according to the prescribing information |
Seroquel XR | Quetiapine | Tablet | Modified-release |
Simcor | Niacin, Simvastatin | Tablet, Extended Release | Extended Release |
Sinemet | Carbidopa-levodopa | Capsule, Extended Release | Extended-release |
Sinuvent PE | Albuterol Sulfate | Tablet, Extended Release | Extended Release |
Sitavig | Acyclovir Lauriad | Tablet, Buccal | Do not crush, chew, suck, or swallow. Reapply if swallowed within first 6 hours. |
Slow-Fe | Ferrous Sulfate | Tablet, Enteric Coated | |
Solodyn | Minocycline | Tablet | Modified-release |
Somnote | Eszopiclone | Capsule, Liquid Filled | Swallow capsules whole. Do not break, open, or chew the capsules |
Sotret | Isotretinoin | Capsule, Liquid Filled/Gelatin | May cause esophageal irritation |
Sotyktu | deucravacitinib | Tablet | Do not crush, cut, or chew the tablets per the prescribing information |
Sotyktu | Enzalutamide | Tablet | Do not crush according to the prescribing information |
Sporanox | Itraconazole | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Sprycel | Dasatinib | Tablet | Antineoplastic Teratogenic |
Stahist | Astemizole | Tablet, Extended Release | Extended Release |
Stavzor | Valproic Acid | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Staxyn | Vardenafil Hydrochloride Trihydrate | Tablet, Disintegrating | Place on tongue to rapidly dissolve. Tablet should be taken whole and not crushed or split. |
Stivarga | Regorafenib | Tablet | Antineoplastic |
Strattera | Atomoxetine | Capsule | Irritant (ocular) |
Sudafed 12 Hour, 24 Hour | Pseudoephedrine | Tablet | Modified-release |
Sular | Nisoldipine | Tablet | Modified-release |
Symdeko | Tezacaftor; Ivacaftor | Kit, Oral Tablets | Swallow tablets wholÄ—. |
Symmetrel | Amantadine Hydrochloride | Tablet, Extended Release | Swallow whole; do NOT chew, crush, or divide |
Synjardy XR | Empagliflozin-metformin hydrochloride | Tablet, Extended Release | Do not split, crush, chew, or dissolve tablets |
Syprine | Trientine hydrochloride | Capsule | Potential for contact dermatitis when exposed to capsule content; wash exposed area with water promptly |
Tabloid | Thioguanine | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Tabrecta | Capmatinib | Tablet | Do not crush according to the prescribing information |
Tafinlar | Dabrafenib mesylate | Capsule | Do not open, crush, or break TAFINLAR capsule per the prescribing information |
Talicia | Omeprazole/amoxicillin/rifabutin | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Talzenna | Talazoparib | Capsule | Swallow capsules whole; do no open or dissolve |
Targiniq ER | Oxycodone Hydrochloride/Naloxone Hydrochloride | Tablet, Extended Release | Potentially fatal dose of oxycodone if tablet is disrupted |
Tarpeyo | Budesonide | Capsule, Delayed Release | Swallow capsule whole; do not open crush or chew |
Tasigna | Nilotinib | Capsule | Antineoplastic Modified-release Can be opened for administration of intact granules |
Tavist-D | carbinoxamine maleate-pseudoephedrine hydrochloride | Capsule, Extended Release | Extended-release |
Tavneos | Avacopan | Capsule | Swallow whole; do not crush, chew, or open capsule |
Taztia XT | Diltiazem Hydrochloride Extended-Release | Capsule, Extended Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Tazverik | Tazemetostat | Tablet | Swallow tablets whole; do not cut, crush, or chewed |
Tecfidera | Dimethyl Fumarate | Capsule | Modified-release |
Technivie | Ombitasvir, paritaprevir, and ritonavi | Tablet, Extended Release | Swallow whole; do not split, crush, or chew |
Tegretol XR | Carbamazepine | Tablet | Modified-release |
Tembexa | Brincidofovir | Tablet | Swallow tablets whole; do not divide, break, or crush |
Temodar Temodal (Canada) | Temozolomide | Capsule | Irritant (cytotoxic) |
Tenuate Dospan | Diethylpropion Hydrochloride | Tablet, Extended Release | Extended Release |
Tepanil; Tenuate | diethylpropion hydrochloride | Tablet, Extended Release | Extended-release |
Tepmetko | Tepotinib | Tablet, Film-coated | Swallow tablets whole. Do not chew, crush, or split. |
Tessalon Perles | Benzonatate | Capsule | Local anesthetic effect could increase the risk of choking |
Theo-24 | Theophylline | Capsule | Modified-release. Can be opened for administration of intact granules |
Theochron Uniphyl | Theophylline | Tablet | Modified-release |
Theocron | Theophylline Anhydrous | Tablet, Extended Release | Extended Release |
Tiazac | Diltiazem | Capsule, Extended Release | Extended Release |
Tibsovo | Ivosidenib | Tablet | Do not crush according to the prescribing information |
Tolsura | Isavuconazole | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Topamax | Topiramate | Capsule, Tablet | Bad taste Capsules can be opened for administration of intact granules |
Topamax | Topiramate | Capsule, Coated Pellets | May be sprinkled on soft food |
Topiramate XR | Topiramate Extended-Release | Capsule, Extended Release (Trokendi XR only) | Do not sprinkle on food, chew, or crush |
Toprol-XL | Metoprolol Succinate | Tablet | Modified-release. Scored tablets can be split |
Toviaz | Fesoterodine | Tablet | Modified-release |
Tracleer | Bosentan | Tablet | Women pregnant or possibility of becoming pregnant should not handle broken or crushed tablets |
Trental | Pentoxifylline | Tablet, Extended Release | Extended Release |
Trexall | Methotrexate | Tablet | Requires special handling to limit exposure to health risks (Ref-2) |
Treximet | Sumatriptan/Naproxen Sodium | Tablet | Do not crush according to the prescribing information |
Triglide | Fenofibrate | Tablet | Do not crush according to the prescribing information |
Trijardy XR | empagliflozin-linagliptin-metformin hydrochloride | Tablet, Extended Release | Do not split, crush, dissolve, or chew tablets |
Trikafta | Elexacaftor/tezacaftor/ivacaftor; ivacaftor | Tablets (Kit) | |
Trilipix | Fenofibric Acid | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Trokendi XR | Topiramate | Capsule, Extended Release | Do not sprinkle on food, chew, or crush |
Troxyca ER | Oxycodone; Naltrexone | Capsule, Extended Release | Swallow intact capsule whole or capsule may be opened and the contents sprinkled on applesauce and ingested immediately without chewing |
Truseltiq | Infigratinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Tukysa | Tucatinib | Tablet | Do not crush according to the prescribing information |
Turalio | Pexidartinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Tussicaps | Chlorpheniramine | Capsule, Extended Release | Extended Release |
Tussionex | Chlorpheniramine polistirex-hydrocodone polistirex | Capsule, Extended Release | Extended-release |
Tylenol Arthritis Pain Extended-Release | Acetaminophen | Tablet | Modified-release |
Uceris | Budesonide | Tablet | Modified-release |
Ukoniq | Umbralisib | Tablet | Do not crush according to the prescribing information |
Ultomiris | Avacopan | Capsule | Swallow whole; do not crush, chew, or open capsules |
Ultram ER | Tramadol Extended-Release | Tablet, Extended Release | Potentially fatal overdose of tramadol if tablet is disrupted |
Ultresa | Pancrelipase | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Uniphyl | Theophylline | Tablet, Extended Release | Extended Release |
Uptravi | Selexipag | Tablet, Film Coated | Do not split, crush, or chew |
Urocit-K | Potassium citrate | Tablet, Extended Release/Wax Coated | Extended Release |
Uroxatral | Alfuzosin hydrochloride | Tablet, Extended Release | Extended-release |
Valcyte | Valganciclovir | Tablet | Irritant Teratogenic, carcinogenic |
Vantrela ER | Hydrocodone Extended-Release | Tablet, Extended Release | Do not crush, chew, or dissolve as this may lead to uncontrolled delivery of a potentially fatal overdose. |
Venclexta | Venetoclax | Tablet, Film Coated | Do not chew, crush, or break tablets |
Vepesid | Etoposide | Capsule | Requires special handling to limit exposure to health risks (Ref-2) |
Verapamil SR | Vverapamil hydrochloride | Tablet, Sustained Release | |
Verelan, Verelan PM | Verapamil | Capsule | Modified-release. Can be opened for administration of intact granules |
Verzenio | Abemaciclib | Tablet | Must be swallowed whole according to the prescribing information |
Vesicare | Solifenacin | Tablet | Bad taste |
Videx EC | Didanosine | Capsule | Modified-release |
Viekira XR | Dasabuvir, ombitasvir, paritaprevir, and ritonavir | Tablet, Extended Release | Swallow whole; do not split, crush, or chew |
Vimovo | Naproxen; Esomeprazole | Tablet, Film Coated/Delayed Release | Film-coated; Delayed-Release |
Vimpat | lacosamide | Tablet | Swallow whole with liquid; do not divide |
Viokace | Pancrelipase | Tablet | Do not crush according to the prescribing information |
Viramune XR | Nevirapine | Tablet, Extended Release | Extended Release |
Viramune XR | Nevirapine | Tablet | Modified-release |
Vitrakvi | Larotrectinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Vitrasert | Ganciclovir | Implant | Requires special handling to limit exposure to health risks (Ref-2) |
Vivjoa | Oteseconazole | Capsule | Swallow whole; do not chew, crush, dissolve, or open |
Voltaren XR | Diclofenac | Tablet | Modified-release |
Vonjo | Pacritinib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
VoSpire ER | Albuterol | Tablet | Modified-release |
Votrient | Pazopanib | Tablet | Increased rate of absorption and exposure |
voxelotor | Oxbryta | Tablet | Do not cut, crush, or chew |
Vumerity | Diroximel fumarate | Capsule, Delayed Release | Swallow whole and intact. Do not crush or chew, or sprinkle contents on food. |
Welireg | Belzutifan | Tablet | Per the prescribing information, do not chew, crush, or split WELIREG prior to swallowing |
Welireg | Guselkumab | Tablet | Do not crush according to the prescribing information |
Wellbutrin SR | Bupropion hydrochloride | Tablet, Extended Release | Extended-release |
Wellbutrin XL | Bupropion hydrochloride | Tablet, Extended Release | Extended-release |
Xalkori | Crizotinib | Capsule | Swallow capsule whole according to the prescribing information |
Xanax XR | Alprazolam | Tablet, Extended Release | Extended-release |
Xartemis XR | Oxycodone hydrochloride-acetaminophen | 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 | Cenobamate | Capsule/Tablet | Teratogenic; Requires special handling to limit exposure to health risks (Ref-2) |
Xeljanz XR | Tofacitinib citrate | Tablet, Extended Release | Swallow whole and intact. Do not crush, split, or chew. |
Xeloda | Capecitabine | Tablet | Swallow whole; do not cut or crush |
Xenleta | Lefamulin | Tablet | Do not crush according to the prescribing information |
Xigduo XR | Dapagliflozin-metformin hydrochloride | Tablet, Extended Release | Extended-release |
Ximino | minimally modified low molecular weight heparin | Capsule, Extended Release | Extended Release |
Xospata | Glasdegib | Tablet | Do not split or crush |
Xospata | Gilteritinib | Tablet | Do not crush according to the prescribing information |
Xpovio | Selinexor | Tablet | Do not crush according to the prescribing information |
Xtampza ER | Oxycodone extended-release | 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 | Enzalutamide | Capsule | Antineoplastic |
Yonsa | Abiraterone acetate, micronized | Tablet | Do not crush or chew tablets per the prescribing information. |
Yosprala | Aspirin-omeprazole | Tablet, Delayed Release | Swallow whole with liquid; do not split, chew, crush or dissolve |
Zantac 25 | Ranitidine hydrochloride | Tablet, Effervescent | |
Zejula | Niraparib | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Zelboraf | Vemurafenib | Tablet, Film Coated | Film-coated |
Zenpep | Pancrelipase | Capsule, Delayed Release | Swallow capsules whole. Do not break, open, or chew the capsules |
Zinnat | Cefuroxime axetil | Tablet, Film Coated | Film-coated |
Zohydro ER | Hydrocodone bitartrate | Capsule | Swallow capsules whole. Do not break, open, or chew the capsules |
Zolinza | Vorinostat | Capsule | Irritant (skin and mucous membrane) |
Zorprin | Aspirin | Tablet, Extended Release | Extended Release |
Zortress | Everolimus | Tablet, Extended Release | Extended Release |
Zovirax | Acyclovir | Tablet, buccal | Do not crush, chew, suck, or swallow; must be reapplied if swallowed within first 6 hours |
Zubsolv | buprenorphine-naloxone | Tablet | Do not crush or chew. Not recommended for splitting |
Zyban | Bupropion hydrochloride | Tablet, Sublingual | |
Zydelig | Idelalisib | Tablet, Extended Release | Extended Release |
Zyflo CR | Zileuton | Tablet | Do not crush according to the prescribing information |
Zyrtec D | Pseudoephedrine/Cetirizine | Tablet | Modified-release |
Zyrtec-D 12 Hour | Cetirizine hydrochloride-pseudoephedrine hydrochloride | Tablet, Extended Release | Extended-release |
Zytiga | Abiraterone acetate | Tablet | Swallow ZYTIGA tablets whole. Do not crush or chew tablets per the prescribing information |
What Are The Reasons These Medications Shouldn't Be Crushed?
There are a number of reasons why medications on the above list should not be crushed, which include:
- Crushing extended-release medications can lead to a rapid release of a large dose of the drug at once, potentially causing harm
- Crushing delayed-release medications can disrupt the protective mechanism designed to shield the drug from gastric acids or prevent gastric mucosal irritation
- Crushing sublingual or buccal tabs can impact their effectiveness.
- Crushing pills based on certain technologies (such as amorphous solid dispersion or nanocrystals) can change the drug's bioavailability.
- Bitter-tasting medications can be unpleasant to consume if crushed, and crushing medications that are irritating or hazardous can pose a risk to the person handling the drugs.
- If a hazardous medication (such as a carcinogenic substance) must be crushed, it's important to follow USP Chapter <800> standards in healthcare settings or advise outpatients on proper procedures. The product information for these hazardous medications explicitly states not to crush.
- A list of hazardous medications is available on the NIOSH website
If you have a question about any drug on this list or have a suggestion for an addition, please contact one of our pharmacists.
Where Does Our Information Come From?
Guidance regarding medications that should not be crushed comes from various sources, including:
- The FDA-approved prescribing information for the individual drugs
- NIOSH (National Institute for Occupational Safety & Health)
- Drug Compendia (e.g., UpToDate, Elsvier Clinical Key, Micromedex)
- Personal communication with the drug manufacturer
- Clinical studies (e.g., To crush or not to crush: A brief review of novel tablets and capsules prepared from nanocrystal and amorphous solid dispersion technologies)
If you need a specific reference for a drug contained on the list and it isn't noted, please contact us directly and we'll be sure to provide that information for you.